Stories with related Professional Interests

Medicine to CMS: Medicare Report Inflates Success of Quality Program - 05/01/2019

If you read the recent Centers for Medicare & Medicaid Services (CMS) report on the first-year of the Quality Payment Program, you’d likely come away with the perception that the program’s launch was an overwhelming success. But a closer look by the Texas Medical Association raises serious doubts about CMS’ numbers, transparency, and cheerleading – so much so that TMA and seven other state medical associations are asking the agency to take back the report.


Physicians Tell Feds: Rework Network Adequacy Plan - 02/08/2019

The Texas Medical Association and the Texas Pediatric Society are urging the Centers for Medicare & Medicaid Services to reconsider several parts of its proposal to redefine adequate networks for Medicaid.


Panel: Value-Based Care Bearing Fruit - 01/30/2019

Although some of the numbers documenting access to care in Texas are less than encouraging, the shift to value-based care in Medicaid is showing positive signs, a panel collectively told the Texas Medical Association’s Winter Conference on Saturday at the Hyatt Regency Austin.


Pediatrician Named HHSC Medicaid Chief Medical Officer - 01/15/2019

San Antonio pediatrician Ryan Van Ramshorst, MD, has been appointed chief medical officer for Medicaid and the Children's Health Insurance Program within the Texas Health and Human Services Commission.


Medicaid Eligibility Verification Website to Be Shuttered Friday - 12/13/2018

The Texas Health and Human Services Commission (HHSC) will decommission the YourTexasBenefitsCard.com website and the Medicaid eligibility verification Interactive Voice Response system at 7 pm (Central) on Friday.


TMA Offers to Help New HHSC Chief Reform Medicaid - 11/30/2018

The Texas Medical Association knows the state’s Medicaid managed care system needs to get better, and physicians are ready to help the Texas Health and Human Services Commission’s new leader make it happen. That’s what TMA and three other organizations told new HHSC Executive Commissioner Courtney Phillips, PhD, in a letter this week welcoming her to her new post and highlighting steps to cut Medicaid red tape and enhance access to care.


Webinar Can Help You Clear Medicaid Telemedicine Static - 10/12/2018

Do you understand telemedicine in Texas, particularly when treating Medicaid patients? If not, you might want to register for a live, free webinar on telemedicine and telehealth services scheduled for the end of October.


Medicaid HMO Credentialing – and Recredentialing – Just Got Easier - 04/03/2018

Starting this week, Texas physicians can save time getting credentialed and recredentialed for Texas' 19 Medicaid managed care plans.


CMS Extends Texas’ Medicaid 1115 Waiver - 01/10/2018

Late in December, CMS awarded Texas a five-year extension of its Medicaid Section 1115 Transformation Waiver, providing crucial funding for public and private safety-net hospitals that are improving care delivery for Medicaid and low-income uninsured patients.


Change Around the Block? - 07/02/2017

Proponents of a block grant or per-capita cap trumpet them as vehicles for the federal government to give the states a capped amount of funding for Medicaid that legislatures would effectively distribute how they see fit. Questions abound as to what capped Medicaid funding would look like, and what effect it would have on the current Medicaid-eligible population, covered services, and physician payments.


TMA's Medicaid Recommendations Can Improve Care, Reduce Costs - 01/10/2017

As state lawmakers begin preparing for the 2017 legislative session, TMA and four state specialty societies delivered a detailed, five-page document with significant recommendations to improve the Texas Medicaid program.


Drug Debacle - 11/21/2016

Medicaid's Vendor Drug Program is under examination by the Texas Legislature. TMA's Physicians Medicaid Congress is seizing the opportunity to call for an administrative overhaul of a drug benefit physicians describe as unnecessarily complicated and confusing.


TMA Asks HHSC to Request More Medicaid, Public Health Funds - 10/11/2016

It's that time in the state's two-year budget cycle when state agencies prepare funding requests for the Texas Legislature to consider in next year's session. No agency's budget is more important to physicians than that of the Texas Health and Human Services Commission (HHSC), whose massive portfolio includes the state's Medicaid, public health, mental health, and women's health programs.


