Stories written by Phil West

Legislators Can Request Health Insurance Mandate Analysis Via New State Law - 11/18/2025

Though the filed version of the bill would have heavily favored insurance companies, TMA successfully worked to add data transparency provisions to promote a comprehensive and unbiased analysis. Lawmakers also focused on price transparency bills affecting how facilities can bill patients for services.

Physicians Must Refund Medicare Overpayments Voluntarily, Program Administrator Cautions - 11/13/2025

Novitas, Texas’ Medicare administrator, reminds physicians they should promptly bring incorrect payments to its attention. TMA can assist physicians with payment issues through its Physician Payment Resource Center.

Touting Texas: David N. Henkes, MD, Championed the State’s Physicians in 25 Years on the AMA Delegation - 11/13/2025

David N. Henkes, MD, recalls his first American Medical Association meeting in San Francisco as a new member of the Texas Delegation to the AMA. The November 2001 conference was, in a word, “overwhelming.”

Now Is the Time: Texas Delegates to AMA Make a Strong Push for Fixing What Ails Medicare - 11/13/2025

Texas Medical Association members made their voices heard at the American Medical Association’s three-day National Advocacy Conference (NAC), Feb. 10-12, 2025, calling for a long-term Medicare payment fix.

Medicine Calls for Exemption to New $100,000 H-1B Visa Application Fee - 11/11/2025

International medical graduates (IMGs) make up about a quarter of Texas’ physician workforce, considering both licensed physicians and residents. But a White House executive order, requiring a new $100,000 fee for H-1B work visa applicants, could squeeze this crucial pipeline in meeting health care needs.

New Medicaid Managed Care Laws Lauded as Wins for Texas Patients - 11/10/2025

Medicaid captured the Texas Legislature’s attention during the 2025 session, with lawmakers passing a quartet of bills focused on improving managed care statewide, including nutrition and newborn support, physician enrollment, and credentialing.

Direct Payment Model Available to All Texas Physicians Under New State Law - 11/10/2025

House Bill 541, now in effect, replaces the “direct primary care” nomenclature from a TMA-backed 2015 law with the more inclusive “direct patient care.” In a typical direct care model, patients pay a monthly fee, and in return, receive services like office visits and in-office procedures without involving insurance.

Reaching for the Stars: For Bernard A. Harris Jr., MD, NASA Was the Start of a Childhood Dream Fulfilled - 11/07/2025

Bernard A. Harris Jr., MD, an astronaut and physician who has done two spacewalks, will be the featured speaker at the opening general session of TexMed, the Texas Medical Association’s annual conference, convening April 16-18, 2026. He’s titled his speech “An Astronaut’s Perspective: The Future of Medicine and Beyond.”

Covering Distances: Physicians, Lawmakers, Med Schools Look to Improve Rural Patient Access to Care - 11/07/2025

Texas legislators are taking notice of the dearth of physician care in rural counties with solutions, medical schools are gaining ground with successful rural-specific training tracks, with TMA all the while pushing for further steps to assuage rural health care shortages in Texas.

Medicaid Mindfulness: New Texas Law Raises Certain Violations to Same Level as Intentional Fraud - 11/07/2025

Senate Bill 1038 provides a key state agency with a new array of penalties, signaling the state’s focus on safeguarding Medicaid spending. In the process, however, it has elevated potential penalties for unknowingly violating Medicaid program rules to the same level as those for intentional fraud. 

Scholarship Winner Takes Unconventional Journey to Medical School - 11/07/2025

The first-year medical student at University of North Texas Health Science Center’s Texas College of Osteopathic Medicine volunteers with a free clinic in Fort Worth and teaches music to high school students. His path to medicine impressed a panel led by TMA’s president-elect.

Medicare Physician Fee Schedule Retains Payment Increase and Concerning Cuts - 11/06/2025

A new practice efficiency cut impacting thousands of codes and a cut targeting hospital-based services could offset a one-time payment boost. TMA staff are poring over the 1,216-page final rule ahead of its Nov. 20 webinar, free for physicians.

