Related Stories

Submit 2020 Data Now to Avoid Medicare Pay Cut - 01/08/2021

If you participated in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), the window to submit data to the Centers for Medicare & Medicaid Services (CMS) opened Jan. 4 and closes March 31. The deadline to submit all claims under the Quality performance category is March 1.

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.

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.

TPHC Statement: Contact Tracing is Effective Scientific Tool to Combat COVID-19 - 06/05/2020

Statement by Texas Public Health Coalition Chair Jason V. Terk, MD, in response to recent questions about the State of Texas’ COVID-19 contact tracing program.

Disaster Liability - 05/18/2020

Expansion of the Good Samaritan law to volunteer health care professionals and sponsoring health care institutions for care, assistance, or advice provided during a disaster

The Power of Data: UTHealth Publishes Claims Statistics - 04/30/2020

After three years of work, the Center for Healthcare Data at McGovern Medical School at UTHealth is sharing part of its growing trove of numbers for data-driven discussions on many aspects of health care in Texas. The center doesn’t have all the answers. But its work under a federal certification from the Centers for Medicare & Medicaid Services (CMS) has resulted in valuable state and regional statistics that the center leaders believe provide food not only for thought, but also for policy.

Seeking a Measure of Reason: TMA Joins Collaborative to Standardize Quality Metrics - 03/31/2020

TMA joins collaborative seeking to identify and standardize quality metrics.

Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 03/31/2020

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.

CMS Postpones 2019 MIPS Reporting Deadline to April 30 - 03/23/2020

With a key deadline for clinicians in the Merit-Based Incentive Payment System approaching fast amid the COVID-19 pandemic, the Centers for Medicare & Medicaid Services is giving those clinicians a month of extra time to submit their data.

Submit 2019 QPP Data by March 31 to Avoid a 7% Medicare Payment Cut - 03/02/2020

The data submission period for Medicare’s 2019 Quality Payment Program (QPP) is under way and closes on March 31. If you haven’t started the process, now is the time to ensure your data for the Merit-Based Incentive Payment System (MIPS) is in order and submit it in time to make corrections by the deadline, if needed.

TPHC Praises Bill to Make State College Campuses and Offices Tobacco-Free - 02/20/2020

Statement by Eduardo Sanchez, MD, chair of the Texas Public Health Coalition and former Texas commissioner of health, in support of legislation filed to make Texas state college campuses and state agencies tobacco-free.

Texas Physicians Propose Mass Violence Prevention Strategies - 02/03/2020

How should Texas address the incidents of mass violence that have rocked the state in recent years? Physicians laid out medicine’s priorities before a special committee of the Texas House of Representatives late last week.

Supporting Fair APM Payments: AMA Backs Accounting for Social Determinants of Health - 01/02/2020

Alternative payment models (APMs) are considered a key part of the future of value-based care. But for them to be successful, the American Medical Association says, APMs need to be fair, which means adjusting for the circumstances that make physicians’ cost and care challenges unique.

Section 7: Invest in Public Health and Behavioral Health - 12/04/2019

The phrase “public health” elicits numerous images: first responders at a natural disaster, disease detectives peering through microscopes, posters, videos and flyers urging parents to vaccinate their children against deadly diseases, anti-smoking campaigns. Public health is all of this and more. It’s state and local government agencies, and individual physicians, working to detect, respond to, and prevent what’s bad for the health of Texans.

Out of Physicians' Hands: TMA Challenges Unfair Quality Measures on Medication Adherence - 12/04/2019

Only patients can pick up their own prescriptions, and only patients can propel that medication into their own bodies. Physicians can educate, emphasize, and admonish – but at the end of the day, they can’t restrain and “pill” a squirming, uncooperative patient like a dog or cat. It’s up to patients to do the right thing for themselves. Yet, some health plans’ quality programs are putting that onus on physicians – through medication adherence metrics that determine whether physicians and accountable care organizations (ACOs) in value-based contracts receive bonus payments.

AMA House Punts on Texas Plan to Fix QPP - 11/20/2019

A decision on whether the American Medical Association (AMA) will join the Texas Medical Association’s call for major changes to Medicare’s Quality Payment Program (QPP) will have to wait a few more months, the AMA House of Delegates decided at its annual meeting in Chicago last week. The QPP overhaul was just one of 11 resolutions the Texas delegation to the AMA took to the five-day meeting. Most of the other 10 received a very warm welcome.

