Related Stories

New Federal Rules Limit Short-Term Insurance Plans, Enhance Protections - 04/17/2024

Following advocacy by the Texas Medical Association, the U.S. departments of Health and Human Services, Labor, and the Treasury recently issued final rules that strengthen consumer protections related to short term, limited duration insurance.

TMA Pushes for Prior Authorization Limits, Clarity - 04/16/2024

After hearing story after story of delays and denials, the Texas Medical Association is pushing the Texas Legislature to sign off on measures that would significantly curb insurers’ ability to require prior authorization on needed care, as well as clarify for both physicians and patients what it means when prior authorization is required.

Cigna Launches Digital Newsroom for Payer Updates - 04/12/2024

Physicians and practice staff looking for updates from one of Texas’ major payers, Cigna Healthcare, can now refer to the company’s new digital newsroom.

TMA Moment in Time: Texas' First PPO Rules - 04/09/2024

TMA fought to ensure fair regulation of PPOs, which now dominate the health plan market.

TMA to IRS: Direct Primary Care, Health Care-Sharing Ministries Aren’t Insurance - 04/05/2024

The Texas Medical Association is urging the IRS to reconsider a proposed rule that would classify direct primary care (DPC) arrangements and health care-sharing ministries (HSMs) as insurance.

TMA Sues Feds Over Unfair Rule for Surprise Billing Law - 03/22/2024

The Texas Medical Association filed a lawsuit in federal district court in Tyler, Texas, after the Biden administration failed to follow clear direction from Congress about how to implement the dispute resolution process set forth in the No Surprises Act, legislation that was passed in 2020 to protect patients from surprise medical bills.

TDI Proposed Rules for State Network Adequacy Law Raise Strong Concerns - 03/20/2024

After securing network adequacy reform during the 2023 regular state legislative session, the Texas Medical Association has shifted its focus to ensuring the Texas Department of Insurance’s network adequacy rules conform to the plain language and intent of the law.

Power Data: Texas' Claims Database Will Help Clarify Care Costs - 03/15/2024

Texas is building an all-payer claims database, which will provide a clearer view of opaque health care costs.

TMA Develops New AI Education - 03/10/2024

Responding to significant interest from members after a 2023 standing-room-only TexMed event, the Texas Medical Association has developed a free webinar for members to learn how to integrate augmented or artificial intelligence technology, including ChatGPT, into patient care.

Find Other CME - 02/29/2024

Check out other CME offerings from around the state.

May Owen, MD, Outreach Program Funds Women Physician Programs, Activities - 02/26/2024

To partner with small and mid-sized county medical societies to provide women physicians with programming and activities at the local level, the Texas Medical Association’s Women Physicians Section has established the May Owen, MD, Outreach Program.

TexMed 2024 CME Submissions Are Open - 01/11/2024

Have an educational topic in mind to be considered for TexMed 2024, taking place at the Omni Dallas, May 2-4, 2024?

Physicians’ DEA Registration Now Requires Training on Substance Use Disorder - 01/03/2024

Physicians who must register or renew their registration for a Drug Enforcement Administration license will face a new requirement as of June 27: To register, they will have attest to taking a one-time, eight-hour training on how to treat patients with opioid or other substance use disorders.

Comprehensive Prior Authorization Reforms Needed, Medicine Tells Feds - 11/30/2023

As the Centers for Medicare & Medicaid Services (CMS) seeks ways to relieve the burdens of prior authorization on health care, it should not rely solely on automation of electronic health records. Instead, CMS should seek comprehensive reforms that include transparent PA requirements and protections of continuity of care as well as automation, the Texas Medical Association, American Medical Association, and a host of other medical societies wrote in a letter to CMS Administrator Seema Verma last week.

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.

New CME! Talk to Parents About Vaccine-Preventable Diseases - 09/06/2023

Talking to parents about vaccines can be challenging, especially with the anti-vaccine movement, and the COVID-19 pandemic has caused a decline in childhood vaccinations across the country. That’s why the Texas Medical Association has created a CME course to better prepare you for these conversations.

Humana Claims Issues Require Resubmission Due to Technical Error - 09/01/2023

Practices that used Mimecast's secure message portal to submit claims issues, questions, or appeals to Humana between July 17 and Aug. 28 will need to resubmit those reports due to a technical error.

Business of Medicine Conference Offers More – And More Practical – Educational Programming - 08/31/2023

With an eye toward equipping physicians to navigate the modern medical practice landscape, the Texas Medical Association’s inaugural Business of Medicine conference in October offers more than triple the amount of educational content compared with last year’s counterpart, Fall Conference.

TMA Wins Fourth Lawsuit Challenging Payment Calculations in Surprise Billing Arbitration - 08/28/2023

Marking a fourth victory for the Texas Medical Association in as many lawsuits, a court 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.

TMA Welcomes New Court Ruling in NSA Lawsuit - 08/25/2023

Statement by Rick W. Snyder II, MD, Texas Medical Association (TMA) president, in response to the ruling by the U.S. District Court for the Eastern District of Texas regarding TMA’s third No Surprises Act (NSA) lawsuit.

TMA Resumes In-Person Meetings with Major Texas Payers - 08/25/2023

After a pandemic-induced hiatus, the Texas Medical Association recently resumed in-person meetings with Texas’ major payers to solve physicians’ payment policy problems, a practice that dates back more than 25 years.

CMS to Recoup Chronic Care Management Payments - 08/21/2023

Some Texas physicians and outpatient facilities might have to refund payments they received for chronic care management services performed during 2015 and 2016 under the Medicare Physician Fee Schedule, federal officials said.

Report: Most Private Payers Have Stopped COVID Cost-Sharing Waivers - 08/21/2023

Private health insurance plans have largely stopped waiving patient cost-sharing for COVID-19 treatment, according to a recent report by the Peterson Center on Healthcare and Kaiser Family Foundation. The data represent an overwhelming shift from payer cost-sharing policies during 2020 as indicated by previous research.

United Will Eliminate Prior Authorization Requirements for Certain Procedures - 08/11/2023

Physicians have long complained about onerous prior authorization requirements, which often delay care and sometimes have catastrophic consequences. One payer seems to be listening.

Court Delivers TMA Win Against Fee Hike, Batching in Surprise Billing Arbitration - 08/10/2023

The court struck down a 600% administrative fee increase and certain unfair rules that narrowed the law’s provisions on combining or “batching” surprise-billing arbitration claims. The decision is one of several victories TMA has won against federal regulators tasked with implementing the federal No Surprises Act.