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The Math of Medicare for All - 01/09/2020

With two of the current top Democratic candidates – Sens. Bernie Sanders (I-Vermont) and Elizabeth Warren (D-Massachusetts) – espousing Medicare for All, supporters and detractors alike are asking more in-depth questions about the proposal, particularly how much it will cost.


Use New Medicare IDs to Avoid Rejected Claims - 01/07/2020

Your Medicare patients have ditched their old Medicare ID numbers. It’s high time you do, too, to avoid unpaid claims in the new year. Starting Jan. 1, Medicare beneficiary identifiers (MBIs) replace patients’ old Social Security number-based health insurance claim numbers (HICNs). Novitas Solutions, the Medicare payer for Texas, will reject any claim submitted with a patient’s HICN, with a few exceptions. You will have to refile the claim with the patient’s MBI to get paid.


Medicare Sequestration Cuts, GPCI Floor Continue - 01/07/2020

As we begin 2020, it’s a good time to remember that several Medicare policies that affect physician payment remain in effect. Medicare sequestration, the federal government’s 2% across-the-board payment cut, will continue until further notice. In addition, Medicare’s 1.0 floor for the Geographic Practice Cost Indices (GPCI) has been extended temporarily, once again, to May 23.


Physicians Needed for Medicaid Managed Care Advisory Panel - 12/19/2019

The Texas Health and Human Services Commission (HHSC) is accepting applications for its State Medicaid Managed Care Advisory Committee. The panel advises HHSC on Medicaid managed care operations statewide.


Apply by Dec. 31 for MIPS Reporting Exceptions - 12/17/2019

Did your practice face an unusual extreme hardship this year? Do you practice in a rural area with poor internet connectivity? If so, you could qualify for an exception to the Merit-Based Incentive Payment System (MIPS) reporting requirements for the 2019 performance year. The application deadline is Dec. 31.


Help Medicaid Patients Keep Appointments With Free Rides - 12/11/2019

If your Medicaid patient has trouble keeping his or her appointments with your office due to lack of transportation or gas money, be sure the patient knows how to seek help from Medicaid.


TMA to Lawmakers: Stop Proposed Medicare Changes - 12/06/2019

Federal lawmakers must hold hearings immediately to stop proposed changes to Medicare that would cause lasting and serious damage to the program and to health care in the United States, Texas Medical Association President Douglas Curran, MD, told two key Texas congressmen today.


Far-Reaching Implications: The Ripple Effects of Texas' Uninsured Rate - 12/04/2019

Data compiled by the Texas Medical Association and other organizations, as well as physicians’ own anecdotal experiences, show how 5 million uninsured patients in Texas become 5 million dominoes. As they fall, so do countless others representing the health of Texas: The economy and well-being of entire communities. The classmates and friends of uninsured children. And yes, the physicians who deal with the burdens of treating uninsured patients in emergency rooms and providing uncompensated care.


New Help to Get Paid for CCM Services - 12/02/2019

A new initiative aims to raise awareness of the benefits of chronic care management (CCM) services for Medicare patients with multiple chronic conditions and to support physicians in starting CCM programs.


Chronic Care Management’s Five Codes: Know Which to Use - 11/22/2019

Q. If I provide more than 20 minutes of chronic care management (CCM) services to my Medicare patient, can I bill more than one unit or more than one line item of CPT 99490 in the service period to account.


Don't Miss Out! Medicare Pays for Chronic Care Management - 11/22/2019

Do you manage patient referrals and care transitions between and among physicians and health care settings? Do you spend time reconciling medication lists and managing prescription refills for your patients? Do you take calls during and after office hours to address patient care needs? If the answer is yes and you're not billing for these types of services, you're missing out on a new CPT code and practice revenue opportunity from Medicare.


Can We Contract Out Chronic Care Management Services? - 11/22/2019

Under the Medicare Chronic Care Management (CCM) Services program, can my practice subcontract CCM services to a case management company?


Is Medicare’s Chronic Care Management Program for You? - 11/22/2019

Interested in the possibility of getting paid as much as $75,000, or even more, for something you already more or less do? Medicare now pays separately for chronic care management services. To help you decide if this new opportunity is right for your practice, TMA created a new online resource center.


Chronic Care Management: The Patient Agreement - 11/22/2019

Securing a patient’s informed and written consent is an important part of the Medicare Chronic Care Management Services program. Medicare requires it, and you’ll be sure your patients understand how it works.


AMA House Rejects MIPS Plan - 11/20/2019

Led by the Texas delegation, the American Medical Association House of Delegates on Tuesday rejected as inadequate a plan to improve Medicare’s Quality Payment Program (QPP) and its highly-flawed Merit-Based Incentive Payment System (MIPS) track.


“Patient Privacy Must Be Protected,” TMA Says in Response to Ascension-Google Partnership - 11/14/2019

Protecting sensitive patient health information should remain a top priority as technology and health care continue to intersect, Texas Medical Association President David C. Fleeger, MD, said Thursday in response to a partnership between Google and Ascension health system.


The Uninsured in Texas Quick Links - 11/13/2019

The Uninsured in Texas Quick Links


Do Your Security Risk Assessment Before Dec. 31 - 11/13/2019

If you participate in the Medicare Merit-Based Incentive Payment System (MIPS), conducting or updating a risk assessment is a requirement in the Promoting Interoperability category. In order to meet the 2019 performance year requirements, you must complete your security risk assessment by Dec. 31. This is not an optional measure. Thankfully, an upgraded tool from the U.S. Department of Health and Human Services (HHS) might make the assessment easier.


Learn The ABCs of the QPP With Free CME - 11/12/2019

The Texas Medical Association has heard from physicians who are just now tuning in to the 2019 Quality Payment Program (QPP) and don’t know where to begin to avoid the 7% Medicare payment penalty in 2021.


Big Noises Big Issues: Health Care Takes Center Stage One Year Out From 2020 Election - 11/11/2019

One year from now, Texas voters will hit the polls. They’ll be voting for president, for Congress, and for seats in the Texas Legislature. At the state and national levels, health coverage, Medicaid access, and prescription drug costs have gotten plenty of attention already, and they’ll get plenty more between now and the closing of the polls on Nov. 3, 2020. Here’s a look at some of the major health care debates taking center stage during the 2020 election cycle, what voters are and will be hearing about, and what Texas Medical Association policy says on those particular issues.


20 Everyday HIPAA Tips to Help You Stay Compliant - 11/11/2019

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.


20 Everyday HIPAA Tips - 11/11/2019

 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.  


TMA PracticeEdge ACOs Tops for State, National Medicare Savings - 11/11/2019

Three accountable care organizations formed through TMA PracticeEdge were among state and national leaders in generating Medicare savings during the 2018 Medicare Shared Savings Program performance year.


Get Details About Your 5% Medicare Bonus - 11/05/2019

If you participated in the advanced alternative payment model (APM) track during the 2017 Quality Payment Program (QPP) performance year, full details of your 5% APM incentive payment are finally available.


CMS Finalizes Changes to QPP, Medicare Fee Schedule - 11/04/2019

Changes to Medicare’s Quality Payment Program (QPP) finalized Friday include both wins and losses for medicine, according to Texas Medical Association staff's initial analysis of the QPP final rule for 2020.