Stories written by Emma Freer

Medicare Advantage Audits Expected to Rise in Face of Increased Federal Scrutiny - 09/20/2023

Based on a new rule and in response to heightened scrutiny, Medicare Advantage plans – and the physician practices that care for patients enrolled in them – should expect an increase in the number of audits related to such risk-sharing contracts.

Noncompete Concerns Spark Ongoing TMA Advocacy, Resources - 09/19/2023

The Texas Medical Association continues to receive reports of physician concerns over noncompete agreements, underscoring medicine’s ongoing legislative and regulatory advocacy efforts to strike a balance that works for physician employers and employed physicians alike.

Medicare Fee Schedule Proposal Remains “Highly Flawed,” Underscores Need for Reform - 09/18/2023

The proposed 2024 Medicare physician fee schedule came as no surprise, following earlier iterations that deepen physician pay cuts and increase complexities associated with the Merit-Based Incentive Payment System (MIPS) – prompting organized medicine to ramp up its call for reform that would break this cycle.

State Law Banning Refusal of Care to Certain Unvaccinated Patients Takes Effect - 08/30/2023

Starting Sept. 1, a new state law prohibits clinicians caring for patients enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) to refuse health care services based on their vaccination status.

TMA Border Health Conference Tackles Medicine’s Most Pressing Issues - 08/28/2023

As physician advocates, policymakers, and community leaders gathered in Harlingen for the Texas Medical Association’s annual Border Health Conference, the wide-ranging agenda included many of medicine’s priority issues along the Texas-Mexico border.

TMA Resumes In-Person Meetings with Major Texas Payers - 08/25/2023

After a pandemic-induced hiatus, the Texas Medical Association recently resumed in-person meetings with Texas’ major payers to solve physicians’ payment policy problems, a practice that dates back more than 25 years.

New Texas Law Shortens Data Breach Notification Period - 08/21/2023

Texas physician practices and other health care facilities soon will be required to give more timely and public notice of any breaches of computerized data, including electronic health records and billing information.

Medicare to Launch Dementia Payment Model - 08/14/2023

A new, voluntary Medicare payment model focused on dementia care will add to the value-based care options for certain specialists, who often lack a path away from fee-for-service payment.

United Will Eliminate Prior Authorization Requirements for Certain Procedures - 08/11/2023

Physicians have long complained about onerous prior authorization requirements, which often delay care and sometimes have catastrophic consequences. One payer seems to be listening.

Court Delivers TMA Win Against Fee Hike, Batching in Surprise Billing Arbitration - 08/10/2023

The court struck down a 600% administrative fee increase and certain unfair rules that narrowed the law’s provisions on combining or “batching” surprise-billing arbitration claims. The decision is one of several victories TMA has won against federal regulators tasked with implementing the federal No Surprises Act.

Free Live Webinar: Medicaid Continuous Eligibility Unwinding – Preparing Your Patients and Your Practice - 08/09/2023

More than 2.5 million Texans benefitted from continuous Medicaid coverage during the COVID-19 public health emergency, which ended on May 11, triggering an “unwinding” process with far-reaching consequences for patients and physicians alike.

TMA Opposes Congressional Proposal to Cap Office-Based Physician Pay - 08/07/2023

A recently filed federal bill would recycle a controversial formula that TMA has waged several lawsuits against in the federal surprise billing regulatory context to limit payments for health care services furnished in physician offices.

Medicaid Drops Thousands of Texans; Many Still Qualify - 08/07/2023

Texas’ effort to “unwind” continuous Medicaid coverage – a pandemic-era benefit – has resulted in a steep coverage cliff. State officials and advocates urge physicians to help soften patients’ falls. Read more.

Patient Care Protected: Scope Creep/GME Funding - 08/07/2023

The Texas Medical Association's top legislative priority this session was to protect independent diagnosing and prescribing as the practice of medicine and to address current workforce shortages in a way that ensures patients have access to the same standard of care, regardless of where they live.

Physician-Led Results: Scope-of-Practice Creep/GME Funding - 08/07/2023

As in most legislative sessions, TMA once again successfully defended against the myriad scope-of-practice expansion attempts that surfaced, instead advocating for and winning more sustainable solutions to the state’s physician workforce shortage, including investing in graduate medical education.

Frontline Defender: Umar Latif, MD, Tackles Physicians' Moral Injury Plight - 08/05/2023

Frisco psychiatrist Umar Latif, MD, applies his expertise in suicide prevention and treatment among military personnel and veterans to another crisis on the home front: moral injury among physicians.

Patient Care Protected: Network Adequacy, Surprise Billing - 08/04/2023

Spurred by physician reports of insurers taking advantage of their leverage in contract negotiations, the Texas Medical Association prioritized network adequacy reform this session.

Patient Care Protected: Prior Authorization Reforms - 08/04/2023

Carrying the torch from last session, the Texas Medical Association followed up on its 2021 gold-card success with a new prior authorization reform for vulnerable patients and other insurance-related policy wins this session.

Patient Care Protected: Physician Autonomy/Corporate Practice Protections - 08/04/2023

Despite an onslaught of attempts by state government and corporate entities to undermine the patient-physician relationship, the Texas Medical Association successfully prevented any new measures criminalizing patient care this legislative session

Patient Care Protected: Medical Liability Reforms - 08/04/2023

For the 20th year in a row, the Texas Medical Association successfully defended the state's medical liability reforms, in keeping with its legislative priorities for the most recent session.

Patient Care Protected: TMA Secured Big Legislative Wins With a New Strategy - 08/04/2023

Guided by a set of priorities and girded by grassroots physician advocacy, the Texas Medical Association entered the 2023 legislative session with a laser focused approach and came out hitting targets in every area of medicine’s agenda.

TMA Fights Another “Devastating” Medicare Physician Pay Cut Threat - 08/04/2023

Despite medicine’s calls for comprehensive reform, the recently proposed 2024 Medicare physician fee schedule would continue the worrying trends of deepening physician pay cuts and increased risk associated with the Merit-Based Incentive Payment System.

Texas Receives $3.3 Billion Federal Grant to Expand Broadband Access - 07/27/2023

Texas recently received the largest federal grant of any U.S. state to support broadband expansion, and the state has high need. Physicians say the boost will help ease telehealth care, among many other benefits. Read more.

Congress Weighs Medicare Payment Reform During Health Care Consolidation Hearings - 07/25/2023

Federal lawmakers in both chambers recently took up the issue of increasing consolidation – and, with it, decreasing competition – in the health care industry. Surfaced as possible solutions were several of the Texas Medical Association’s legislative priorities, including Medicare physician payment reform.

Congress Conducts MACRA Check-Up - 07/25/2023

Federal lawmakers seem to be listening to calls for reform for the Medicare Access and CHIP Reauthorization Act (MACRA), as the House Energy & Commerce Committee’s Oversight & Investigations Subcommittee recently hosted a “MACRA Checkup” hearing to examine the law’s “successes and remaining challenges.”