Stories written by Joey Berlin

Staying the Course: Medicine Enters an Unprecedented Session at the Texas Legislature - 01/16/2021

The way the Texas Legislature conducts business during the 2021 session may look different due to the COVID-19 pandemic. But the Texas Medical Association’s commitment to improving health care remains the same. Some of those goals are up against deep cuts to state agency budgets. At the same time, however, the pandemic has created opportunities for medicine to bend lawmakers’ ear on some of its longstanding goals, including advancing access to care, vaccines, health coverage, and telemedicine.


Legislative Hotline Jan. 15: House Adopts Mask Protocol for New Session, Announces Electronic Comment Portal - 01/16/2021

The Texas Legislature finished its last business Thursday before a long early vacation, after the House of Representatives adopted rules for the 2021 session, including a mask requirement on the House floor and the option to electronically submit comments.


Legislative Hotline Jan. 13: House Speaker Chosen as Session Gets Under Way - 01/13/2021

The Texas Legislature on Tuesday gaveled in what’s sure to be one of the most unique sessions in its history, with both the House and the Senate making quick work of their first day before adjourning.


Look for Tax Forms on CARES Act Payments - 01/12/2021

It’s tax season, and if you received payments in 2020 through certain federal Coronavirus Aid, Relief, and Economic Security (CARES) Act programs, be on the lookout for a tax form that includes information on those payments.


The COVID-19 Relief Bill: What It Means For Medicare Payments - 01/11/2021

When Congress passed the omnibus spending and COVID-19 relief bill at the tail end of 2020, it carried important implications for physicians operating under this year’s Medicare physician fee schedule, including some changes that will positively affect doctors’ bottom line.


Proposed CMS Payer Requirements Shouldn’t Burden Physicians, TMA Says - 01/08/2021

A federal proposal that would require more transparency in insurers’ prior authorization denials in Medicaid and more sharing of such information with physicians could improve care delivery, but  also could result in more responsibilities on already overburdened physicians, TMA told the Centers for Medicare & Medicaid Services.


TMB Extends Waiver Allowing Pain Prescription Refills via Telemedicine - 01/08/2021

The Texas Medical Board has extended a waiver until March 2 that allows for refills of prescriptions for chronic pain patients who recently saw their doctor via telemedicine.


Troubling Trend: Texas’ 2018 QPP Data Contains More Bad Signs - 01/05/2021

As the Centers for Medicare & Medicaid Services continues to churn out glowing data annually on its Quality Payment Program (QPP), a full picture of the program’s impact eludes the agency’s reporting. According to the Texas Medical Association’s analysis of state-level data in the 2018 QPP Experience Report, it’s clear that small practices continue to feel most of the program’s punitive pressures.


The Customer Is Always Right? Patient-Reported outcome Measures Have Fans and Detractors - 01/05/2021

For too long, some doctors say measures of a physician’s quality of care have been about process: the average length of a patient stay, for example, or a patient’s readmission rate. The bottom line is results, and that’s why a shift to patient-reported outcome (PRO) measures is necessary. However, even proponents of PRO measures note that collecting the information from patients for those metrics places burdens on physicians, and some remain skeptical of bonuses and penalties tied to a measure that derives from a subjective factor: what patients think.


A Different Kind of Patient: CME from TMA Helps Docs ID Human Trafficking Victims - 01/04/2021

A newly revised Texas Medical Association CME teaches physicians how to recognize human trafficking victims who come into their office, and how to help these patients escape what’s sometimes referred to as “modern-day slavery.”


The Tele-Future is Now: Will Telemedicine's Footprint Be Permanent Post-COVID-19? - 12/29/2020

COVID-19 threw Texas physicians headlong into telemedicine. Will its increased footprint be permanent? Physicians tell Texas Medicine that depends how telemedicine will be regulated and paid for.


Help TMA Standardize Quality Measures in Value-Based Care - 12/18/2020

Would you like a say in what measures should be a standard part of insurance quality programs across the nation – and which ones shouldn’t? The Texas Medical Association now has input in that discussion and could use your help.


