Medicare

Medicare to Expand Coverage for Colorectal Cancer Screening - 12/02/2022

Medicare patients soon will benefit from expanded coverage of colorectal cancer screening tests, following advocacy by the Texas Medical Association and others in organized medicine.


Fight Impending Medicare Cuts With This TMA Toolkit - 11/18/2022

Physician Medicare pay is about to fall without congressional help, so the Texas Medical Association created several ways for doctors to speak out via its Medicare Pay Cuts Toolkit.


Medicare Pay Cuts on the Horizon: Tell Congress to Act - 11/08/2022

Unless Congress acts by the end of the year, physicians face another big cut to their Medicare payments on Jan. 1.


TMA Fights Another Proposed Medicare Pay Cut, While Pressing for Reform - 09/26/2022

TMA recently responded to the Medicare's 984-page proposal with concerns about a 4.4% pay cut and other potentially harmful changes related to scope expansion, e-prescribing penalties, and physicians’ administrative burden.


Inflation Reduction Act Expands Health Coverage, Ignores Medicare Payment Fix - 08/30/2022

The Inflation Reduction Act, which President Joe Biden signed into law on Aug. 16, has made headlines for its deficit- and climate change-related provisions. But the omnibus legislation also will expand health care coverage and lower Medicare prescription drug costs.


MIPSperceptions: Study Confirms Doctors’ View of Medicare Program as Burdensome - 08/22/2022

Physicians’ perceptions of Medicare’s Merit-based Incentive Payment System (MIPS) have run along these and other unflattering lines since MIPS first launched in 2017. But a Physicians Foundation-funded study published in the Journal of General Internal Medicine sought to better quantify how physician practice leaders perceive MIPS, one of the two participation tracks in Medicare’s Quality Payment Program. (The Texas Medical Association has representation on the Physicians Foundation’s board of directors.)


Medicare ACOs Face Key Changes in Proposed Fee Schedule - 08/10/2022

In an effort to boost participation in accountable care organizations, Medicare has significant changes to its shared savings program on tap in the proposed 2023 physician fee schedule.


Biden Administration to Launch Specialty Payment Model - 07/27/2022

A new, voluntary Medicare payment model option focused on cancer care opens the value-based care door wider for specialists at a time when such models have been limited.


Medicare Delays Penalties for Appropriate Use Program - 07/18/2022

After long-standing warnings from the Texas Medical Association and others in medicine about Medicare’s appropriate use criteria (AUC) program, Medicare is delaying the next phase of the program, in which physicians face monetary penalties.


Proposed Medicare Fee Schedule Includes Physician Pay Cut, Expanded Access to Care - 07/15/2022

The recently proposed 2023 Medicare physician fee schedule would deepen physician pay cuts while expanding access to telemedicine, behavioral health care, and cancer screening. If implemented, it also would significantly modify the Medicare Shared Savings Program.


TMA Calls on Lawmakers to Stop the Latest Medicare Pay Cut - 06/28/2022

Just days remain for Congress to stop yet another pending Medicare physician pay cut, and the Texas Medical Association is again feverishly working the nation’s Capitol.


Feds Declare “Long COVID” a Disability - 06/10/2022

Although the pandemic rages on, there may be some relief in sight for people with lingering effects from COVID 19 infection – or “long COVID” – as well as consequences for the physicians who treat and employ them. The Biden administration in late


TMA Fighting to Stop Yet Another Medicare Pay Cut – and Looking for System Overhaul - 06/08/2022

After decades of Medicare physician pay cuts – the latest of which is set to take effect on July 1 – the Texas Medical Association and others in organized medicine have set their sights on comprehensive reform.


Hospital Ownership the Focus of New Medicare Report - 05/09/2022

In an effort to analyze the impact of consolidation within the health care system, Medicare for the first time has released data on mergers and acquisitions for enrolled hospitals and nursing homes between 2016 and 2022. The action follows up on the Biden Administration's Executive Order on Promoting Competition.


Delay Upcoming Medicare Cut, TMA Tells Congress - 04/08/2022

With just days remaining until the latest Medicare physician pay cut takes effect, the Texas Medical Association has been lobbying for an eleventh-hour act of Congress to stop it.


Medicare Lowers Thresholds to Cover Lung Cancer Screening - 04/05/2022

Medicare has announced expanded coverage for lung cancer screening using low-dose computed tomography, the only recommended screening test for the disease.


MIPS Participation Drops per Preliminary Report - 04/05/2022

Fewer clinicians participated in Medicare’s Quality Payment Program in 2020, and fewer participants earned incentive payments compared with 2019, according to preliminary data recently released by the Centers for Medicare & Medicaid Services.


AMA Updates Estimated Medicare Payment Impacts - 04/05/2022

Following medicine’s fervent advocacy in late 2021 that convinced Congress to stop almost all of a nearly 10% Medicare physician pay cut for 2022, the American Medical Association has released an updated analysis on Medicare payments by specialty for this year.


A Long-Overdue Fix: Comprehensive Medicare Reform Could Halt Pay Cuts - 03/31/2022

Physicians say Medicare reform is the only solution to the problem of periodic pay cuts  – and they’re prepared to fight for it.


Congress Scraps Most of Medicare Cuts, Heeding Medicine’s Warnings - 03/08/2022

The Texas Medical Association and many others in organized medicine bellowed through a collective bullhorn, urging Congress to pull Medicare physician payments back from the brink.


TMA: Thanks for Saving Medicare; More Work Ahead - 01/14/2022

Statement by Texas Medical Association (TMA) President E. Linda Villarreal, MD, in reaction to Congress passing legislation Thursday averting most of a 9.75% Medicare cut to physician payments, which was scheduled to take effect on Jan. 1, 2022.


The X{EPSU} Modifiers Further Define Modifier 59 - 12/27/2021

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines


Practice e-Tips on Medicare - 12/03/2021

Get practice tips on all things Medicare. Learn what Medicare requires for enrollment, participation, billing, claims, coding, documentation, and more.


TMA Ask the Expert: Medicare Physician Fee Schedule - 12/02/2021

The Centers for Medicare & Medicaid Services’ (CMS’) 2022 Medicare Physician Fee Schedule takes effect on Jan. 1 and raises several concerns for physicians treating Medicare patients, including a series of mandated pay cuts totaling nearly 10% and changes to the already complex Quality Payment Program (QPP).


Changing Your Medicare Participation Status for 2022 - 11/30/2021

The Texas Medical Association is still working to convince Congress to stop several cuts for 2022 payments for Medicare physician services that would total nearly 10%. But with those cuts still going into effect as of now, you may wish to modify their Medicare participation status.