Action: Oct. 1, 2013

TMA Action Oct. 1, 2013   News and Insights from Texas Medical Association 

INSIDE: Government Shutdown Won't Affect Medicare

Government Shutdown Won't Affect Medicare Claims
Don’t Leave $15,000 on the Table
ICD-10 One Year Away
State Hires Medicaid Meaningful Use Auditor
Had Your Flu Shot?
National, State Lawmakers to Address Fall Conference
Learn How to Be the Leader Your Hospital Needs
Physicians Foundation Webinar on Practice Innovation

New Technologies Help Build Strong Patient Relationships
Mentors Wanted for Tomorrow's Physician Leaders
Unspent Funds? Renew Your TMA Membership Today
Together Rx Access Ends in February
TMA Seminars Prepare You for Medicare in 2014
Award Honors Academic Physicians
Managing Childhood Concussion
Keep Those Anson Jones Nominations Coming
This Month in Texas Medicine

Government Shutdown Won't Affect Medicare Claims

Medicare claims will continue to be paid despite the government shutdown, the American Medical Association says.

An AMA advisory said other Centers for Medicare & Medicaid Services (CMS) activities, "including health care fraud and abuse control, the Center for Medicare and Medicaid Innovation, and activities related to implementation of the Affordable Care Act, will continue. States will continue to receive funding for Medicaid and the Children's Health Insurance Program." 

AMA says a Department of Health and Human Services staffing contingency plan shows that government operations "authorized by law, including those that do not rely on annual appropriations, and those that involve the safety of human life and protection of property will largely be unaffected."

Operations not continuing during the shutdown, AMA says, include discretionary funding for health care fraud and abuse strike force teams; the Centers for Disease Control and Prevention seasonal influenza program; payments under the Children's Hospital Graduate Medical Education Program and the National Vaccine Injury Compensation Program; Food and Drug Administration food safety, nutrition, and cosmetics activities; and recertification and initial surveys for Medicare and Medicaid providers. 

Don’t Leave $15,000 on the Table

If you want to begin participating in the Medicare electronic health record incentive program, be sure to start your meaningful use reporting period by Oct. 3, 2013, or you will miss out on $15,000 of the incentive.

If you begin the program in 2013, the total incentive for participation over a four-year period is $39,000. The total amount goes down to $24,000 if you wait until 2014, which is the last year to begin participating in the Medicare EHR Incentive Program. In addition, penalties begin in 2015 for physicians who have not adopted and begun meaningfully using a 2014-certified EHR by July 1, 2014. Maximize your incentive by starting the program as soon as possible.

Find out more about the meaningful use criteria with the TMA Meaningful Use Toolkit, or view the TMA on-demand webinar Meaningful Use: Useful for Your Practice. Also, regional extension centers (RECs) have been established across the country to help physicians with selection, implementation, and meaningful use of an EHR to ensure eligible physicians meet the requirements needed to earn the incentive. Visit the TMA REC Resource Center for more details on location, eligibility and contact information. If you have additional questions, contact the TMA HIT Helpline at 800-880-5720 or by email.

ICD-10 One Year Away

As of today, you have exactly one year to complete the transition from the ICD-9 to the ICD-10 system for coding your claims. Unless you begin using ICD-10 on Oct. 1, 2014, your claims will not be paid. 

The Centers for Medicare & Medicaid Services mandated that physician practices, other practitioners, clearinghouses, and health plans use ICD-10, developed by the World Health Organization. But with more than five times the number of codes than ICD-9 and a completely different structure, ICD-10 requires extensive changes.  

The Texas Medical Association offers you many resources to make the switch. You can start by visiting TMA's ICD-10 resource page. The page features TMA'sComplete ICD-10 Implementation Solution. It walks your practice through every aspect of preparation, including policies, procedures, processes, relationships with other organizations, and technology. It comes with two licenses for SimpleSolutions Transition Software and instruction videos. The software can generate a medical practice's top 50 codes in a matter of minutes. It also allows you and your office staff to search ICD-9 and ICD-10 by code, description, and key word; create and save a list of commonly used codes; and develop and print quick-reference conversion lists. 

