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Medicine Pushes For Expanding Medicaid Coverage to New Moms - 12/19/2019

Federal lawmakers must pass a bill that would allow states to provide 12 months postpartum coverage to mothers who lose Medicaid coverage two months after giving birth, and would provide a bump in Medicaid matching dollars for those states, medicine and others said in a letter this week.


Open Enrollment 2020: Be Prepared for Coverage Changes - 11/13/2019

You’re probably already aware that open enrollment for commercial health insurance plans, including those on the Affordable Care Act Exchanges, opened Nov. 1 and will run through Dec. 15. While some patients won’t make any changes to their coverage, others will make significant changes, including enrolling with a completely different health plan.


Texas Continues to Lead Nation in Uninsured Adults and Kids - 09/30/2019

As of 2018, 11.2% of Texas children younger than 19 were uninsured, up from 10.7% in 2017, according to data the Census Bureau released last week. All told, Texas has led the nation in uninsured residents over the past two years, Census data show.


The ACA Marketplace - 09/19/2019

Physicians find themselves in a land of confusion months after the debut of the Affordable Care Act health insurance marketplace. Pervasive problems with the exchange rollout, including enrollment delays and questionable health plan networks, disrupt physicians' office operations and affect patients' access to care.


Raise Taxes on Vape Products to Decrease Youth Usage - 04/09/2019

HB 4013 and HB 3364 would deposit tax revenues to the state’s general revenue fund, while HB 1144 directs tax revenues to the Children’s Health Insurance Program (CHIP). Evidence shows more smokers favor tobacco taxes when they are not a general revenue raising tool – in a study of current smokers, only 25% favored increasing taxes on cigarettes, but support climbed to 60% if taxes funded health care programs.


Where Do We Go From Here With Our Health Care System? - 03/04/2019

To say that Medicare works well, denies the fact that in many patients are no longer able to go to the doctor of their choice. In fact, even finding a doctor is difficult. Additionally, many doctors no longer participate in the Medicare program. This program is only one step away from a single payer health care system, which was once referred to as socialized medicine.


Feb. 27 Hotline: Physicians Urge State to Put $500 Million More Into Medicaid - 02/27/2019

Yesterday, the Texas Medical Association urged state budget writers to invest $500 million of general revenue in Medicaid to improve access to care in Texas.


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.


Section 10: Lift the Federal Regulatory Burden - 01/16/2019

TMA focuses most of its advocacy activities on the Texas Legislature and state agencies and courts. Because the federal government plays such an outsize role in health care policy and programs, however, TMA also conducts extensive advocacy with the U.S. Congress and federal regulatory agencies. As on the state level, much of TMA’s work in Washington is intended to ensure physicians receive fair payment for the medical services they provide to patients, and to win relief from onerous government regulations.


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.


ACA Ruling An Opportunity to Improve Health Care Access - 12/19/2018

The Texas Medical Association believes a Texas federal judge’s recent ruling that the Affordable Care Act (ACA) is unconstitutional provides a bipartisan pathway to strengthen access to health care and provide coverage for the 4.5 million Texans without health care coverage.


Texas Medical Association Eager to Work Alongside Governor Abbott to Improve Access to Health Care in Texas - 12/18/2018

The Texas Medical Association (TMA) believes a Texas federal judge’s recent ruling that the Affordable Care Act (ACA) is unconstitutional provides a bipartisan pathway to strengthen access to health care and provide coverage for the 4.5 million Texans without health care overage.


Enrollment in Health Insurance Through the Marketplace After Implementation of the Affordable Care Act in Texas - 11/29/2018

The Journal — October 2016 Tex Med. 2016;112(10):e1. By Gordon Gong, MD, MS; Cassandra C. Huey, MS; Coleman Johnson, JD; Debra Curti, MEd, RHIA; and Billy U. Philips Jr, PhD, MPH Gordon Gong, MD, MS; Coleman Johnson, JD; Debra Curti, MEd, RHIA; and Billy U. Philips Jr, PhD, MPH, F. Marie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center, Lubbock, Texas; and Cassandra C. Huey, MS, F. Marie Hall Institute for Rural and Community Health, and Department of Human Development and Family Studies, College of Human Sciences, Texas Tech University, Lubbock, Texas.  Send correspondence to Billy U. Philips Jr, PhD, MPH, Executive Vice President and Director, The F. Marie Hall Institute for Rural and Community Health, Marie Hall Chair and Professor, Family and Community Medicine, Texas Tech University Health Sciences Center, Suite 2B440, 3601 4th St, MS 6232, Lubbock, TX 79430-6232; e-mail: billy.philips@ttuhsc.edu.  Abstract One ...


