Related Stories

Health Insurers Now Required to Post Comprehensive Price Data - 08/01/2022

Physicians, patients, and employers have long wondered whether they’re getting a fair shake from health insurers, whose prices have been clouded in secrecy – until now.


Pay Now or Pay Later? Supreme Court Adds Clarity Around Negligence Awards - 07/29/2022

Case by case, courts are clarifying a piece of Texas’ tort reform law that’s meant to keep physicians from paying part of a medical negligence award in one prohibitive and devastating gulp.


“Black Robes, Not White Coats”: Can Courts Compel Unproven Treatments? - 06/29/2022

COVID-19 patients and their families have involved judges and attorneys in an effort to compel physicians to treat the disease in unproven ways, against their medical judgment. And in some cases around the country, patients’ families have been successful in getting a court order to do so. The Texas Medical Association’s Committee on Patient-Physician Advocacy, while not directly involved in such cases, has a keen interest in making sure physicians can exercise their medical judgment.


Contract Do’s and Don’ts: How to Negotiate From a Place of Strength - 06/29/2022

By leaning on Texas Medical Association resources and their own health care attorney, physicians can gain confidence and better negotiate favorable terms to secure their economic success.


How to Start a Medical-Legal Partnership - 06/29/2022

Medical entities can join forces with legal entities to form medical-legal partnerships (MLPs), and these partnerships are helpful for patients whose conditions are worsened by social determinants of health.


Picking the Right Battles: TMA Stands Up for Medicine in the Courts - 06/29/2022

When a big point of legal contention arises – “big” meaning impactful for Texas physicians and their patients – the Texas Medical Association responds big. That’s been the case for decades, including in the courts. 


Cigna Delays Records Request Policy, Staving Off “Administrative Nightmare” - 06/29/2022

Cigna has delayed the implementation of a new billing policy after the Texas Medical Association and others in organized medicine pushed back, warning that it would have negative implications for physicians, practice staff, and patients.


Supreme Court Sides With Physician’s Push to Clear National Practitioner Data Bank Record - 06/14/2022

In a major victory for medicine, a Texas Supreme Court decision has paved the way for physicians exonerated of wrongdoing to fully clear their names in the National Practitioner Data Bank (NPDB), the federal clearinghouse that records certain adverse or disciplinary actions taken against health care workers.


Dulling the Pain of Future Damages: High Court Ruling Addresses Periodic Payments - 05/31/2022

Texas Supreme Court decision carries new implications for periodic payment of future medical expenses.


Cigna to Request Records for Certain Office Visits, Unleashing Possible “Administrative Nightmare” - 05/26/2022

Cigna recently began alerting physicians to a new billing policy that could have far-reaching consequences for Texas physicians, practice staff, and patients.


Turn to TMA to Resolve Insurance Hassles - 05/19/2022

If you or your practice is dealing with prompt-pay or other health plan problems, the Texas Medical Association can help resolve those issues through TMA’s Reimbursement Review and Resolution Service. The Texas Department of Insurance last week released a bulletin reminding plans that a portion of prompt-pay penalties must be paid to the state.


Surgeon’s Multimillion-Dollar Defamation Award Tossed by Texas Supreme Court - 05/16/2022

The Texas Supreme Court has nullified a $6.4 million jury verdict for a Houston cardiothoracic surgeon in his lawsuit alleging defamation and business disparagement by Memorial Hermann Hospital System.    


AMA Honors TMA Attorney With Lifetime Achievement Award - 05/04/2022

The American Medical Association (AMA) has honored Donald P. “Rocky” Wilcox, vice president and general counsel of the Texas Medical Association (TMA), with the Medical Executive Lifetime Achievement Award. The award honors a medical association executive who has contributed substantially to the goals and ideals of the medical profession.


Legal Legacies: TMA General Counsel Rocky Wilcox Retires After 42 Years of Service - 05/01/2022

After nearly five decades of service to organized medicine, Rocky Wilcox, the man behind TMA’s storied history of advocating for physicians and their patients through the legal and legislative systems is retiring. But the legacy he leaves behind has put physicians in Texas – even across the nation – on solid legal ground.


Feds Finally Open Dispute Portal Under Surprise-Billing Law - 04/20/2022

Physicians needing to formally settle a dispute with insurers over certain out-of-network payments under the federal No Surprises Act finally can initiate that process online.


New Telehealth Code Sparingly Adopted - 04/20/2022

Despite the availability of a new Medicare code corresponding to telehealth provided to patients at home, Texas Medical Association payment staff say health plans are adopting it sparingly.


Surprise Billing Rules Garner More Legal Action - 04/05/2022

Pressure is mounting on federal authorities with several legal actions now aiming to stop what physicians and hospitals say is an unfair arbitration process outlined in rules implementing the No Surprises Act, legislation passed in 2020 to address surprise medical bills.


Court Hearing Approaches in TMA Surprise Billing Lawsuit - 04/05/2022

With a Feb. 4 court hearing on the horizon, the Texas Medical Association recently reiterated its strong opposition to a part of a federal rule that medicine says unfairly favors health insurers when directing arbiters to resolve payment disputes between insurers and physicians under the federal surprise billing law.


Power Data: Texas' Claims Database Will Help Clarify Care Costs - 03/31/2022

Texas is building an all-payer claims database, which will provide a clearer view of opaque health care costs.


Communication Amid Complexity: An Interview With TDI Commissioner Cassie Brown - 03/31/2022

With a number of new and fluctuating state and federal laws and regulations, Texas Department of Insurance (TDI) Commissioner Cassie Brown has her plate full when it comes to health plan regulation.


A Looming Deadline: What the Public Health Emergency's End Means for Coverage - 03/31/2022

The end of the public health emergency could mean big changes to Medicaid, telemedicine, and private insurance coverage.


AMA: High Concentration in Insurance Markets - 03/31/2022

Most U.S. commercial health insurance markets are “highly concentrated” among the top insurers in those markets, and evidence strongly suggests insurers are “causing competitive harm to consumers and providers of care.” Those were the findings of the American Medical Association’s 2021 update to its annual study, Competition in Health Insurance.


Navigating a Broken System: Helping Patients Use Health Resources - 03/31/2022

Whether patients do or don’t have health insurance, they need physicians’ help to make the most of their health care resources.


Medicaid to Fix Physician Enrollment Problems With TMA's Help - 03/31/2022

A rocky start for the state’s new Medicaid Provider Enrollment and Management System frustrated a number of practices around the state – and caused some worries that care they provided might go unpaid.


Investigations of Gender-Affirming Care Halted Again by Appeals Court - 03/24/2022

The latest court order in the battle over gender-affirming care in Texas has once again blocked the state from investigating that care as child abuse.