Also available is TMA's ICD-10Now! How and Why on-demand webinar. It offers a detailed look at everything you need to know and do to prepare for ICD-10.

The resource page also includes information on implementation timelines, ICD-10 facts and myths, and access to TMA'sICD-10 Video Vault. 

The TMA Knowledge Center Alert Service will keep you up to date with the newest articles and latest developments on ICD-10 and other health care topics. TMA Knowledge Center staff have created custom searches on ICD-10 and many other topics set to run each week. The results of these searches are emailed directly to you, or you can pick them up via RSS feed. TMA Knowledge Center alerts provide citations and abstracts along with some full-text access. Log on to and select "ICD-10 via email" or "ICD-10 via RSS" to sign up.

For more information on the ICD-10 transition and how to prepare, see "One Year to Go" in the October issue of  Texas Medicine

State Hires Medicaid Meaningful Use Auditor

The Texas Health & Human Services Commission hired Davila, Buschhorn & Associates to audit payments to Texas physicians under the Medicaid electronic health record (EHR) incentive program. A separate auditing firm is examining Medicare EHR incentive payments.

Physicians who fail the audit may have to repay the money they received. They do have the right to appeal. Details about the audit process and appeals are available here.

The Medicaid EHR auditor may ask you for information on patient volume that determines your eligibility to participate in the incentive program, as well as compliance in meeting the meaningful use measures. Pediatricians must have at least 20 percent of their patients on Medicaid; all other specialties must have at least 30 percent to qualify for the program.

To prepare for a possible audit, document how you calculate your patient volume and keep screenshots or reports. Also, document meaningful use calculations and maintain all reports used for attestation.

For more information on the audits, call TMA's Health Information Technology Department at (800) 880-5750 or email HIT.

TMA recognizes the complexities of the EHR incentive program and recommends physicians struggling with the program to consider contracting with one of the Texas regional extension centers (RECs). Details about the REC program and which one serves your area are available in TMA's Texas REC Resource Center



Had Your Flu Shot?

Oct. 1 is Influenza Awareness Day, designated by the Texas Legislature to educate Texans about the health risks associated with the flu. Take action to keep yourself, your family, and your patients healthy.

Get vaccinated against the flu. If you haven't gotten your annual flu vaccination, you can get it at TMA's Fall Conference on Saturday, Oct. 19, from 7:30 to 8:30 am. The shot clinic is sponsored by TMA's Committee on Infectious Diseases and TMA's Be Wise — ImmunizeSM program. 

 You can also fight the flu by:   

  • Hanging TMA's poster in your office to encourage your colleagues and staff to get vaccinated;
  • Educating your patients about the importance of the flu vaccination with free materials available from Be Wise — Immunize; and
  • Showing your support for the flu vaccination by taking the pledge from the Centers for Disease Control and Prevention. 

Local Vaccination Champions Needed 
The Be Wise program is looking for physicians, medical students, and TMA Alliance members who want to improve their community's health and vaccination rates. Learn how you can make a difference by attending the Be Wise — Immunize outreach meeting on Friday, Oct. 18 (in conjunction with TMA's Fall Conference), from 3:30 to 5:30 pm in TMA's Thompson Auditorium. 

Be Wise began in 2004 to help increase Texas' vaccination rates through education and hands-on, immunization clinics. More than 245,000 children, adolescents, and adults have received vaccinations through Be Wise. Come find out what tools and resources Be Wise — Immunize has to offer for local events.

If you have questions, contact Tammy Wishard, TMA's outreach coordinator, at (800) 880-1300, ext. 1470. RSVP by Oct. 10 so we'll save you a spot.  

Be Wise — Immunize is a joint initiative led by TMA physicians and the TMA Alliance, funded by the TMA Foundation through generous grants from H-E-B and the TMF Health Quality Institute.

