Stories with related Professional Interests

TMA Questions QPP Data Showing Most Clinicians Will Receive Medicare Bonus in 2021 - 11/05/2020

The Centers for Medicare & Medicaid Services (CMS) has released preliminary data for the 2019 Medicare Quality Payment Program (QPP), which shows more than 95% of participating clinicians earned an incentive payment that they’ll see next year. However, Texas Medical Association experts are skeptical of the preliminary data.


TMA Balks at Proposed Medicare Payment Cut, More Changes to QPP During Pandemic - 10/12/2020

Physicians who renew their medical licenses after Sept. 1, 2020, are required to take one hour of CME that addresses human trafficking. TMA has now published its own CME course to educate physicians on how to identify, treat, and respond to people who are at risk or who have been trafficked.


Last Chance to Start Certain 2020 MIPS Reporting Tomorrow - 10/02/2020

If you participate in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), you will have to report on the required measures – Promoting Interoperability and Improvement Activities – starting Saturday, Oct. 3.


Buying Time: Medicine’s Warnings Prompt CMS to Delay Dramatic Coding and Payment Changes - 06/23/2020

Medicine’s warnings prompt CMS to delay dramatic coding and payment changes.


Running Out of Reasons: Low Payments, Hassles Leave Physicians Wondering: Why stay in Medicare? - 06/01/2020

Texas physicians who deal with Medicare’s substandard payments and world-class administrative hassles are feeling underappreciated. The latest report from the committee that advises Congress on Medicare payment policy may exacerbate that feeling. In March, the Medicare Payment Advisory Committee (MedPAC) released its annual report assessing payments to physicians, among other sectors. MedPAC recommended no changes to the 2021 Medicare physician fee schedule, meaning no increase in physician payments.  


Appropriate Use of Time? Medicare Rules for Advanced Imaging Orders Pose Prior-Auth Burdens - 04/09/2020

An effective way to cut down on overuse of potentially harmful imaging, or a prior authorization-esque burden on physicians who order needed tests? Texas physicians see Medicare’s “appropriate use” system for advanced imaging both ways. As of Jan. 1, physicians ordering advanced imaging tests for Medicare patients must consult an electronic portal, which evaluates whether the test meets Medicare’s own “appropriate use criteria” for whether a test should be ordered. Then when the claim is filed, physicians must document that they checked the system and its determination.  


TMA Opposes Attempts to Expand Audiologists’ Scope - 02/14/2020

Proposed federal laws that would give audiologists unlimited access to Medicare patients without a physician referral could lead to lasting, and expensive, harm to patients, medicine once again told U.S. Senate and House leadership this week.


Don't Miss Out! Medicare Pays for Chronic Care Management - 11/22/2019

Do you manage patient referrals and care transitions between and among physicians and health care settings? Do you spend time reconciling medication lists and managing prescription refills for your patients? Do you take calls during and after office hours to address patient care needs? If the answer is yes and you're not billing for these types of services, you're missing out on a new CPT code and practice revenue opportunity from Medicare.


Get Details About Your 5% Medicare Bonus - 11/05/2019

If you participated in the advanced alternative payment model (APM) track during the 2017 Quality Payment Program (QPP) performance year, full details of your 5% APM incentive payment are finally available.


Put Patients Over Paperwork, TMA Tells CMS - 08/19/2019

Allow physicians to use electronic health records how they see fit, eliminate prior authorization requirements, lift the ban on physician-owned hospitals, and allow a real out-of-network option. Those are among the 15 recommendations the Texas Medical Association presented to the Centers for Medicare & Medicaid Services, which is seeking to reduce administrative burdens and red tape in the Medicare program.


Medicare Muzzle? New Rules May Make Physicians Reluctant to Speak Up - 08/02/2019

New Medicare rules on local coverage determinations may make physicians reluctant to speak their minds.


Get Paid for End-of-Life Care Discussions With Patients - 07/18/2019

Since 2016, the Centers for Medicare & Medicaid Services has used two Current Procedural Terminology (CPT) payment codes for conversations about end-of-life treatment.


Will You Get a Medicare Bonus or Pay Cut Next Year? - 07/11/2019

 If you participated in the 2018 Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP), it’s now possible to check whether you’ll receive a Medicare payment bonus or cut next year.  Physicians should check their 2018 MIPS performance feedback and 2020 payment adjustment as soon as possible in case the Centers for Medicare & Medicaid Services (CMS) made mistakes when calculating your data, which happened last year. 


Use Modifiers to Override Correct Coding Initiative Edits - 05/28/2019

Correct Coding Initiative Edits Now Free on Internet


Medicine to Feds: Back Off Prior Authorization Requirements - 03/07/2019

The Texas Medical Association, American Medical Association, and a host of other medical societies are trying to stop onerous, care-impeding prior authorization requirements from overrunning Medicare Advantage plans.


Medicare Enrollment Application Revised - 03/04/2019

A new Medicare enrollment application form for physicians and nonphysician practitioners will go into effect May 1.


How to File a Medicare Extended Repayment Plan - 03/04/2019

  Extended repayment plans (ERPs) are an option for returning overpaid money to Medicare. Ideally, you should request an ERP immediately after receiving the initial demand letter. However, you can request an extended payment plan any time while the overpayment is outstanding. 


Medicare Billing Guidelines for NPs, CNS, and PAs - 03/04/2019

Billing Guidelines for Nurse Practitioners (NP),Clinical Nurse Specialists(CNS),and Physician Assistants (PA)


Texas Clinics Repay Medicare for Improper Claims - 03/04/2019

Several Texas dialysis clinics in El Paso and the Dallas-Fort Worth area have had to repay Medicare for treating people in the country illegally.


Novitas Mails Medicare Revalidation Letters - 03/04/2019

On March 1, Novitas, the Texas Medicare claims processor, began sending physicians in the Medicare program letters asking them to revalidate their enrollment information. Physicians not on the March 1 mailing list will receive their letters either March 15 or March 29.


How's Novitas Doing? - 03/04/2019

Medicare wants to know what you think of the job Novitas Solutions is doing administering the Medicare program in Texas.


CMS Sends Home Health Reports - 03/04/2019

The Centers for Medicare & Medicaid Services (CMS) sent physicians comparative billing reports on home health services. The reports contain peer comparisons that give you insights into your coding and billing practices through tables and graphs that compare your billing and payment patterns to your peers both statewide and nationally.


Government Shutdown Won't Affect Medicare Claims - 03/04/2019

Medicare claims will continue to be paid despite the government shutdown, the American Medical Association says.


Cornered: Proposed Medicare Fee Overhaul Could Box In Doctors - 02/05/2019

Proposed overhaul to Medicare payments for complex patient care visits and same-day office-based procedures could box in Texas physicians.


Review Your Physician Compare Data Before Jan. 7 - 12/20/2018

The Centers for Medicare & Medicaid Services (CMS) recently opened its Physician Compare preview period, which will allow you to check out your 2017 QPP performance data and 2016 clinician utilization data before it’s publicly reported on Physician Compare in early 2019. CMS will close the preview period on Dec. 31, so you’ll want to review your information and check for errors as soon as possible.