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Medical Futility Law Sustained - 08/02/2019

Court tosses out challenge to ethics committee review of end-of-life care.


Final Verdict? Case Tests Court's Ability to Overturn a Jury Verdict - 08/02/2019

It was an overwhelming, 12-0 verdict – a jury’s unanimous rejection of a negligence case against a Laredo physician. Then, a judge took that decision away and ordered a new trial – not because of jury misconduct, or any procedural stumble that usually negates a court decision. It was taken away, essentially, because the judge said so.


The Meaning of Monthly: Court Ruling Offers Hope on Pain Clinic Registrations - 08/02/2019

Physicians can encounter a web of confusion and unfairness when it comes to navigating the Texas Medical Board (TMB). A Travis County district court has given Texas physicians clarity and hope when it comes to certain medical board investigations. The court’s decision, if it holds up, establishes an important precedent for when physicians are required to register their facility as a pain management clinic.


Setting the Record Straight: Supreme Court Curtails TMB for Over-Sanctioning Physician - 08/02/2019

Eight years ago, when he experienced a rare patient death, McAllen family physician Ruben Aleman, MD, signed the death certificate the way Texas physicians had been doing it for years, and the only way he knew how: using pen and paper. That resulted in the Texas Medical Board (TMB) not only coming after him, but accusing him of “unprofessional or dishonorable conduct that is likely to deceive or defraud the public” – words found in the state Medical Practice Act. The Texas Supreme Court recently decided that was an overreach for a physician who simply hadn’t signed up on the state’s electronic death registration system, which at the time was relatively new.


Breaking Up Is Hard to Do: Physicians Can Get Subpoenaed in Divorce Cases - 03/11/2019

Physicians subpoenaed to participate in a divorce case, whether to testify or simply to supply medical records to the court, could find themselves at the center of an acrimonious split. There are certain things they should know.


The Right to Fight: Attorney-Client Protections for Physicians and Other Professionals Under Threat - 03/05/2019

The Texas Medical Association is asking the Texas Supreme Court to make sure physicians can maintain the right to keep attorney-client communications private when doctors testify as experts in their own cases.


The Risk of Speaking Up - 02/04/2019

Whistleblowing may be ethical, but physician protections for it could stand to improve.


Section 3: Hold Health Insurers Accountable - 01/30/2019

Beaumont anesthesiologist Ray Callas, MD, is tired of beating his head against the wall trying to get “in-network” with health insurance companies. And he’s tired of the surprise bills his patients receive when he can’t get in.  


“A Threat to All Texas Physicians:” TMA Backs Surgeon in Defamation Suit - 01/02/2019

Miguel Gomez, MD’s well-publicized legal fight isn’t over yet. In its latest turn, the Texas Medical Association is still standing behind the surgeon as he fights to uphold a verdict against one of the state’s largest nonprofit hospital systems for defaming him.


Court Sides With Medical Examiner in Suit Over Autopsy - 12/21/2018

With the Texas Medical Association’s help, a Harris County medical examiner has won the latest battle in a lawsuit over an autopsy he performed following a woman’s 2007 shooting death.


Legal Examination: Case Tests Lawsuit Immunity For Medical Examiners - 12/21/2018

Case tests lawsuit immunity for medical examiners.


Office Cleaners Clean Up on Patient Files - 07/10/2018

Two Austin men now face federal prison sentences after pleading guilty to conspiracy to commit fraud, and two others are still wanted as part of an identity theft ring, according to a recent statement from the U.S. Attorney’s Office for the Western District of Texas. Their targets: patient files lifted when they worked for an office cleaning company that serviced medical practices.


High Court Decision in Nondisclosure Case A Win For Medicine - 06/20/2018

The Texas Supreme Court sided with the Texas Medical Association in a nondisclosure case that TMA warned would have significant, troubling implications had it gone the wrong way.