Be Wise — Immunize is a service mark of the Texas Medical Association.   

National, State Lawmakers to Address Fall Conference

The patient-physician relationship will be the focus of the TMA Fall Conference, Friday and Saturday, Oct. 18-19, at the AT&T Conference Center in Austin.

Saturday's session begins at 7:30 am with a Dawn Duster session on TMA's new Physician Services Organization for Patient Care.

The general session begins at 8:45 am with remarks by TMA President Stephen Brotherton, MD. U.S. Sen. Ted Cruz (R-Texas) will follow with an update on issues in Congress. Sen. Jane Nelson (R-Flower Mound) will then make a presentation on the 10th anniversary of passage of tort reform in 2003.

Next on the agenda will be a panel discussion on Protecting the Patient-Physician Relationship. Panel members will be state Reps. Susan King (R-Abilene), Sarah Davis (R-Houston), and Nicole Collier (D-Fort Worth).

The session ends with a recap of the 2013 legislative session by Evan Smith, chief executive officer and editor-in-chief of the Texas Tribune.

You can get your flu shot and other vaccinations recommended for health care professionals at the conference. Physicians and their families, medical students, and office staff can get a vaccination Saturday, Oct. 19, from 7:30 to 8:30 am. The event is sponsored by TMA's Committee on Infectious Diseases and TMA's Be Wise — ImmunizeSM program. 

Flu shots, including the new quadrivalent vaccine, and flu mist will be available. You also can get a Tdap (tetanus, diphtheria, and pertussis) or MMR (measles, mumps, and rubella) vaccination.

The cost for a flu shot is $27; for quadrivalent vaccination (limited supply), $40; for FluMist, $40; for Tdap, $80; and for MMR, $105.

Be Wise — Immunize is a joint initiative led by TMA physicians and the TMA Alliance, funded by the TMA Foundation through generous grants from H-E-B and the TMF Health Quality Institute. Since the program began in 2004, more than 235,000 vaccinations have been given to Texas children, adolescents, and adults.

Be sure to reserve your vaccination when you register for the conference.

TMA councils, boards, committees, and sections will meet during the conference.

Be Wise — Immunize is a service mark of the Texas Medical Association.  

Learn How to Be the Leader Your Hospital Needs

Physician leaders can – and should – make a huge difference in how a hospital operates if they have the tools to get it done.

Consider this an invitation to pick up your toolbox at the IMQ/PACEPlatinum Level Training Program for Physician Leaders Nov. 7-9 at the Grand Hyatt Hotel in San Antonio. Whether you're the chief of staff, a department head, or chair of a committee, this conference provides information that any physician who has any leadership position needs. You not only get the information you need to know, but you also get practical training on how to accomplish your goals.

A Physicians Foundation grant helps lower conference prices to $595. Click here to register.  

Physicians Foundation Webinar on Practice Innovation

You can learn about new medical practice models physicians are testing around the country in a Physicians Foundation webinar, Practice Innovation: New Models for the 21st Century, from noon to 1 pm CT on Wednesday, Oct. 2.  

Speakers will include previous recipients of Physicians Foundation grants. 

The Physicians Foundation  is a nonprofit 501(c)(3) organization that seeks to advance the work of practicing physicians and help facilitate the delivery of health care to patients. TMA Executive Vice President/Chief Executive Officer Louis J. Goodman, PhD, is the foundation's president.   


New Technologies Help Build Strong Patient Relationships

Actively engaging your patients not only boosts patient loyalty and word-of-mouth referrals, but also can potentially improve the health outcome of your patients. Patient engagement is a significant portion of the meaningful use requirements needed for the electronic health record (EHR) incentive program. Emerging technologies such as patient portals, personal health records, and online forms allow patients to communicate securely with you and your staff in an efficient, productive way. 