More Pain for Small Shops? 2020 Quality Program Rule Could Mean More Penalties - 10/01/2019

Small and solo practices already take the worst of the administrative and financial pounding the Quality Payment Program (QPP) dishes out each year. In the Texas Medical Association’s analysis, the government’s plans for the QPP in 2020 would make the situation even harder on those smaller shops. Since QPP’s birth in 2017, small practices have struggled with the demands and synapse-straining complexities of the program’s Merit-Based Incentive Payment System (MIPS). And TMA analysis shows the payment penalties those “have-not” practices incur fund the bonus payments earned by MIPS “haves” – often, larger practices with the resources to make the program work. Under the 2020 changes that the Centers for Medicare & Medicaid Services (CMS) has proposed, the maximum penalties for practices who don’t hit their MIPS targets will be larger than ever. But TMA’s review shows that MIPS – despite CMS’ claims to the contrary – isn’t getting any simpler.

Prepare for Disasters with TMA’s Help - 09/24/2019

Tropical Depression Imelda deluged parts of Southeast Texas late last week, serving as an all-too-real reminder of the devastation that natural disasters can cause. Whether you or your practice have been directly affected by the storm, or if you are caring for patients who have been, look to the Texas Medical Association’s Disaster Preparedness and Response Resource Center for up-to-date information and tools.

File Your MIPS Targeted Review Request by Sept. 30 - 09/18/2019

Physicians have two weeks to file a targeted review request to appeal errors in their 2018 Merit-Based Incentive Payment System (MIPS) performance feedback and 2020 Medicare payment adjustment under the Quality Payment Program (QPP).

Anybody There? Physicians Unfairly Penalized for AWOL Medicare Advantage Patients - 09/04/2019

You’ve tried and tried and tried. Phone calls, emails – nothing. A Medicare Advantage plan assigned you a patient who didn’t choose you, and the patient is driving that point home – by ignoring you. Or maybe the contact information the plan gave you is out of date, and the patient’s latest phone number or email is unknown. Either way, your as-yet-unseen patient is AWOL – and you can be penalized for it on health plans’ quality ratings, which ultimately can affect payments. New Texas Medical Association policy takes aim at the unfairness this lack of patient response can present for physicians, while opening up an opportunity for medicine to work with health plans to solve the problem.

Yes, You Do Have to Comply With a MIPS Audit Request - 08/14/2019

TMA finally received clarification from CMS: If you receive an Merit-based Incentive Payment System (MIPS) audit request for the 2017 and/or 2018 performance years, compliance is indeed mandatory, and there are possible punishments for noncompliance.

Unfair Playing Field? QPP Scoring May Hurt Physicians Not Hospital-Affiliated - 08/02/2019

As 2019 rolls on and physicians operate under new portions of the Merit-Based Incentive Payment System (MIPS), many physicians may face an even bigger disadvantage — simply by virtue of not billing the vast majority of their services at a hospital.

TMA to Congress: Undo Payment Freeze, Help Physicians With MACRA - 06/25/2019

Physicians participating in the Quality Payment Program’s Merit-Based Incentive Payment System and alternative payment models need help from Congress to succeed, and lawmakers need to undo an upcoming freeze on Medicare payments. That’s what the American Medical Association, the Texas Medical Association, and dozens of other medical societies told House of Representatives and Senate leaders in both parties in a letter sent last week.

Physicians Concerned Over State’s Inaccurate Death Reporting - 06/25/2019

Some Texas physicians are concerned that the state’s death statistics are not as accurate as they should be. Like in many states, Texas’ death reporting system feeds inconsistent information into the state’s vital statistics database. As a result, distorted death statistics inaccurately portray how people are dying, which could have negative public health implications.

Be On the Lookout for MIPS Audit Request - 06/25/2019

The Centers for Medicare & Medicaid Services has contracted with Guidehouse, a nationwide consulting firm, to audit physicians who participate in the Merit-Based Incentive Program, which is under the Quality Payment Program. If you submitted MIPS data for 2017 and/or 2018, you could receive a request for information via email or certified letter from Guidehouse.