Learn Medicare Payment Updates, Earn CME in Live TMA Webinar - 10/31/2025

TMA’s first live Medicare webinar in six years will also address changes to quality and alternative payment programs, as well as a new pilot testing AI in prior authorization. Register now and submit questions in advance.

Medicare to Test Enhanced Technology Utilization Review in Texas - 10/30/2025

The Wasteful and Inappropriate Service Reduction (WISeR) Model is set to debut in Texas and five other states in January 2026. It would require certain Medicare services to undergo “enhanced technology” review.

Ivermectin Can Now Be Dispensed in Texas Without Physician Prescription - 10/28/2025

TMA testified patient safety is at risk when physician oversight is removed from prescription medication dispensation. Concerns included determining proper dosages and potential interactions with other drugs.

Ban on Physician-Owned Hospital Creation Could Be Lifted by Congress - 10/27/2025

Physician-owned hospitals create greater access to care and allow physicians to counter increasing market consolidation, according to the American Medical Association. TMA signed on to AMA’s letter supporting federal efforts to promote such facilities.

ACOs Earn Record $4.1 Billion in Medicare Shared Savings Program Payouts - 10/21/2025

Three in four accountable care organizations (ACOs) nationwide earned performance payments for contributing to health care savings. Those operating in Texas outpaced national numbers, with nearly 90 percent receiving payouts.

HHSC Extends Medicaid Revalidation Another Six Months - 10/21/2025

The state is providing physicians with additional time to take a key step in caring for Medicaid patients. It’s also providing a reentry pathway for physicians disenrolled last year.

Value-Based Care Extended to Texas PPO, EPO Health Plans for Primary Care Physicians - 10/20/2025

The new state law authorizes primary care physicians to enter into value-based care (VBC) payment arrangements with state-regulated PPOs and EPOs, if they choose to. The new law includes several guardrails TMA advocated for that seek to promote fair dealing in VBC negotiations.

Federal Changes May Narrow Certain Medicaid Eligibility Provisions, Boost Others - 10/17/2025

Changes on the horizon include a shortened timetable for giving new Medicaid applicants retroactive coverage, more frequent eligibility checks, and an expansion of the populations eligible for home and community-based services. Texas will also need to reconcile an issue concerning CHIP waiting periods and benefit caps.

2025 Legislative Wrap-Up: TMA Defeats Concerning Vaccine Bills For Second Session in a Row - 10/02/2025

Two bills that did survive will took effect Sept. 1, one of which imposes a specific informed consent form on physicians.

Physicians Tout Augmented Intelligence, with Caveats, at Business of Medicine Conference - 09/25/2025

At this year’s event, augmented intelligence (AI) took center stage with multiple presentations on its practical applications for physicians. Presenters and TMA staff still caution against over-reliance and liability.

New Medicare Payment Complicated by Other Provisions in Proposed Rule - 09/25/2025

Despite a one-time pay increase, newly proposed adjustments in the 2026 Medicare physician fee schedule could offset the reprieve. This tops many issues TMA remarked upon in a lengthy comment letter to federal officials encompassing worrisome changes to certain quality payment programs and telemedicine flexibilities.

Physicians Brace for Expiration of ACA Tax Credits, Uninsured Fallout - 09/25/2025

An estimated 1.3 million Texans could lose coverage due to the combined effects of Affordable Care Act marketplace changes under OBBBA and the expiration of the enhanced premium tax credits at the end of this year. “Physicians are definitely going to feel the effects.”

New Law Allows Health Plans to Steer Patients Via Incentives, Changes Ranking and Tiering Protections - 09/16/2025

Senate Bill 926, which took effect Sept. 1, authorizes certain health plans to steer patients toward certain physicians or health care entities via cost-sharing incentives. TMA advocacy secured provisions that help protect against deceitful steering and help physicians monitor and guard against errors.