Related Stories

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 Or maybe the contact information the plan gave you is out of date, and the patient’s latest phone number or email is unknown.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.


False Impression: Medicine Says Medicare Report Inflates Success of Quality Program - 08/02/2019

High participation, “significant strides,” overwhelming success. That was the picture the Centers for Medicare & Medicaid Services painted in a March report on the first year of the Quality Payment Program. But a closer look by the Texas Medical Association raises serious doubts about CMS’ numbers, transparency, and cheerleading – so much so that TMA and seven other state medical associations are asking the agency to rescind the report.


AMA House Punts on Texas Plan to Fix QPP - 06/26/2019

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.


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.


Faulty Guidelines - 06/03/2019

Former Texas Medical Association President Josie Williams, MD, was tenacious in advocating that organized medicine pay zealous attention to two topics: data and guidelines. In this, she was both sage and prescient. We have done well in following her recommendations on data, but we continue to fall far short of where we need to be on guidelines.


Get Awarded For Your Quality Work in 2018 - 05/23/2019

Did you submit Merit-Based Incentive Payment System data for the 2018 Quality Payment Program and feel like you deserve some kind of recognition for your hard work all year long? Apply now for the 2018-19 Physician Practice Quality Improvement Award.


Medicine to CMS: Medicare Report Inflates Success of Quality Program - 05/01/2019

If you read the recent Centers for Medicare & Medicaid Services (CMS) report on the first-year of the Quality Payment Program, you’d likely come away with the perception that the program’s launch was an overwhelming success. But a closer look by the Texas Medical Association raises serious doubts about CMS’ numbers, transparency, and cheerleading – so much so that TMA and seven other state medical associations are asking the agency to take back the report.


Deadline to Submit 2018 MIPS Data is April 2 - 03/27/2019

If you plan to participate in the Merit-Based Incentive Payment System, submitting your data for 2018 on time is not something to fool around with. That’s why the Texas Medical Association reminds you that the deadline to submit data for the Centers for Medicare & Medicaid Services’2018 Quality Payment Program is April 2 – the day after April Fool’s Day.


National Specialty Societies With MACRA Information - 03/27/2019

To help you get the best information possible, TMA has identified direct links to MACRA news, resource centers, education, and advocacy from national specialty societies. Visit your specialty society online for information specific to your specialty, setting, and practice.


How to Avoid MIPS Penalty with Minimal Reporting by April 2 - 03/25/2019

For 2018 reporting, your 2020 Medicare payments will be cut even more – by 5 percent – if you are required to participate in MIPS but choose not to submit data. So if you’d rather get paid in full next year (or – even better – receive a payment bonus), there’s still time to submit 2018 data. But you should act fast. The deadline is April 2.


Free MIPS Help from TMF Health Quality Institute - 03/22/2019

The Texas Medical Association has heard from physicians who do not know if they are required to participate in Medicare’s Merit-Based Incentive Payment System (MIPS) as well as those who know they need to participate – and know they need help.


CMS Working to Correct MIPS Payment Errors - 03/05/2019

The Centers for Medicare & Medicaid Services says it has become aware of an error in MIPS payment adjustments applied to Medicare Part B drugs, and is working to resolve the issue.


New Options for Medicare’s 2019 Quality Payment Program - 01/08/2019

Just when you thought no one could make the Quality Payment Program any more complicated, the agency that runs the program has done just that. Beginning in 2019, the Centers for Medicare & Medicaid Services will split the QPP’s advanced alternative payment model (APM) track into two options: the original Medicare Option, and the new All-Payer Combination Option.


MIPS Training and Assistance - 12/12/2018

TMA's practice management consultants can conduct a MACRA readiness assessment of your practice and provide customized on-site assistance to help you with your practice's specific needs. The assessment will focus on clinical processes, electronic health record optimization, and workflow improvement opportunities to help increase your MIPS scoring.


MIPS Audit? Here’s What You Need to Know - 11/19/2018

Are you planning to submit data to the Merit-Based Incentive Payment System under the 2018 Quality Payment Program? If so, the Centers for Medicare & Medicaid Services could tap you for a MIPS audit in the future. Here are some things to know to prepare your practice.


Give QPP Feedback, Get MIPS Credit - 11/12/2018

Have you explored the Quality Payment Program (QPP) website lately? Did you have trouble finding what you were looking for? Did you click on all the links but leave the website with more questions than answers? If the answer is yes, tell the Centers for Medicare & Medicaid Services (CMS) all about it and get credit for the Merit-Based Incentive Payment System (MIPS) improvement activities category.


The Results Are In: Physicians Finally See How They Fared in First Year of MIPS - 10/16/2018

Physicians finally see how they fared in the first year of Medicare's "MIPS" quality payment program.


Medicare Gets It Wrong, Re-Calculates MIPS Scores and Changes 2019 Payment Adjustments - 09/18/2018

All Texas physicians should recheck their 2017 Merit-Based Incentive Payment System (MIPS) or Alternative Payment Model (APM) information to ensure the correct MIPS payment adjustment (bonus or penalty) was applied for 2019 Medicare payments.


CMS Proposes Big Medicare Changes for 2019 - 07/19/2018

The Centers for Medicare & Medicaid Services last week proposed what the agency called “historic changes” in the Medicare program. TMA is already digging deep into the proposal to make sure the changes are good for Texas physicians and your patients.


How Will Quality Scores Affect Your 2019 Medicare Payments? Get an EIDM Account ASAP - 07/10/2018

The Centers for Medicare & Medicaid Services on July 1 will release final MIPS scores, performance feedback, and Medicare payment adjustment determinations (bonuses and penalties). But you’ll need an EIDM account to access your report card.


MACRA Corner: TMA Wants To Hear From You On The QPP - 05/04/2018

The TMA MACRA Resource Center receives hundreds of visits every month from physicians looking for the latest QPP information. To bring you the best education and resources, TMA wants to hear from you on the QPP.