AMA Opposes New Federal Surprise Billing Measure, Urges More Discussion - 12/17/2020

The American Medical Association is opposing the latest “No Surprises Act” and urging more vetting of the bill, which was agreed upon this week by key House and Senate committee leaders.TMA agrees with AMA’s assessment of the bill.


Some Telemedicine Now Allowed Across State Lines to Battle COVID-19 - 12/09/2020

The U.S. Department of Health and Human Services has paved the way for health care professionals to administer certain telehealth services across state lines to help in the fight against COVID-19, giving out-of-state physicians some interstate telehealth treatment allowances beyond what Texas state law allows.


CMS Finalizes Cut to Many Physician Payments, Adds Telehealth Codes in 2021 Fee Schedule - 12/04/2020

Medicare has finalized its 2021 physician fee schedule, resulting in payment cuts to many physicians due to the much-maligned budget neutrality requirements the Texas Medical Association has advocated against.


Arbitration Law Will be “Messy,” Bring Operational Concerns, Panelists Say - 12/02/2020

 The state’s new law allowing arbitration of payment disputes on certain out-of-network care carries concerns for physicians and uncertainty about what it will look like from an enforcement standpoint, a panel told the Texas Medical Association Winter Conference on Saturday morning.


Patient Privacy’s New Frontier: AMA Aims to Keep Apps Honest With Personal Health Data - 12/01/2020

In the evolving world of health information technology, some vendors that store and transmit health information – such as the tech minds behind certain mobile apps – are getting their hands on patient data without any HIPAA leash to rein in their use of it. Now, organized medicine is doing its part to preserve patients’ privacy when their health information finds its way outside of HIPAA-covered organizations.


Rewarding Results: Texas Medicare ACOs Perform Promisingly - 11/30/2020

For the Medicare Shared Savings Program (MSSP) and many of the accountable care organizations (ACOs) that participated in it, 2019 was billed as a transition year. But data released by the Centers for Medicare & Medicaid Services (CMS) in September show Texas ACOs fared quite well last year – and a number of Texas physicians and ACO officials say the savings generated are worth the gruntwork that MSSP requires.


The Power of Community: TMA Envisions Locally Focused ACO Model - 11/30/2020

TMA is developing a promising, locally focused version of the accountable care organization (ACO) model that could help cover uninsured and underinsured Texans who fall in the gap or “hole” in the state’s safety net: those who make too much money to qualify for Medicaid coverage as it’s now administered in Texas, but also don’t qualify for Medicare.


Priority: Primary Care - 11/30/2020

The Texas Medical Association and other corners of organized medicine know primary care is part of the bedrock of a sturdy health care system. So medicine – including the Texas Primary Care Consortium (TPCC), of which TMA is a member, and the Texas Academy of Family Physicians (TAFP) – is engaging policymakers to not only help the state’s primary care system survive the pandemic, but also enable it to thrive for the long haul.


Federal Agencies Adopt Rule Mandating Health Plan Price Transparency - 11/24/2020

A number of health plans will be required to be more transparent about coverage pricing starting in early 2021 after the recent adoption of a rule by three federal agencies.


AMA Advocates for 24/7 Prior Authorization Processing - 11/19/2020

AMA delegates passed new policy on Tuesday that advocates for insurers and benefit managers who require prior authorization to have staff available to process  those approvals 24 hours a day, year-round, “including holidays and weekends.”


CMS Increases Advanced APM Thresholds for 2021 - 11/13/2020

If you participated in Medicare’s Quality Payment Program (QPP) this year as a Qualifying Alternative Payment Model Participant (QP), you’ll need to keep an eye on your status for 2021.


Telemedicine Boot Camp: Physicians Get Trained for the Future of Remote Care - 11/12/2020

Thanks in large part to COVID-19, telemedicine has arrived. Where does it go from here? That was much of the focus of a Telehealth Virtual Bootcamp, an Aug. 29 presentation by the Telehealth Initiative that touched on technology, applications, and payment.


Allow Choice Between In-Person and Virtual Learning, TMA Tells School Leaders - 11/12/2020

Although face-to-face education is superior to virtual learning, the time isn’t right for school districts to “completely dismantle” remote schooling, the Texas Medical Association is telling state education leaders.