Stories with related Professional Interests

Safety in Statute: State Law Guides Violence Prevention in Health Care - 11/18/2024

A new state law guides violence prevention plans in health care.  


Shielding the Gold Card Law: TMA Fights to Guarantee Gold Card is Implemented as Intended - 04/09/2024

Texans earned one of its most prolific victories with its prior auth exemption law but still fights to guarantee it's implemented as intended.


RICO Settlements: TMA's Leadership Against Payer Abuses Resulted in Relief, Reform - 04/09/2024

Back in 2001, the Texas Medical Association and the other plaintiffs alleged the nation’s major health plans had conspired to delay and reduce payments to clinicians and hospitals; the resulting lawsuits, brought under the federal Racketeer Influenced and Corrupt Organizations Act (RICO), represented a watershed moment in TMA history.


TMA to IRS: Direct Primary Care, Health Care-Sharing Ministries Aren’t Insurance - 04/05/2024

The Texas Medical Association is urging the IRS to reconsider a proposed rule that would classify direct primary care (DPC) arrangements and health care-sharing ministries (HSMs) as insurance.


Exceptional Circumstances: TMA Advocates “Legislative Clarity” Amid State Abortion Bans - 03/05/2024

TMA advocates “legislative clarity” amid state abortion bans.


Telemedicine Flexibilities Preserved in Medicare Fee Schedule - 03/05/2024

The 2024 Medicare physician fee schedule (MPFS) extended several pandemic-era telehealth flexibilities, many of which impact physicians who treat rural patients and those with behavioral health needs.


Coding Changes in Fee Schedule Promote More Accurate Payment for Complex Visits - 03/05/2024

The 2024 Medicare physician fee schedule allows physicians to list G2211 in addition to codes used in office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians also can use it for telehealth visits.


Added Security: Free Tool Helps Practices Comply with the HIPAA Security Rule - 01/05/2024

Federal officials updated a free tool to help small and medium-sized practices comply with the HIPAA Security Rule.


Misdirected: Health Plan Directories See Damaging Gaps Awaiting Final Rules - 12/04/2023

Health plan directories see damaging gaps while awaiting No Surprises Act final directory rules – and accountability.


All in Good Faith: No Surprises Act Requires Practices to Provide Good Faith Estimates of Charges - 12/04/2023

No Surprises Act transparency provisions require practices to provide patients good faith estimates of expected charges – on strict timelines


Reintegration: NarxCare and Pharmacy Management Systems Free for Physicians - 11/07/2023

Integration of the state prescription monitoring program and NarxCare into EHRs and pharmacy management systems again is free for physicians, following TMA advocacy  


Prescription Pitfalls: Vendor Drug Program Restricts Physicians to Prescribing Certain Medications - 11/05/2023

Amid rising drug costs, Texas Medicaid’s Vendor Drug Program often restricts physicians to prescribing medications that may not be best for their patients


Court Delivers TMA Win Against Fee Hike, Batching in Surprise Billing Arbitration - 08/10/2023

The court struck down a 600% administrative fee increase and certain unfair rules that narrowed the law’s provisions on combining or “batching” surprise-billing arbitration claims. The decision is one of several victories TMA has won against federal regulators tasked with implementing the federal No Surprises Act.


Can 34,616 Physicians Be Wrong About MOC? - 05/05/2023

The recently released findings of a national survey show that only 12 percent of the 34,616 physicians who answered the survey value the MOC program. Forty-six percent said they have mixed feelings, and 41 percent said they do not value it.


Federal Telehealth Extension Bill Advances to Senate - 08/31/2022

Signaling strong support to build on the COVID-19-era gains in telemedicine, the U.S. House of Representatives overwhelmingly passed a bill that would extend Medicare’s telehealth payment and regulatory flexibilities through the end of 2024, should the public health emergency end before then.


CMS Continues Webinar Series on No Surprises Act - 07/07/2022

Two upcoming webinars from the Centers for Medicare & Medicaid Services (CMS) – including one scheduled for next week – will educate physicians on the federal No Surprises Act (NSA) as part of a collaboration between CMS and the American Medical Association.


Feds Scrap TMA-Opposed SUNSET Regulation-Review Rule - 06/03/2022

The U.S. Department of Health and Human Services (HHS) has turned out the lights on a “sunset” rule requiring extensive federal review of thousands of regulations, which the Texas Medical Association and others in organized medicine believed would needlessly divert HHS’ attention from the COVID-19 pandemic.


New CMS Rule Allows More Physician Self-Referrals Under “Stark Law” - 12/04/2020

Physicians who have financial relationships with medical services facilities, such as labs and imaging services, are able to refer more Medicare or Medicaid patients to those facilities under a final rule published this week.


TMA to AG: Protect Physician Data from Open Records Request - 11/23/2020

The Texas Medical Association is fighting to keep confidential the personal and financial data of physicians who recently participated in an independent dispute resolution process created by Texas’ surprise billing law – Senate Bill 1264.


Mismatch Game: PMP Errors Could Harm Patient-Physician Relationship - 10/30/2020

Now that Texas prescribers must check a patient’s history in the state’s prescription monitoring program (PMP) before prescribing opioids, plus three other drug classes, the errors are becoming more apparent.  


Be Vigilant - Hospital Medical Staff Bylaws and You - 09/16/2020

To bolster an argument that bylaws are binding on physicians, medical staff, and a hospital, the Texas Medical Association Office of the General Counsel has crafted language that could improve the binding effect of your hospital’s bylaws.


The PMP Requirement Begins - 08/18/2020

With EHR integration in place, physicians must check the state prescription monitoring program (PMP) prior to prescribing an opioid starting March 1.


The Updated Skinny on Texas’ Surprise Billing Law - 07/08/2020

The Texas Medical Association has updated its white paper on Texas’ law for settling out-of-network billing disputes involving state-regulated health plans.


Clear as Mud? Federal Rule Will Mandate Hospitals to Post Prices on a Menu of Services - 04/30/2020

From electronic health records to quality reporting, today’s physicians deal with plenty of distractions from patient care. Starting in 2021, hospital-employed physicians may find themselves adding another one: explaining to patients the difference between their hospital’s multiple published prices for the same service.


TDI Fines Blue Cross $10 Million for Delays, Errors - 03/11/2020

Blue Cross and Blue Shield of Texas will pay a $10 million fine for providing consumers incorrect information, delays in out-of-network claims processing, and errors in marketing materials, the Texas Department of Insurance has announced.