Act Now to Avoid Losing Your Medicaid Enrollment Status - 10/11/2016

Thanks to lobbying from TMA and organized medicine, the Centers for Medicare & Medicaid Services extended the deadline for physicians and other health professionals, including advanced practice nurses and physician assistants, to reenroll in Medicaid to Sept. 25, 2016. The initial deadline for reenrollment, driven by a provision in the Affordable Care Act, was March 24.


HHSC Offers STAR Kids Webinar for Physicians - 10/11/2016

If you participate in Medicaid, don't forget about the STAR Kids managed care program coming Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 years and younger who have disabilities.


Medicaid Reenrollment Application Deadline Passed; Reenroll Now - 10/10/2016

The June 17 intermediate submission deadline for Medicaid reenrollment has passed. If you participate in the Medicaid program and haven't submitted your application, please do so immediately. The Texas Health and Human Services Commission will process applications submitted after June 17 but can't guarantee those applications will be finalized by the federal deadline of Sept. 24, which could result in these applicants' disenrollment from Texas Medicaid and denial of payment.


Improve LARC Access With New Toolkit - 10/10/2016

You can help make long-acting reversible contraceptives (LARCs) available to all Texas women with the help of a new toolkit developed by the Texas Health and Human Services Commission in conjunction with the Texas Department of State Health Services and the Texas chapter of the American College of Obstetricians and Gynecologist. LARCs provide a highly effective contraceptive option with high rates of patient satisfaction and continued use. Improving access to LARCs is a TMA priority.


Healthy Texas Women Program Began on July 1 - 10/10/2016

On July 1, the Texas Health and Human Services Commission (HHSC) launched Healthy Texas Women, a new program that provides family planning services, screenings, and immunizations for low-income women and girls. HHSC expects Healthy Texas Women, a combination of the Texas Women's Health Program and the Expanded Primary Health Care Program, to serve at least 300,000 women. HHSC says more than 5,000 health care professionals — up nearly 30 percent from 3,800 providers two years ago — all across Texas are part of Healthy Texas Women.


STAR Kids Takes Effect Nov. 1; Training Available - 10/10/2016

If you participate in Medicaid, don't forget about the implementation of the STAR Kids managed care program on Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 and younger who have disabilities.


Medicaid Upgrade - 05/13/2016

Enhancements to Medicaid's electronic enrollment portal aim to speed up the process as physicians face reenrollment in the program.


Medicaid Transformation Waiver Extension Request Due Sept. 30 - 05/13/2016

Texas’s five-year 1115 Medicaid Transformation Waiver will expire Sept. 30, 2016. To extend or renew the waiver, the Texas Health and Human Services Commission (HHSC) has to submit a request to the Centers for Medicaid and Medicare Services (CMS) by Sept. 30, 2015.


Medicaid Restores Payment Levels for Child Vision Services - 05/13/2016

Medicaid is restoring physician payments for 50 pediatric eye codes to higher levels paid prior to July 1, 2015. The increase, which takes effect April 1, averages 6.6 percent across all codes.


Medicaid Not Jumping at TMA’s 1115 Waiver Ideas - 05/13/2016

State Medicaid officials offered a lukewarm response to TMA's recommendations to increase physician involvement in Medicaid transformation plans, boost physicians’ Medicaid payment rates, and design a privately-based plan to cover more uninsured, low-income Texas adults.


Makena Added to Medicaid, CHIP Formulary Starting June 15 - 05/13/2016

Starting June 15, Makena, the brand name version of 17P or hydroxyprogesterone caproate, will be on the Texas Health and Human Services Commission (HHSC)  Medicaid and Children's Health Insurance Program formulary. Makena will be available in a 120 mg/5 mL dosage as both a medical and pharmacy benefit. HHSC's Vendor Drug Program implemented Makena as a Medicaid pharmacy benefit in an effort to help reduce preterm births by expanding access to the drug.


HHSC Holds Information Sessions on STAR Kids Program - 05/13/2016

The Texas Health and Human Services Commission (HHSC) has scheduled information sessions at various locations around the state this month and in February to educate doctors and families on the new STAR Kids program. The new managed care program will provide Medicaid benefits to those younger than 21 who have disabilities and who receive a Medicaid waiver or Supplemental Security Income benefits in the Medicaid program.