Stories written by Phil West

Webinar: Review Medicaid Revalidation Extension, Retroactive Enrollment - 01/30/2025

The state’s Medicaid administrator is hosting a series of informational webinars to provide details for physicians eligible for a deadline extension, as well as for those who may qualify for backdated validation after being disenrolled.


Fees to Remain Unchanged for Federal Surprise Billing Dispute Resolution - 01/24/2025

The $115 amount, a nonrefundable fee each party in a dispute must pay, represents a significant reduction from what was once a proposed $350 fee that TMA successfully challenged in litigation.


Physicians Rally Around TMA Legislative Priorities at Inaugural Virtual Event - 01/15/2025

With the curtain rising on the 2025 legislative session rising Jan. 14, TMA leaders detailed to attendees how its top 10 legislative priorities tie into physicians’ needs across the state, and how to help advocate at the Capitol on medicine’s most pressing issues in similar upcoming TMA events.


Landmark Antitrust Settlement in BCBS Case Granted Preliminary Approval - 01/09/2025

Physicians can now file a claim in a $2.8 billion settlement fund given preliminary approval by a U.S. District Court involving Blue Cross Blue Shield. The final verdict is expected in July.


TMA’s Top Legislative Priorities: Guarding Against Scope of Practice Expansion - 01/06/2025

TMA is working to grow the physician workforce and preserve physician-led health care in Texas.


TMA’s Top Legislative Priorities: Striking the Right Balance on Noncompete Agreements - 01/06/2025

TMA endorses a noncompete agreement policy protecting both employee and employer physicians.


TMA’s Top Legislative Priorities: Protect Medicine from Corporate Influence - 01/06/2025

TMA continues its work to keep nonmedical entities and corporate influences from interfering with physicians.


TMA’s Top Legislative Priorities: Seeking Prior Authorization Reform - 01/06/2025

In 2025, TMA will advocate for improvements to a landmark prior authorization bill and address burdensome Medicaid practices.


I Never Knew TMA: Did So Much Legislative Work - 12/16/2024

The Texas Medical Association's legislative agenda protects the patient-physician relationship from interference.


Doctoring Cars: Cade Clark, MD, Puts Lessons to Use Outside the Human Machine - 12/11/2024

Dr. Clark, a hematologist at the Baylor Charles A. Sammons Cancer Center in Dallas, sees his work as a doctor and his work on cars as similar practices, drawing on the scientific method and thinking about how multiple systems must work together.


I Never Knew TMA Membership: Could Help With Addressing My Insurance Needs - 12/11/2024

Those who belong to the Texas Medical Association can access policies tailored specifically to them and their practices from two TMA-endorsed entities.


I Never Knew TMA: Offered Practice-Specific Help - 12/10/2024

Whether you’re a physician in solo or small group practice in a rural area, employed by a large group or system in an urban market, or somewhere in between, TMA’s Practice Services team can assist with resources necessary to manage your practice.


HHSC Extends Medicaid PEMS Revalidation in Response to TMA Letter - 12/06/2024

By demonstrating how the Texas Health and Human Services Commission’s (HHSC’s) Medicaid enrollment and revalidation process is “time-consuming, cumbersome and confusing,” TMA has helped secure an extension for physicians with upcoming revalidation dates. HHSC has also added new reporting requirements.


Health Insurance Market Increasingly Consolidated, Federal Report Details - 12/03/2024

Market consolidation in health insurance increased from 2011 to 2022, per a recently released federal report, with the potential to impact payment and access to care.


I Never Knew TMA: Is On Call to Answer My Questions - 11/27/2024

Launched by TMA in October 2003, the Knowledge Center fields anywhere from 100 to 215 questions per week from physicians, their practice managers, and even some patients.  


I Never Knew TMA: Offered a Wealth of CME - 11/27/2024

CME is one of TMA's most abundant membership benefits and comes in multiple delivery systems.


TMA Letter Calls Out HHSC Over Medicaid Payment Rates - 11/25/2024

TMA responded to the state’s latest proposed Medicaid rates, issuing a letter calling out the lack of an inflationary adjustment, bringing along anesthesiologists and oncologists who will specifically be affected. Read more.


TMA Leadership Encourages Legislative Relationships to Protect Medicine - 11/18/2024

To best serve medicine’s agenda in the upcoming Texas legislative session, the Texas Medical Association urges members to make and capitalize on relationships with their local representatives, as leadership previewed the likely tumultuous session ahead at the close of TMA’s Business of Medicine Conference last week.


Future Noncompete Bills Must Strike Balance, TMA Tells Texas Lawmakers - 11/18/2024

In the practice of medicine, noncompete agreements have special public policy concerns, “as their use can impact continuity of care, access to needed medical services, and patient choice of a physician,” the Texas Medical Association recently testified to the Texas Senate Business and Commerce Committee. That’s largely why any future bills on noncompete agreements should “strike a reasonable balance between the employer’s interests and the interests of the employee and the public.”


Reform Can’t Wait: Medicine Prescribes Urgently-Needed Improvements to Flawed Medicare Payment System - 11/13/2024

When the Centers for Medicare & Medicaid Services (CMS) in July proposed a fifth consecutive round of cuts to physicians’ Medicare payments – contributing to a nearly 30% lag behind inflation growth since 2001 – medicine immediately mobilized.


Congress Introduces Stopgap Bill to Halt Impending Medicare Pay Cut - 11/13/2024

While Congress considers a comprehensive Medicare payment fix, this new bill would halt the current proposed cut and provide a needed payment increase over the next year.


Majority of House Members Sign On to Appeal to Fix Medicare - 11/13/2024

Supporting medicine’s plea to halt the scheduled 2.8% cut in Medicare payment for physicians in 2025, a majority of U.S. House of Representatives members signed on to a letter urging House leadership to take action before the end of its current session Jan. 3.


TMA Critiques CMS’ Proposed Fee Schedule for Myriad Shortfalls - 11/13/2024

Noting that “private practices are breaking under the pressure of lack of adequate payment and increasing overhead,” the Texas Medical Association recommended numerous improvements to the 2025 proposed Medicare physician fee schedule. The schedule leads off with a 2.8% cut to physician payments and adds layers of complexity to its Quality Payment Program, among other administrative burdens.


'Fighting Our Best': TMA Efforts Help Improve End-of-Life Care Bill - 11/11/2024

Mark Casanova, MD, has a sign in his office reminding him of his team’s unconventional motto “Stomp Out Suffering.” “A number of years ago, at the end of a team meeting, I just uttered the words as


TMA Joins New Statewide Insurance Reform Coalition - 11/08/2024

The newly created Texas Coalition for Patients calls for “common sense policy reforms” around health insurance, including greater transparency around prior authorizations. TMA leaders say the organization will augment medicine’s related advocacy.