Stories written by Joey Berlin

TMA Weighs In On COVID-19 Surprise Billing, Insurance Premiums, and More - 09/09/2020

TMA submitted written testimony Tuesday to the House Committee on Insurance, providing details and recommendations on price gouging, surprise medical bills, health insurance premiums, and more caused by the COVID-19 pandemic.


Dulling the Pain of Future Damages: High Court Ruling Addresses Periodic Payments - 09/02/2020

Texas Supreme Court decision carries new implications for periodic payment of future medical expenses.


Same Old Hurdles: Pharmacy-Mandated Obstacles to Filling Opioid Scrips - 09/02/2020

PMP requirement doesn’t lower pharmacy-mandated obstacles to filling opioid scrips.


A Social Shift: COVID-19 Disparities Prompt Emphasis on Value-Based Care - 09/02/2020

COVID-19 disparities prompt Medicare to call for stronger emphasis on value-based care.


Schools Can Exclude Students with Vax Opt-Outs In an Epidemic, TMA Says - 08/20/2020

If school districts during an epidemic want to exclude students who have declined vaccinations for reasons of conscience, both the law and public health considerations are on their side, the Texas Medical Association has told Texas Attorney General Ken Paxton.


TMA Releases Tools to Navigate School Reopening - 08/19/2020

Led by its School Reopening Workgroup, the Texas Medical Association is offering schools and physicians tools to mitigate risk for COVID-19 spread as classes resume across the state.


TMA to IRS: Direct Primary Care, Health Care-Sharing Ministries Aren’t Insurance - 08/19/2020

The Texas Medical Association is urging the IRS to reconsider a proposed rule that would classify direct primary care (DPC) arrangements and health care-sharing ministries (HSMs) as insurance.


The PMP Requirement Begins - 08/18/2020

With EHR integration in place, physicians must check the state prescription monitoring program (PMP) prior to prescribing an opioid starting March 1.


CMS’ 2021 Fee Schedule Proposal Could Lower Physician Pay - 08/12/2020

Payments to some physicians who treat Medicare patients would fall from 2020 levels under the Centers for Medicare & Medicaid Services’ (CMS’) proposed physician fee schedule for 2021. CMS last week released the annual draft rule, which also recommends updates to the Quality Payment Program (QPP).


What to Do If a Staff Member or Patient Tests Positive - 08/05/2020

The TMA COVID-19 Task Force has created a guide for what to do when someone in your office – whether a staff member or a patient – tests positive for the disease. The guide includes links to important information on disinfection, work-restriction, and legal and ethical resources.


Road to Recovery: COVID-19 Tests, Bends, and Breaks Texas Practices - 08/03/2020

Ricardo Garza, MD, was still walking the tightrope: standing, but unable to withstand another gust of wind. COVID-19 swept away about 35% of the San Antonio solo cardiologist’s practice revenue, and that was just what he could calculate as he waited for insurers to process straggling claims. But he had returned to in-office operations without any layoffs. While some practices are surviving – and trying their best to prepare for future threats – others weren’t so lucky. On-the-ground experiences align with the Texas Medical Association’s Practice Viability Survey in showing COVID-19 was, and still is, a disruptor unlike any other – challenging or torpedoing the viability of various practice types.


Quarantine’s Quandary: Some Texans Unable to Self-Isolate - 08/03/2020

As the state ramps up “contact tracing” as a key part of Gov. Greg Abbott’s plan to stop the spread of COVID-19 and return Texas to economic normalcy, some health officials say physicians can help those for whom quarantine and isolation are a challenge.


Leadership by Fire: Stephanie Stephens New Texas Medicaid, CHIP Director - 08/03/2020

Stephanie Stephens received a not-so-welcome gift entering her new job running Medicaid operations for the nation’s second-largest state: A global pandemic. In that sense, the universe wasn’t easy on Ms. Stephens, the new director of Medicaid and CHIP for the Texas Health and Human Services Commission (HHSC).


Pandemic Poses Legal Pitfalls: TMA Seeks Better Liability Shields - 08/03/2020

Under Texas law, physicians treating COVID-19 patients in a volunteer capacity have potential defenses against lawsuits that might arise from that care. But for non-volunteer physicians on the COVID battlefield – often working in harrowing, overloaded settings, high on patient count and low on equipment – the same liability shields don’t exist. And with a resurgence in COVID-19 cases and hospitalizations taking hold in June, the Texas Medical Association continued its pandemic-long push to extend liability protections to all frontline physicians, volunteer or not.


TMB Sets Rules on Acute-Pain Scrip Limit, Opioid CME - 07/31/2020

Texas’ pain management requirements underwent several important changes by law in the past year. Now, the Texas Medical Board has issued rules clarifying what prescribers must do to comply with those laws.


Comptroller: Texas Faces Projected Deficit for 2021 - 07/22/2020

Since October, Texas (along with the rest of the world) has become a much different place. And just nine months after he projected a budget surplus for 2021, Comptroller Glenn Hegar this week said the state is now facing a projected deficit of more than $4.5 billion.


TMA Task Force Begins Tackling School Reopening - 07/21/2020

With big questions still lingering about the planned resumption of public and private schools in Texas next month, Texas Medical Association physicians are pooling their expertise to offer crucial input to state policymakers and the public.


The Updated Skinny on Texas’ Surprise Billing Law - 07/08/2020

The Texas Medical Association has updated its white paper on Texas’ law for settling out-of-network billing disputes involving state-regulated health plans.


Some Clarity, Some Fog: AG Opines on Physician-Optometrist Relationship - 07/01/2020

An opinion by the Texas attorney general will keep the Texas Optometry Board (TOB) from exerting influence over the practice of medicine – to a certain point.


Covered for COVID? Business Interruption Insurance Could Come in Handy - 07/01/2020

Business interruption insurance could come in handy for losses related to COVID-19.


Buying Time: Medicine’s Warnings Prompt CMS to Delay Dramatic Coding and Payment Changes - 06/23/2020

Medicine’s warnings prompt CMS to delay dramatic coding and payment changes.


Cases Up, Deaths Down; What’s Going On With COVID-19 in Texas? - 06/17/2020

Texas Medicine Today reached out to several leading public health experts to try to make sense of the data and find out what the numbers are telling us about that current status of the COVID-19 pandemic in Texas.


TMA to State: Protect Physician Pay, Women’s Health Programs from Budget Cuts - 06/04/2020

The Texas Medical Association is applauding state leaders’ decision to leave Medicaid and CHIP benefits out of a planned 5% budget reduction for 2020-21. But TMA also is asking the state to protect physicians’ Medicaid payments and women’s health programs from its cuts.


Tort Reform on Trial: Houston Case Challenges Noneconomic Damage Cap - 06/01/2020

Houston case poses challenge to key tort reform limit on noneconomic damages.


Running Out of Reasons: Low Payments, Hassles Leave Physicians Wondering: Why stay in Medicare? - 06/01/2020

Texas physicians who deal with Medicare’s substandard payments and world-class administrative hassles are feeling underappreciated. The latest report from the committee that advises Congress on Medicare payment policy may exacerbate that feeling. In March, the Medicare Payment Advisory Committee (MedPAC) released its annual report assessing payments to physicians, among other sectors. MedPAC recommended no changes to the 2021 Medicare physician fee schedule, meaning no increase in physician payments.