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Physicians Must Validate Email to Avoid Medicaid Disenrollment, Payment Delays - 05/29/2024

Texas physicians who care for Medicaid patients should confirm their email address is valid in the Texas Medicaid and Healthcare Partnership’s Provider Enrollment Management System to ensure effective communication and timely payments from the state Medicaid administrator.


Innovation for Every Age: Texas Primary Care Physicians Improve Access for Older Patients - 05/06/2024

Texas' population is aging, highlighting the importance of access to high-quality, coordinated primary care that bridges complex systems, various clinicians, and concurrent chronic conditions.


Feds Extend Marketplace Special Enrollment Amid Medicaid Unwinding - 04/19/2024

Texas patients who have been disenrolled from Medicaid in the wake of the COVID-19 public health emergency now have more time to find alternative coverage on the federal marketplace. The extension could mitigate a coverage cliff about which the Texas Medical Association has long raised concerns.


Medicare May Seek Payment Recoupment for 2023 Claims - 04/09/2024

A new report by the Government Accountability Office shows physicians may face possible recoupments – or additional payment – for claims filed in 2023 as a result of over and underpayments by Medicare, Medicaid, and other federal programs.


Postpartum Coverage Extension Brings Payment Complexities - 04/05/2024

As the 12-month postpartum coverage Texas legislature approved took effect March 1, physicians and their practice staff should take note of subsequent payment complexities, Texas Medical Association experts caution.


MedPAC Backs Medicare Physician Payment Increase – Again - 03/26/2024

Echoing advocacy by the Texas Medical Association and others in organized medicine, the Medicare Payment Advisory Commission recently reupped its recommendation that Congress increase Medicare physician payment by tying such payment to inflation, among other factors.


Congress Mitigates 2024 Medicare Physician Pay Cut - 03/21/2024

Congress recently passed legislation halving the 3.4% Medicare physician pay cut that took effect on Jan. 1, 2024, following a months-long, high-pressure advocacy campaign by the Texas Medical Association, the American Medical Association, and others in organized medicine. But TMA and its allies continue to push for additional reform given that any cut threatens physicians’ practice viability and vulnerable patients’ access to care.


Cyberattack Prompts CMS to Extend 2023 MIPS Flexibilities - 03/19/2024

The Centers for Medicare & Medicaid Services recently announced two flexibilities related to Medicare’s Merit-Based Incentive Payment System 2023 performance year, citing the recent cyberattack on Change Healthcare and heeding advocacy by organized medicine.


Medicare Sunsets Beleaguered Appropriate Use Criteria Program - 03/14/2024

After longstanding opposition from the Texas Medical Association and others, the Centers for Medicare & Medicaid Services finally nixed the appropriate use criteria program for advanced diagnostic services as part of the 2024 Medicare physician fee schedule.


Feds’ Response to Cyberattack Aids Physicians, But Further Measures Needed - 03/14/2024

Eligible physician practices and others impacted by the recent cyberattack on Change Healthcare now may apply for accelerated and advanced payments for certain Medicare and Medicaid claims.


Medicare to Debut “Stay of Enrollment” Status for Physicians, Others - 03/13/2024

Medicare soon will introduce a “stay of enrollment” status for physicians and others enrolled in the federal program, despite pushback from the Texas Medical Association.


Physicians May Face Lower Payment as CMS Resumes Lab Data Collection - 03/11/2024

The Centers for Medicare & Medicaid Services will continue to collect data from physician-owned laboratories to inform private payer rates despite pushback from the Texas Medical Association.


Middle Ground: Medicare Offers Options Amid Shift to Value-Based Care - 03/05/2024

Physicians are divided on the issue of value-based care, but, with Medicare forging ahead, the Texas Medical Association is focused on monitoring the development of alternative payment models, educating members about their options, and advocating for physician protections.


Medicine’s MIPS Win: 2024 Medicare Physician Fee Schedule Stabilizes Program - 03/05/2024

The Centers for Medicare & Medicaid Services yielded to the Texas Medical Association’s concerns about its proposal and the impact of constant changes to MIPS on its participants.


Senate Moves Toward Medicare Pay Fix - 02/28/2024

After hundreds of physician leaders from across the country, including Texas, gathered in Washington, D.C., in mid-February, U.S. senators appear to be moving toward a Medicare pay fix alongside House efforts.


Congress’ Failure to Stop Medicare Payment Cut Frustrates, Threatens Texas Physicians, Patients - 02/27/2024

"Congress failed patients and the physicians who care for them" when it failed to stop a 3.37% Medicare physician payment cut in the measure that averted the latest government shutdown on Jan. 19. So says TMA President Rick Snyder, MD, in reaction to the "extremely disappointing" news. Physicians and patients across Texas already are feeling the sting, and TMA will not let up in its efforts to protect them.


Medicare Cuts Forcing Doctors Out - 02/27/2024

A 3.37% cut in Medicare physician pay is scheduled to hit on Jan. 1, 2024 [Editor's note: The cut took effect]. That’s on top of the 2% cut that took effect earlier this year and other compounding cuts over the years. In total, inflation-adjusted physician Medicare pay has fallen 26% since 2001. Medicare physician pay cuts are forcing some physicians out of the program.


Medicaid, CHIP Postpartum Coverage Extension Will Take Effect March 1 - 02/08/2024

After a multi-session advocacy effort by the Texas Medical Association, specialty societies, and women’s health advocates, Texans who are enrolled in Medicaid or the Children’s Health Insurance Program and who are pregnant or become pregnant will see their postpartum coverage automatically extended starting March 1.


Medicare Toolkit Social Media Graphics - 01/12/2024

Once again, physicians face cuts to their Medicare payments in 2024, stinging practices trying to stay viable and care for the most vulnerable patients. The Texas Medical Association strongly urges Congress to find permanent, sensible solutions to the Medicare physician payment system.  


Spending Growth Rate for Physician Services Slows - 01/09/2024

Although spending on physician and clinical services increased 2.7% year-over-year to $884.9 billion in 2022, the spending growth rate fell, due in part to a slowdown in the use of such services and in physician prices. In comparison, spending on physicians and clinical services grew 5.3% in 2021.


Medicare Payment Crisis Forces Rural Practice Closure - 01/04/2024

If Congress does not act by the end of the year to stop the impending Medicare physician payment cut, many practices will be forced to reduce available health care services, cut office hours, or even forgo treating Medicare patients altogether, organized medicine has warned over and over in its months-long advocacy campaign.


CMS Introduces Electronic Documentation Submission Tool - 01/02/2024

The Centers for Medicare & Medicaid Services (CMS) has developed a free service to help physician practices of varying sizes and documentation workloads upload and submit medical documents, including prior authorization requests, electronically.


Enroll As an Ordering or Referring Physician to Avoid Claims Denials - 12/15/2023

Physicians must enroll, at minimum, as an ordering or referring physician to provide Medicare patients with services or prescriptions. Failing to enroll may lead to denials on claims and services.


Add-On Payment Code for Complex Visits to Start in 2024 - 12/08/2023

Beginning in January, physicians will be able to receive more accurate payment for complex visits with Medicare add-on code G2211. But the Texas Medical Association continues to push for additional guidance as confusion over the code’s use persists.


How to File a Medicare Extended Repayment Plan - 12/06/2023

  Extended repayment plans (ERPs) are an option for returning overpaid money to Medicare. Ideally, you should request an ERP immediately after receiving the initial demand letter. However, you can request an extended payment plan any time while the overpayment is outstanding.