Stories written by Joey Berlin

You Write Scripts? You Better Sign Up With the PMP - 02/28/2024

If you don't yet have a user account set up with the state's prescription monitoring program (PMP), known as PMP Aware, now is a good time to get it done.


Surprise! Balance Billing Still a Focus at the Capitol - 02/20/2024

A year after the house of medicine scored big wins on some of the state’s biggest insurance issues, the Texas Legislature is trying to dive further into what is and what isn’t working.


TMA, Lawmakers Working to Tackle Telemedicine Parity, Prior Authorization - 11/30/2023

As one of the most unique eras of both living and lawmaking continues, attendees at TMA’s Winter Conference heard about medicine’s legislative agenda in both Austin and Washington, D.C., and how COVID-19 has helped shape this year’s legislative focus.


Report: Most Private Payers Have Stopped COVID Cost-Sharing Waivers - 08/21/2023

Private health insurance plans have largely stopped waiving patient cost-sharing for COVID-19 treatment, according to a recent report by the Peterson Center on Healthcare and Kaiser Family Foundation. The data represent an overwhelming shift from payer cost-sharing policies during 2020 as indicated by previous research.


Federal Prior Auth Bill Filed in Congress - 07/25/2023

U.S. Rep. Michael C. Burgess, MD (R-Lewisville), is following his fellow Texas physicians’ lead on curbing insurers’ hassle-laden prior authorization burdens, introducing a federal bill similar to the “gold-card” law the Texas Medical Association proposed and championed into law at the state level.


TMA Convinces CMS to Give Harvey-Affected Physicians a Break - 07/20/2023

At TMA's request, CMS announced in December that physicians in areas affected by Hurricane Harvey will not be required to participate in the Quality Payment Program's (QPP's) Merit-Based Incentive Payment System (MIPS) for 2017. Thus, those physicians won't incur a 4-percent Medicare payment cut in 2019.


HHS Doling Out About $9 Billion in Fourth Phase of PRF - 07/20/2023

Texas practitioners are receiving more than $642 million in Provider Relief Fund (PRF) Phase 4 payments totaling nearly $9 billion nationally, the federal Department of Health and Human Services (HHS) announced.


Legislative Hotline March 4, 2021: TMA Opposes End-of-Life Care Bill That Poses Threat to “Do No Harm” - 07/17/2023

The Texas Medical Association is once again working to stop legislative attacks on a physician’s sacred creed to “do no harm,” which includes taking care of patients in their last days.


Legislative Hotline Feb. 11, 2021: TMA, Lawmakers Seek to Strengthen State Immunization Registry - 07/17/2023

The Texas Medical Association, the Texas Hospital Association, and several state lawmakers stand behind legislation that would fix technological issues with the state’s registry, ImmTrac2, and make entry of a patient’s vaccination data the default.


Legislative Hotline Jan. 27: Texas’ 2022-23 Budget Proposals: What They Mean for Medicine - 07/17/2023

The Texas House and Senate have both unveiled their starting-point proposals for the 2022-23 budget, and the Texas Medical Association has been digging into the numbers to see what the proposals represent as a starting point for medicine. Here is a look at some of what’s in the two (largely similar) budget offerings.


Legislative Hotline Feb. 8, 2021: Why Get Involved in TMA Advocacy? “No Better Thing to Do” - 07/17/2023

"It’s vital, it’s important, it’s meaningful." TMA encourages physicians to become involved in advocating for medicine's key issues this legislative session.


Legislative Hotline, Feb. 26: Invest in Coverage Expansion, Medicaid Improvements, TMA Tells Senators - 07/17/2023

With nearly one-fifth of all Texans lacking health care coverage, the Texas Medical Association is urging the  Senate Finance Committee to provide comprehensive, meaningful coverage for the state.


Physicians Will Lead Legislature’s Controlled Substances Committee - 07/17/2023

When a special joint committee of the Texas Legislature tackles issues with controlled substances this year, physician-lawmakers will take the lead.


Where Does Immunity for Government-Employed Physicians End? - 07/17/2023

The Texas Medical Association is fighting to ensure the Texas Supreme Court does not disrupt liability protections for physicians who are employed by a state medical school or other government entity.


Hotline Jan. 21, 2021: Physicians to Have Strong Voice in Texas Senate - 07/17/2023

When Lt. Gov. Dan Patrick released the Texas Senate’s committee assignments last week, the Texas Medical Association was pleased to see extensive committee roles carved out for the chamber’s three physician-legislators.


Fighting Back: Practice Wins Court Battle Over Defamatory Online Reviews - 06/20/2023

One practice’s recent legal battle epitomizes physicians’ worst nightmares when it comes to online reviews. Here’s an extreme but glaring real world example, straight from the documents in a lawsuit that Austin Eye first filed in October 2017 over


Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 05/10/2023

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.


No Surprises Act Includes Directory Update Requirement - 02/10/2023

In addition to resolving payment disputes over out-of-network medical care, the federal No Surprises Act aims to make sure health plans’ practitioner directories stay up to date, and part of that aim puts an onus on physicians.


TMA Win on Surprise-Billing Rule Also a Win for Access to Care - 02/10/2023

When the Texas Medical Association scored a win over federal regulators in a Feb. 23 U.S. district court decision, it wasn’t just a victory for physicians. It was a victory for patients, too, cheers Houston emergency physician and TMA Immediate Past President Diana Fite, MD.


Feds Finally Open Dispute Portal Under Surprise-Billing Law - 02/10/2023

Physicians needing to formally settle a dispute with insurers over certain out-of-network payments under the federal No Surprises Act finally can initiate that process online.


Learn About Surprise-Billing Law’s “Good Faith Estimates” - 02/10/2023

Federal authorities have released a frequently asked questions (FAQ) document on providing “good faith estimates,” included as part of the federal No Surprises Act geared toward curbing surprise medical bills.


Federal Memo Signals Compliance With TMA Court Win – For Now - 02/10/2023

Within days of the Texas Medical Association’s Feb. 23 court victory over federal regulators, the U.S. Department of Health and Human Services (HHS) says it’s taking steps to comply with the court’s decision on rules for the No Surprises Act – even as HHS is “considering next steps” after TMA’s win.


Federal Fairness? Congressional Measure Addresses Out-of-Network Payments - 02/10/2023

Congress in December 2020 passed surprise-billing legislation as part of a wide-ranging coronavirus relief bill, tying a bow on federal lawmakers’ primary health care focus just prior to COVID-19. Texas already had set up its own system for state-regulated plans in 2019 with Senate Bill 1264, which took effect last year.


TMA Keeps Pressing Congress on Surprise Billing - 02/10/2023

As lawmakers continue their work on a federal solution to surprise medical bills, the Texas Medical Association is on guard to make sure patients will be protected – and physicians get a fair shot to get paid properly. TMA joined 18 other state medical and specialty societies on a letter last week to the chairs and ranking members of three U.S. House committees.  


Making Billing More Balanced: Congress Considers Surprise Billing Legislation - 02/10/2023

The widespread call to severely curb or end “surprise” medical bills prompted competing federal legislation during the summer and fall of 2019. The negotiations, maneuvering, and bill markups have continued into this year.