Stories written by Phil West

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: Could Help With Addressing My Insurance Needs - 11/27/2024

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: 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.


Doctoring Cars: Cade Clark, MD, Puts Lessons to Use Outside the Human Machine - 11/21/2024

Cade Clark, MD, puts his anatomy, physiology lessons to use outside the human machine


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.


Medicare Solidifies Pay Cut, Mixed Bag of Changes for Physicians in 2025 - 11/08/2024

In addition to finalizing a nearly 3% pay reduction for physicians, the Centers for Medicare & Medicaid Services also set the trajectory for practices over the next year with changes related to telemedicine, coding and payment, and the Merit-Based Incentive Payment System, among others.


TMA Monitoring Court Injunction Affecting Texas Medicaid Patients - 11/06/2024

The Texas Medical Association is monitoring a court injunction that – for now – prevents the Texas Health and Human Services Commission (HHSC) from entering into contracts with certain Medicaid and Children’s Health Insurance Plan managed care organizations named in HHSC’s notice of award for managed care contracts for the State of Texas Access Reform Medicaid program and CHIP.


Medicine, Feds Still Urge Conservation Amid IV Fluid Shortage - 10/22/2024

Without a clear resolution on the horizon, the Texas Medical Association and American Medical Association continue to urge conservation in response to a nationwide shortage of IV fluids stemming from Hurricane Helene-related damage to the country’s main manufacturing site. Medicine is communicating with state and federal authorities as they monitor the situation.


Hurricane Helene Disrupts IV Fluid Supply Chain - 10/09/2024

The Texas Medical Association has heard from Texas physicians and the North Carolina Medical Society that hospitals and practices are facing shortages of IV fluids following Hurricane Helene’s damage to Baxter International’s North Cove manufacturing site in Marion, N.C.


CMS Reopens 2023 MIPS Hardship Exception for Cyberattack - 09/26/2024

Thanks to medicine’s advocacy, the Centers for Medicare & Medicaid Services has reopened a hardship exception for the 2023 Merit-Based Incentive Payment System (MIPS) performance period to account for February’s Change Healthcare cyberattack.


With FTC Rule in Limbo, Texas Legislature to Reconsider Noncompetes - 09/20/2024

Amid a pair of conflicting court rulings – one of which blocked a Federal Trade Commission (FTC) final rule banning most noncompete clauses – the Texas Senate is pondering related legislation for the upcoming session that could impact a significant number of physicians statewide.


TMA Continues Push for Prior Auth Reform Ahead of 2025 Session - 09/17/2024

Three years after the Texas Medical Association spearheaded “gold card” prior authorization exemption legislation, delays and complications with payer approvals continue to adversely affect physicians and patients.


United Launches National ‘Gold Card’ Program - 09/17/2024

UnitedHealthcare announced the launch of what it’s calling a national “gold card” program, which purports to allow physicians to bypass the prior authorization process and is set to begin Oct. 1.


Texas Senate Committee Evaluates Potential AI Legislation - 09/04/2024

As the Texas Legislature considers new regulatory framework for artificial intelligence (AI) heading into the 2025 session, Texas Medical Association leaders are acting to ensure physicians’ knowledge and decision-making are integrated with the technology and not replaced by it.