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TMA Cheers Appellate Court Ruling in Third NSA Lawsuit - 06/03/2025

Statement by Texas Medical Association (TMA) President Jayesh "Jay" Shah, MD, in response to Friday's order by the U.S. Court of Appeals for the 5th Circuit granting TMA’s petition for rehearing en banc in TMA’s third No Surprises Act (NSA) lawsuit, which vacates the circuit panel’s Oct. 30, 2024 opinion and will result in a hearing by the full panel of judges at a later date.

TMA’s First 2025 Legislative Victory Protects Sensitive Test Results - 05/23/2025

Gov. Greg Abbott signed TMA’s first victory of the 2025 legislative session to allow physicians a way to communicate to their patients receive serious or sensitive test results in a supportive manner rather than via electronic patient portals. Texas physicians will still need to comply with information blocking provisions after the three-day pause.

TMA Preserves Technology’s “Human Element” with New EHR, AI Policies - 05/21/2025

Texas physicians unanimously adopted new TMA policy advocating for EHR-generated health care forms, circumventing lengthy manual processes and unnecessary expenses placed upon physician practices. Also adopted: new policy that strengthens TMA’s efforts to stay abreast of AI advancements.

TMA Forges New Policies on Same-Day Services, Patient Attribution in Value-Based Care - 05/16/2025

The house adopted several other payment-related policies as well, all emerging from ongoing physician frustration with payer practices that hinder patient care.

Insurance Bill Undermining Patient, Physician Protections Heads to House - 05/13/2025

A top target for TMA, House Bill 139 would create a new “employer choice of benefit” health plan exempt from decades’ worth of insurance laws that promise a minimum set of coverage, prompt pay, prior authorization restraints, and other guardrails. Other bad bills with serious consequences for practices also top TMA’s opposition list.

HHS Establishes Information-Blocking Disincentives for Clinicians - 05/01/2025

The U.S. Department of Health and Human Services released a final rule that aims to hold health care professionals, including physicians, accountable for information blocking as determined by the HHS Office of Inspector General.

Top Technology Recommendations Align with TMA Policy, Education - 04/29/2025

TMA technology staff attended a regional meeting of a nationwide cybersecurity coalition comprised of 450 other health care organizations, including the American Medical Association, to learn about emerging technology trends in medicine and how to reduce harm to physician practices.

Prior Authorization Fuels Physician Burnout, Decreases Access to Care, AMA Survey Finds - 04/03/2025

Prior authorization continues to intensify physician burnout, increase health care costs, and limit patients’ access to care, per AMA. Meanwhile, TMA advocates against health plans’ use of artificial intelligence in the prior auth process and aims to reduce its burden on physicians.   

I Never Knew TMA: Had AI Experts on its HIT Committee - 03/31/2025

TMA’s HIT Committee stands among nine councils and 18 standing committees that channel physician expertise to influence policy and programs that support Texas patients and physicians and provide solutions to the challenges they encounter.

Panel Makes Big Change in Draft Federal Surprise Billing Law - 03/18/2025

Thanks to incessant lobbying from physicians, hospitals, organized medicine, and the Physicians Advocacy Institute, a key congressional committee today made significant revisions in a bill to reduce the strain of surprise billing on patients. “This certainly sounds like an improvement,” said Texas Medical Association President David Fleeger, MD, “but the devil will be in the details.”

Proposed Cybersecurity Rule Changes Create Undue Burden, TMA Warns Feds - 03/18/2025

The proposal recommends sweeping, significant revisions to established standards for patient health information, but may overstep its reach and create financial pressure physicians can’t afford.

20 Everyday HIPAA Tips - 03/17/2025

 The goal of HIPAA is to make sure the protected health information you are responsible for or come into contact with remains confidential, secure, and available when you need it. Here are basic steps every practice can take to help make this happen.  

BCBSTX Reprocessing Flu Testing Claims Following Incorrect Denials - 03/03/2025

Blue Cross and Blue Shield of Texas (BCBSTX) is reprocessing certain claims filed between Jan. 1 and Feb. 13, the payer told TMA’s Physician Payment Resource Center. Physicians should continue to review claims to ensure they are correctly reprocessed.

TDI Eases Prior Authorization Request Process for Prescription Renewals - 02/28/2025

After a three-year effort, the Texas Medical Association recently secured a form change that allows physicians to bypass the most onerous part of prior authorization requests when renewing an existing prescription.

TMA Seeks Prior Authorization Reform This Legislative Session - 02/13/2025

The Texas Medical Association (TMA) seeks to cut health insurers’ burdensome delays and denials of patients’ care this legislative session.

Aetna Reverses NPP Payment Reduction Under Incident-To Billing - 02/12/2025

Aetna previously intended to pay nonphysician practitioners (NPPs) 85% of the allowable amount, regardless of whether they billed directly or “incident-to” a physician’s diagnosis and treatment. Meanwhile, the payer upholds a new credentialing requirement.

More Than One in Five Claims Denied in Texas by Non-Group Qualified Health Plans - 02/11/2025

A study of health plans available through HealthCare.gov in 2023 shows one in five claims nationwide were denied – with Texas ranking among the top five states for in-network denials.

Landmark Antitrust Settlement in BCBS Case Granted Preliminary Approval - 01/09/2025

Physicians can now file a claim in a $2.8 billion settlement fund given preliminary approval by a U.S. District Court involving Blue Cross Blue Shield. The final verdict is expected in July.

TMA’s Top Legislative Priorities: Expand Access to Care with Telemedicine Payment Parity - 12/31/2024

TMA supports improving access to high-quality, physician-led telemedicine care that is covered at the same rate as in-person visits.

Ask “Dr. ChatGPT”: What Physicians Should Know About AI - 12/20/2024

Health care adviser Harvey Castro, MD, details what physicians should know about artificial intelligence.

TMA Develops New AI Education - 12/20/2024

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.

Executive Order Requires Safe, Secure Use of AI in Health Care - 12/20/2024

President Joe Biden signed an executive order Oct. 30 establishing new standards for the safe and secure use of artificial intelligence via federal oversight across different sectors, including health care.

Feds Require AI Transparency, Define Info-Blocking Exceptions - 12/20/2024

First-of-their-kind transparency regulations established by the U.S. Department of Health and Human Services aim to help physicians determine the safety of artificial intelligence technology. The new rule also established a new information blocking exception and implemented a 21st Century Cures Act requirement for health IT developers. Read more.

Putting the AI in Paid: Payer Use of Artificial Intelligence Sparks Physician Concerns - 12/20/2024

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.

Protect Patients From Inadequate, Narrow Networks - 11/18/2024

In an out-of-network surprise billing situation, the patient and the insurer have a contractual agreement. The physician and insurer do not. As a result, when we remove the patient from the claims settlement process, the insurer has little market accountability unless additional statutory protections are created.