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.


Health Care Sharing Ministries Are Not Typical Health Insurance, Doctors Caution - 08/08/2018

TMA asked TDI to inform consumers that health care sharing ministries are not insurance. TMA also sought a response about ministries’ promoting themselves using PPO language. TDI responded that it would review TMA’s recommendation.


TMA Asks AMA to Stay Out of Affordable Care Act Suit - 06/20/2018

Leaders of the Texas Medical Association on Tuesday publicly objected to the American Medical Association’s plans to get involved in a high-profile federal lawsuit — filed in Texas — challenging the constitutionality of the Affordable Care Act.


Cleanup, Recovery Continue in Harvey-Affected Areas - 05/10/2018

Since Hurricane Harvey slammed the Texas Coast on Aug. 25, state agencies have deployed resources to the affected areas, health plans have made policy changes, millions of dollars have been raised through donations, and thousands of Texas physicians have put in extra time and effort to address the public health concerns.


TMA: CHIP Managed Care Plans Responsible for Out-of-Network Payments - 04/27/2018

Because federal law prohibits patients covered by the Children's Health Insurance Program (CHIP) from paying anything other than a copay, the state of Texas should require managed care organizations in CHIP to cover the costs for out-of-network physicians. That's the position TMA takes in a formal letter to the Texas Health and Human Services Commission.


Why Did I Get That Medical Bill? - 04/26/2018

A new epidemic has hit; call it "insurance illiteracy." Numerous studies (like this national research and this Texas study) show the public's growing lack of understanding of basic health insurance terms, such as "copay," "out-of-pocket expense," and "network." Reasons given for the problem include the addition of large numbers of people newly insured under the Affordable Care Act and the health insurance industry's growing array of confusing new products and cost-containment strategies.


Trump Signs Executive Order on Association Health Plans: “All Any of Us Can Do Now Is Wait” - 04/20/2018

Texas physicians could see a flood of new insurance plans — including some to cover themselves and their employees — under President Donald Trump's executive order that directs federal agencies to design lower-cost plans outside the Affordable Care Act.


Law Sheds Light on Industry Payments to Physicians - 04/17/2018

Later this year under the Physician Payments Sunshine Act, the Centers for Medicare & Medicaid Services will make public physician payments reported by manufacturers of drugs, medical devices, and biologicals that participate in federal health care programs.


When Patients Don’t Pay Their Premiums in the ACA Marketplace - 04/17/2018

Will physicians have to refund payments to an insurer if a patient who bought coverage from that insurer in the Affordable Care Act marketplace doesn’t pay his or her premiums?


CMS to Enforce Payment Transparency Law - 04/17/2018

The Centers for Medicare & Medicaid Services (CMS) will explain the provisions of the National Physician Payment Transparency Act, also known as the Open Payments Act or Sunshine Act, in a teleconference at 1:30 pm CDT on Wednesday, May 22. The act is part of the Patient Protection and Affordable Care Act and requires manufacturers of drugs, medical devices, and biologicals that participate in federal health care programs to annually report payments and items of value they give physicians and teaching hospitals.


Untested Waters - 04/17/2018

It got off to a really rough start, but the federal government launched the insurance marketplace under the Affordable Care Act (ACA) on Oct. 1. And physicians could encounter their own challenges if they are not vigilant in their business practices with the health plans in the marketplace that take effect Jan. 1, Texas Medical Association officials say. Topping the list is widespread physician uncertainty about whether having existing contracts with insurers means they're already included in an exchange network. Right after that is a federal rule that jeopardizes physician payments if patients with subsidized marketplace coverage don't pay their premiums. Exchange regulations give those patients three months to pay their premiums and allow health plans to deny or later recoup payments from doctors for services provided to patients who end up delinquent.


TMA to Congress: No Sneak Torts - 04/17/2018

The Texas Medical Association, the Texas Medical Liability Trust, and other liability insurers are asking Congress to make sure the Patient Protection and Affordable Care Act does not create new theories of liability or alter the rules governing medical professional liability lawsuits.