TMA Supports Bill to Improve Balance-Bill Mediation - 04/27/2018

Balance or “Surprise bills” may occur when a person insured under a preferred provider organization (PPO) unexpectedly receives services out of network. The mediation process for out-of-network billing is working well in the state of Texas and has been a tremendous patient protection with the narrowing of insurance networks. We have seen growth in the utilization of the mediation process grow from 14 requests in 2010, to 1,677 requests in 2016. Therefore, TMA is supportive of its expansion to all out-of-network health care providers at an in-network facility along with emergency care.  Additionally, we are pleased to see that the legislation maintains the $500 threshold as well as personal responsibility of the patient.


TMA Offers Remedies to Ease Surprise Billing - 04/27/2018

Texas patients sometimes feel the pain from unexpected out-of-pocket costs not covered by their health insurance, known as “surprise billing” or “balance billing.” The Texas Medical Association (TMA) is taking aim at the problem, which occurs when a health insurance company pays less than what a doctor charges, leaving the patient to pay the balance of the bill.


Transparency in Out-of-Network Payments Needed - 04/27/2018

Since the health plan’s contract or agreement is with the enrollee, we hope health plans don’t use the same argument, saying, “It’s proprietary” to circumvent the spirit of this legislation when their own enrollees make the same inquiry about the out-of-network payment methodology.


Texas Physicians Offer Legislators Fix for Surprise Billing Problem - 04/27/2018

The Texas Medical Association (TMA) and its physician members recognize surprise medical billing is a problem, and are offering lawmakers solutions that address the root causes. Physicians point to a confusing health insurance system they say leaves policyholders/patients too-often unaware, subject to unexpected out-of-pocket costs, inadequate coverage, and physicians frustrated by limited access to patients and their health plan networks.


Balance-Billing Ban Back in 2015 Legislature - 04/27/2018

Renewed attention in the 2015 Texas Legislative over balance billing stems in part from interim charges that tasked the Senate State Affairs and House Insurance committees to look at whether existing laws dating back to 2007 are working to inform patients ahead of time when out-of-network physicians might balance-bill them for services their health plans don't fully cover. The issue is in the national spotlight, too, with the proliferation of high-deductible and narrow-network plans sold in the Accountable Care Act insurance marketplace. New federal rules take aim at ACA plans' inadequate networks and inaccurate physician and hospital directories. The Texas Medical Association is pushing for similar health plan accountability measures at the state level, with a careful eye on legislation that could restrict out-of-network physicians' ability to balance-bill for services they legitimately provide.


Capitol Success - 04/26/2018

This legislative session, medicine resolved to ensure physicians can give their patients the best care possible. The hard work paid off in significant victories that largely build on the Texas Medical Association's 2013 legislative successes.


AMA Analyzes Potential Aetna-Humana, Anthem-Cigna Mergers - 04/17/2018

The combined impact of proposed mergers among four of the nation's largest health insurance companies would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within Texas and 16 other states, according to new special analyses of commercial health insurance markets issued by the American Medical Association.


Bill Would Address Inaccurate Insurance Directories - 04/17/2018

With modern technology, there should be no issue in business daily updates to a health plan’s online provider directory.


TMA Seeks New Standards for Health Insurance Sold Across State Lines - 04/17/2018

The Texas Medical Association (TMA) is pushing for national consensus on standards to protect consumers who purchase health insurance across state lines.


“Hey, Doc,” TMA’s Education Campaign, Returns - 03/14/2018

“Hey, Doc” is back to help Texas’ patients and reporters understand the 2015 Affordable Care Act (ACA) health insurance marketplace. Open enrollment begins Nov. 15.


“Hey, Doc,” who must enroll in the marketplace? - 03/14/2018

Enrollment for the health insurance marketplace begins in three days — Nov. 15. Texas physicians want to ensure you have the information you need to start the enrollment process. They week’s “Hey, Doc” segments discuss who must enroll for health insurance and possible penalties for those who decide not to purchase insurance.  


“Hey, Doc” Answers Questions About the ACA Marketplace - 03/14/2018

Enrollment for the Affordable Care Act's health insurance marketplace opened last week. Texas physicians want to make sure patients have all the information they need to make informed decisions when purchasing their insurance coverage, so this week's "Hey, Doc" info segment answers some frequently asked questions about health insurance.