Stories written by Joey Berlin

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.)


Pay Now or Pay Later? Supreme Court Adds Clarity Around Negligence Awards - 07/29/2022

Case by case, courts are clarifying a piece of Texas’ tort reform law that’s meant to keep physicians from paying part of a medical negligence award in one prohibitive and devastating gulp.


The Only Alternative: Medicaid Practices May Not Be Viable Without Value-Based Care - 07/29/2022

For years, the Texas Medical Association has pushed for a significant Medicaid physician pay bump every year that the Texas Legislature meets, without success. As long as that streak continues, physicians looking to make Medicaid more worthwhile for their bottom line have to find another way. Value-based systems – and the alternative payment models that drive them – have been the path Medicaid managed care organizations and practitioners have been methodically walking in recent years.


Ten Years Later: TMA Advocacy Nets Investments in Women’s Health - 07/27/2022

A decade ago, the Texas Legislature made a funding decision that devasted low-income women’s access to health care and the physicians and community clinics that care for them. After 10 years, with the help of TMA advocacy and the formation of the Texas Women’s Healthcare Coalition, funding for family planning and overall women’s health is in significantly better shape.


CDC Authorizes Novavax Adult COVID Vaccine - 07/22/2022

There’s now a fourth COVID-19 vaccine option available in the U.S. after the federal government gave emergency use authorization to the Novavax vaccine for adults.


New FAQ Offers Information on Virtual Credit Card Payments - 07/20/2022

Federal authorities are clarifying the legality of health plans paying claims through virtual credit cards, which typically result in fees for practices.


Aetna Scraps Required Prior Auth for Cataract Surgery - 07/20/2022

Organized medicine’s efforts across the nation to torpedo or curb prior authorization recently got a small but encouraging boost when Aetna rescinded its year-old preauthorization requirement for cataract surgeries.


Texas’ Expanded Medical Cannabis Program: What You Need to Know - 07/19/2022

Legal uses for medical cannabis in Texas have reached an all-time high. Soaring even higher is interest in the Texas Compassionate Use Program under which physicians can prescribe it.


DSHS: Consider Paxlovid as COVID Cases Rise - 07/13/2022

With Texas’ COVID-19 case and hospitalization numbers on a recent upward swing, the state is reminding physicians about the therapeutics available to treat high-risk patients with mild to moderate COVID-19.


TMB Adopts New Requirements on Reporting Conviction Details, Negligence Suits - 07/08/2022

Physicians who are convicted of a felony and certain misdemeanors must now submit a “description” of their infraction to the Texas Medical Board (TMB) within 30 days after the courts wrap up their case. The same requirement now applies to physicians who must pay damages in a medical negligence claim.


Senate Evaluates Post-Pandemic Strategies on Mental Health - 07/01/2022

In the face of “grim” research around the COVID-19 pandemic’s impact on mental health, the Texas Medical Association is telling state lawmakers to respond with robust regulatory support of telehealth and investments to improve all Texans’ access to care.


“Black Robes, Not White Coats”: Can Courts Compel Unproven Treatments? - 06/29/2022

COVID-19 patients and their families have involved judges and attorneys in an effort to compel physicians to treat the disease in unproven ways, against their medical judgment. And in some cases around the country, patients’ families have been successful in getting a court order to do so. The Texas Medical Association’s Committee on Patient-Physician Advocacy, while not directly involved in such cases, has a keen interest in making sure physicians can exercise their medical judgment.


Picking the Right Battles: TMA Stands Up for Medicine in the Courts - 06/29/2022

When a big point of legal contention arises – “big” meaning impactful for Texas physicians and their patients – the Texas Medical Association responds big. That’s been the case for decades, including in the courts. 


Dialing In on Disparities: CDC Grant Helps Texas Tackle COVID-Aggravated Health Gaps - 06/29/2022

It’s a short-term federal grant that Stephen Pont, MD, hopes can make a long-term impact.


The Power of Data: UTHealth Publishes Claims Statistics - 06/29/2022

After three years of work, the Center for Healthcare Data at McGovern Medical School at UTHealth is sharing part of its growing trove of numbers for data-driven discussions on many aspects of health care in Texas. The center doesn’t have all the answers. But its work under a federal certification from the Centers for Medicare & Medicaid Services (CMS) has resulted in valuable state and regional statistics that the center leaders believe provide food not only for thought, but also for policy.


CDC: COVID “Rebound” Chance Doesn’t Affect Paxlovid Recommendation - 06/28/2022

Despite the possibility of a symptom recurrence after a COVID-19 patient is treated with Paxlovid, that antiviral drug remains recommended for initial COVID treatment, the Centers for Disease Control and Prevention says in a recent health alert.


Imaging Contrast Shortage Highlights Need for Relaxed Prior Auth - 06/27/2022

A shortage of iodinated contrast media resulting from recent COVID-19 lockdowns in China has put a focus on prior authorization barriers that unnecessarily impede the imaging services patients need to ensure timely care.


Monkeypox Wave Intensifies; Get Educated With TMA Fact Sheet - 06/24/2022

The monkeypox outbreak in the U.S. is now the worst documented wave of the disease in the nation’s history, surpassing the previous one in 2003. As cases of this rarely seen disease climb, the Texas Medical Association’s Committee on Infectious Diseases has put together a four-page fact sheet, Monkeypox: What Physicians Need to Know, to help educate physicians.


Post-Uvalde, TMA Urges State Support for Mental Health Care and Child Interventions - 06/24/2022

As state lawmakers chart a path forward after the Robb Elementary school shooting in Uvalde last month, the Texas Medical Association is offering stories of hope that illustrate promising potential solutions: investments in mental health systems that can intervene before a troubled youth becomes a perpetrator of gun violence.


CDC Recommends COVID Vaccines for Kids as Young as 6 Months - 06/21/2022

The Centers for Disease Control and Prevention has recommended two COVID-19 vaccines that now can be used for children between 6 months and 5 years old, meaning physicians and other vaccinators can begin giving those shots – and they’re now available for ordering through the state’s Vaccine Allocation & Ordering System.


State Webinar: COVID Vaccines for Kids Under 5 - 06/17/2022

The Texas Department of State Health Services is holding its latest Texas Vaccine Provider Webinar, focusing on the launch of COVID-19 vaccines for children under 5, today from noon to 1:30 pm CT.


Physician-Led Results: Grassroots Advocacy Paid Off in Tangible Wins at the Capitol - 06/15/2022

Texas physicians made the most of an extraordinary, scaled-back session of the Texas Legislature in 2021. They helped pass laws to curb prior authorization hassles; keep physicians from incurring new practice costs; install liability protections for future pandemics like COVID-19; extend postpartum Medicaid coverage for new mothers; and keep graduate medical education (GME) fully funded. And so much more.


Federal Prior Auth Bill Filed in Congress - 06/15/2022

U.S. Rep. Michael C. Burgess, MD (R-Lewisville), is following his fellow Texas physicians’ lead on curbing insurers’ hassle-laden prior authorization burdens, introducing a federal bill similar to the “gold-card” law the Texas Medical Association proposed and championed into law at the state level.


Monkeypox Cases Resurface; CDC Urges Vigilance - 06/09/2022

With cases of monkeypox recently reported in several countries that don’t normally have that virus – including at least one confirmed case in the U.S. – federal health authorities are advising physicians to be on the lookout for the characteristic rash usually associated with monkeypox.


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.