Stories written by Emma Freer

Seeking Balance: TMA Opposes Feds' Implementation of the No Surprises Act - 12/01/2023

The Texas Medical Association supported the patient protections in the federal No Surprises Act but also knew from the beginning that the law's payment arbitration provisions were flawed and could give insurers an advantage.

Closing the Gap: New Texas Network Adequacy Law Tackles Waivers - 11/29/2023

Although Texas has some of the strongest network adequacy rules in the country, poor enforcement and an overused waiver system have weakened physician practice viability and patients’ access to in-network care; thanks to advocacy by the Texas Medical Association, this will soon change.

RICO Settlements: TMA's Leadership Against Payer Abuses Resulted in Relief, Reform - 11/29/2023

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.

Reminder: Apply for 2023 MIPS Hardship Exemption by Jan. 2 - 11/28/2023

Physicians eligible to participate in Medicare’s Merit-Based Incentive Payment System may be spared a steep financial penalty, continuing a trend seen throughout the COVID-19 pandemic.

New Law Prohibits Employer COVID-19 Vaccine Mandates, With Exceptions - 11/15/2023

Thanks to advocacy by the Texas Medical Association, guardrails for patient safety and practice viability are included in a new state law that prohibits employers, including physician offices and health care facilities, from mandating COVID-19 vaccines among employees.

TMB to Start One-Time Fingerprinting Requirements for License Renewals - 11/15/2023

Approximately 75,000 Texas physicians seeking to renew their medical license soon will be required to submit their fingerprints, according to the Texas Medical Board.

CMS Releases 2024 Medicare Advantage and Part D Plan Ratings - 11/13/2023

Medicare patients and the physicians who care for them now have more information to guide their choice of plan in 2024.

Final 2024 Medicare Fee Schedule Solidifies Pay Cuts, Heightens Calls for Reform - 11/13/2023

Now that it’s been finalized, the 2024 Medicare physician fee schedule has solidified yet another pay cut, set for Jan. 1, 2024, underscoring calls for Medicare physician payment reform from physician advocates and lawmakers who’ve recently convened in federal hearings on the topic.

Care Connections: TMA Foundation Grants Tackle Public Health Problems - 11/09/2023

TMA Foundation grants offer a lifeline to Texas physicians tackling public health problems.

PAI Study Shows Cost-Savings of Physician-Owned Hospitals Amid Medicare Reform Debate - 11/08/2023

A recent study commissioned by the Physicians Advocacy Institute and The Physicians Foundation found physician-owned hospitals provide high-quality care at a lower cost to Medicare than traditional hospitals serving similar patient populations.

Patient Care Protected: TMA Secured Big Legislative Wins With a New Strategy - 11/08/2023

Guided by a set of priorities and girded by grassroots physician advocacy, the Texas Medical Association entered the 2023 legislative session with a laser focused approach and came out hitting targets in every area of medicine’s agenda.

First Steps: TMA Secures Medicaid Physician Rate Increases With Hopes for Momentum - 11/05/2023

TMA helped secure the first Medicaid physician rate increases in decades in hopes it will build momentum for future gains.

Report Aims to Catalyze Texas Medicaid’s Shift to Value-Based Care - 11/02/2023

A new report aims to accelerate Texas Medicaid’s transition from a fee-for-service payment model to a value-based one, a shift that has been underway for 25 years.

Coming Unwound: Mass Disenrollments Hurt Patients and Physicians Alike - 11/02/2023

The end of continuous Medicaid eligibility has led to mass disenrollments, hurting patients and physicians alike.

The Trust Model: For Decades, TMA's Insurance Trusts Have Put Physicians First - 11/01/2023

For decades, TMA’s private insurance and medical liability insurance trusts have put physicians first.

The Power of One Voice: Elisabeth Potter, MD's Advocacy Helped Upend CMS' Plan to End Certain Breast Surgery Coverage - 11/01/2023

Elisabeth Potter, MD’s spirited advocacy helped upend CMS’ plan to eliminate coverage for a preferred breast reconstruction surgery.

Texas' Broadband Boom: An Influx of Funds Could Turbocharge Telehealth Access - 10/18/2023

The federal government recently granted Texas $3.3 billion – the largest award of any U.S. state – to deploy and upgrade broadband networks, critical to ensuring access to telehealth care.

Government Shutdown Could Delay Medicare Claims Payments, Reform - 10/18/2023

The looming federal government shutdown would have ramifications for physicians across the country as well as for desperately needed Medicare physician payment reform.

First-Ever MIPS Penalties Surface; Share Your Story With TMA - 10/16/2023

Given recent changes to Medicare’s Merit-Based Incentive Payment System (MIPS) and an ongoing push for Medicare physician payment reform, the Texas Medical Association encourages member physicians who participate in MIPS to closely review their final scores for the 2022 performance year.

“We Can Compete:” Direct Payment Models Present Opportunity for Independent Practices - 10/13/2023

Rising health care costs. Declining outcomes. Restricted patient access to care. Rampant consolidation. Incessant physician payment cuts. Excessive prior authorization. Creeping scope-of-practice attacks.

AMA Launches National Study of Physician Practice Expenses - 10/11/2023

With the backing of the Texas Medical Association and 172 other health care organizations, the American Medical Association recently launched a survey of U.S. physicians to better understand practice expenses and to support its advocacy for physician payment reform.

U.S. House Committee Spotlights TMA Leadership on Surprise-Billing Rules - 10/11/2023

As members of the U.S. House Committee on Ways & Means delved into the flawed implementation of the federal No Surprises Act in a recent hearing, discussion – and commendation – turned several times to the Texas Medical Association’s leadership on the topic.

TMA Wins Two More Surprise Billing Lawsuits; CMS Suspends Arbitrations - 10/03/2023

Marking a fourth victory for the Texas Medical Association in as many lawsuits, a court on Aug. 24 struck down a large portion of the regulations setting forth a methodology insurers use to calculate the qualifying payment amount, or QPA, used in surprise-billing disputes – part of a series of federal rules TMA has long argued skew the arbitration process in insurers’ favor.

Putting the AI in Paid: Payer Use of Artificial Intelligence Sparks Physician Concerns - 10/02/2023

Physicians - worried about payers' increasing use of artificial intelligence to process prior authorization requests, enable value-based care models, and systematically deny coverage - are seeking transparency on behalf of their patients and practices.

Medicare Fee Schedule Proposal Remains “Highly Flawed,” Underscores Need for Reform - 09/28/2023

The proposed 2024 Medicare physician fee schedule came as no surprise, following earlier iterations that deepen physician pay cuts and increase complexities associated with the Merit-Based Incentive Payment System (MIPS) – prompting organized medicine to ramp up its call for reform that would break this cycle.