Related Stories

CMS to Test Prior Auth Requirements for Certain ASC Procedures - 04/10/2024

Texas physicians soon may encounter new Medicare prior authorization requirements for certain services that double as cosmetic procedures when provided at an ambulatory surgical center.

Shielding the Gold Card Law: TMA Fights to Guarantee Gold Card is Implemented as Intended - 04/09/2024

Texans earned one of its most prolific victories with its prior auth exemption law but still fights to guarantee it's implemented as intended.

TMA Moment In Time: Pandemic Response - 04/09/2024

The strength of organized medicine carried TMA and Texas physicians through an unprecedented public health crisis and beyond.

New Law Prohibits Employer COVID-19 Vaccine Mandates, With Exceptions - 02/28/2024

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.

New Poster Encourages Flu Vaccination Amid COVID-19 - 02/28/2024

“COVID-19 is here, but so is the flu.” That is the message of a new downloadable poster available from the Texas Medical Association’s Be Wise – Immunize program to help you stress the need for flu vaccination, this year more than ever.

Prior Auth Processes to Streamline Under Medicare Advantage, Other Federal Programs - 01/23/2024

Physicians who care for patients enrolled in federal health plans can expect shorter prior authorization response times and other process improvements in coming years, thanks to longstanding advocacy by the Texas Medical Association and others in organized medicine.

No Prior Auth Required for Generic Asthma Meds Following Medicaid Formulary Change - 12/19/2023

As of Dec. 15, physicians can prescribe generic asthma medications previously listed as non-preferred on the Medicaid preferred drug list without needing prior authorization.

Send TMA Your Prior Authorization Nightmare Stories - 12/11/2023

Arbitrary. Confusing. Frustrating. Never-ending. Maddening. Those are some of the terms we can actually print that describe physicians’ experience with insurance companies’ prior authorization requirements and approval processes.

FDA Approves New RSV Vaccine, COVID-19 Booster - 10/19/2023

Physicians will have a new vaccine in their arsenal to help protect against respiratory syncytial virus (RSV), a timely development as cold, flu, and COVID-19 illnesses tend to converge and ramp up this time of year and become difficult to differentiate.

Leading in Crisis: Diana L. Fite, MD, Carried TMA During COVID-19 Pandemic - 10/03/2023

Diana L. Fite, MD, carried TMA during the height of the COVID-19 pandemic.

Urge Texans to Get Flu Vaccine Early, Officials Say - 09/06/2023

With flu season on the horizon – and the COVID-19 pandemic expected to continue – Texas physicians should strongly encourage patients to receive a flu vaccination as early as possible.

Talk to Patients About: Breakthrough Infections for COVID-19 Vaccinations - 09/06/2023

 The new mRNA vaccines for COVID-19 are highly effective at giving people immunity against the disease. But as with all other vaccines, that immunity is not 100% for everyone who receives them.  

Tune in Saturday to Watch TMA’s 155th President Take Office - 08/31/2023

Although TexMed 2020 has been canceled, and the Texas Medical Association House of Delegates meeting has been suspended, Diana L. Fite, MD, still will take office as TMA’s 155th president Saturday. Visit TMA’s Facebook page at noon Saturday to watch a live broadcast of her installation and address.

TMA Suspends 2020 House of Delegates Meeting - 08/31/2023

Because of the evolving COVID-19 pandemic, the Texas Medical Association Board of Trustees has voted to suspend the 2020 TMA House of Delegates meeting, either virtual or in-person, until an appropriate time in the future when the crisis has subsided.

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.

Federal Prior Auth Bill Filed in Congress - 07/25/2023

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.

COVID-19: Telemedicine - 07/20/2023

View COVID-19 resources related to Telemedicine.

Public Health Emergency’s End Would Kickstart Medicaid Eligibility Re-Checks. Here’s How to Prepare - 07/17/2023

After strong advocacy by the American Medical Association and other organizations, the U.S. Department of Health and Human Services appears poised to extend the COVID-19 public health emergency for a 10th time.

UPDATE: Feds Poised to Extend COVID-19 Public Health Emergency Through Spring 2023 - 07/17/2023

After continued advocacy by the Texas Medical Association, American Medical Association, and other organizations, the U.S. Department of Health and Human Services seems likely to extend the COVID-19 public health emergency  for an 11th time.

Novavax COVID Vaccine Available to Help Reach Patients Hesitant About mRNA Vaccines - 07/17/2023

The recently introduced COVID-19 vaccine Novavax gives physicians another tool for combating the disease, and it enjoys two important differences from previous vaccines that are potential advantages, says San Antonio infectious disease specialist Charles Lerner, MD, a member of the Texas Medical Association’s COVID-19 Task Force.

PHE End Brings Changes for Telehealth, Billing, and Medicaid - 06/26/2023

The federal public health emergency related to COVID-19 will end May 11 – and with it, several flexibilities related to telehealth coverage, virtual physician supervision of nonphysician practitioners, and Medicaid enrollment for nearly 3 million Texans.

Physician-Led Results: Insurance - 06/21/2023

TMA can count several insurance-related legislative wins this session, including an additional prior authorization reform for vulnerable patients and new protections against bad health plan practices for patients and physicians alike.

United Ties New “Advance Notification” of GI Procedures to Gold-Carding - 06/12/2023

Rather than go through with its controversial prior authorization policy for gastroenterology endoscopy procedures on June 1, UnitedHealthcare (UHC) announced an equally concerning “advanced notification” pilot program requiring early notification and the submission of substitute documentation for certain gastrointestinal procedures.

TMA Joins Fight Against Prior Auth for Gastroenterology Services - 05/15/2023

The Texas Medical Association joined roughly 200 national and state medical specialty societies, patient organizations, foundations, and physician groups in a widespread call urging UnitedHealthcare (UHC) to halt its nationwide policy requiring prior authorization for gastroenterology endoscopy services that take place on or after June 1.