Help Needed: Ideas to Fix Medicaid

TMA's Physicians Medicaid Congress is working to improve Medicaid for those who currently rely on the program or may in the future. We need your help and your ideas. What changes would you like made to the program? At the top of the congress' list are establishing competitive physician payments, mitigating the dual-eligible physician payment cut, and stopping the Office of Inspector General witch-hunts.

We know there are many more improvements, specifically ways the state could simplify and streamline administrative and paperwork requirements.

Tell us what changes you want by participating in tele-town hall meetings on Nov. 27 and 28 at 7:30 pm CST. Please be prepared to offer specific examples.

  • Nov. 27: TMA will call physicians at their home phone numbers at 7:30 pm CST in Austin, Corpus Christi, Dallas, Fort Worth, El Paso, Galveston, Houston, Lubbock, and San Antonio.
  • Nov. 28: TMA will call physicians in small urban and rural areas of the state (same number and time).

The congress, consisting of representatives from TMA's Select Committee on Medicaid, CHIP, and the Uninsured, the Border Health Caucus, and specialty societies, will review all recommendations and vote on those that the congress believes should be the top priority. Then in January, TMA will work with state lawmakers to implement these changes.

Save the date and answer your home phone when TMA calls. If you prefer that TMA call you at another number, contact the TMA Knowledge Center by phone (800) 880-7955 or email.

Office Administrators Welcome
If you would like to invite your office administrator or other member of your staff, contact the TMA Knowledge Center by phone (800) 880-7955 or email.

If you cannot participate in the tele-town hall meeting, send your idea(s) to Helen Kent Davis by Nov. 30. The more detailed and specific information you provide, the better.

Action, Nov. 16, 2012

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    I would like to make sure that we are ensuring that women have continued access to a wide variety of birth control measures. It would also be better to establish a way to make it easier to women to get sterilized, rather than more difficult.

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    We are medical oncologist and we had started a chemotherapy treatment on one of our Medicaid patient at May of 2009. The Texas Medicaid had have giving us so much hard times on reimbursement. They either said that they did not receive our claims or they had put our claims on review. We had to resubmit the claims and call so many times and finally got our payment by September of 2010. These incompetent Medicaid government employees have scared a lot of providers away. Medicaid patients have called to ask if we can accept them lately and we have tried again. It is the same issues, it seems like those government employees who are working in claims department are all so intelligent that they all use the same tactics saying either they cannot find the claims or just say the codes are bundle….etc.
    Even Government has tried to make more people insured under Medicaid but no providers will be willing to accept them since the reimbursement is low, codes are bundled, government employees are incompetent, rules are complicated on all referral and authorization. We, especially an oncologist with high chemotherapy cost, will definitely not able to accept any future Medicaid patients. Those Medicaid HMO companies are worst, the referral and authorization process are so cumbersome and complicated. The revenue from Medicaid cannot even cover any administrative expense!

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    Congress must do the medicare/medicaid fix. It is already very difficult for these pts to find a physician, and will become impossible if reimbursement worsens. Nelson Forsyth, MD

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