 Implementing patient portals, EHRs, and online forms to engage patients can seem daunting, but TMA's October Tech Tuesday webinar will help prepare you to confidently and successfully employ these methods in your practice. When properly used, these technologies can go a long way toward increasing both office efficiency and patient satisfaction.

Register today, and join us on Oct. 15 from noon to 1 pm CT for the Tech Tuesday webinar Hi-Tech Patient Engagement, and remember to come back on Nov. 19 for the final Tech Tuesday program of the year, Patients, Physicians, and the Internet.   

Mentors Wanted for Tomorrow's Physician Leaders

Remember your first professional mentor? The physician who introduced you to all the right people? The one who shared invaluable tricks of the trade? The one who helped to steer you away from trouble? It's time to repay the favor.

The fourth class of scholars in the TMA Leadership College will begin their year of studies at the 2013 TMA Fall Conference. As part of the learning experience, scholars are matched with established physician leaders to serve as mentors. All it takes is a phone call or two each month, a few introductions to your colleagues, and a helpful hand every now and again. Then you can stand proudly when your mentee graduates from the TMA Leadership College at TexMed 2014.

If you're interested, please sign up today

Unspent Funds? Renew Your TMA Membership Today

Do you have funds remaining in your 2013 continuing medical education/dues budget allotment? If so, renew your 2014 TMA membership early, before your funds expire.

To renew now, simply click here now, or call the TMA Knowledge Center at (800) 880-7955.    

Together Rx Access Ends in February

The Together Rx Access program, which allows individuals and families without prescription drug insurance coverage to buy discounted medications, will shut down Feb. 28.

Program officials said a review of their Together Rx Access cardholders' needs shows they may be better served through the health insurance marketplaces created by the Affordable Care Act, expanded Medicaid programs in some states (Texas is not one of them), or by individual company prescription assistance programs.

Uninsured patients can still enroll in the prescription savings program until Dec. 31, and cardholders can continue using their cards at participating pharmacies until Feb. 28. After that, they may be able to purchase prescription medicines through patient assistance programs offered by pharmaceutical companies. They can call the Partnership for Prescription Assistance (PPA) at (800) 981-5851 or visit

For additional information about prescription assistance programs and resources, cardholders can go to NeedyMeds and Rx Outreach on the Together Rx Access website.  

TMA Seminars Prepare You for Medicare in 2014

It's time again to start thinking about Medicare for 2014. TMA's Medicare 2014 seminar series will help you and your staff get on top of next year's changes and make your current Medicare process more efficient. Led by TMA staff specialists, this new seminar provides trends, tips, and resources to help answer all of your Medicare questions.

TMA Director of Payment Advocacy Genevieve Davis will take you through a mock Medicare experience from the first patient phone call through payment. Ms. Davis will give insight on avoiding the most common pitfalls, show methods to streamline your workflow, and give you the rare opportunity to view your Medicare process from the patient's perspective as well as your practice's perspective.

The seminars also will include valuable information covering the changes to Medicare's electronic health record incentive program, the Physician Quality Reporting System, and e-prescribing; actions required in 2014 to prevent penalties; updates from Novitas, including changes to Part B; and a sneak preview of its new website.

Register today to reserve your seat. This seminar series will fill very quickly. To register by phone, call (877) 880-1335.  

  PC Action Ad Oct 13


Award Honors Academic Physicians

The TMA Award for Excellence in Academic Medicine recognizes teaching physicians who are clinicians and have a record of TMA leadership, scholarly activity, mentoring, professional development, advocacy, and community service. If this sounds like you, TMA encourages you to apply for this award created for doctors like you.

"TMA is eager to recognize our physicians who are consummate teachers, role models, and medical professionals," said David P. Wright, MD, chair of the TMA Council on Medical Education. "These awards underscore their value in preparing the future physician workforce and as leaders within TMA and their communities."

The program has four recognition levels: Bronze, Silver, Gold, and Platinum. Eligibility criteria increase for each level. Bronze, Silver, and Gold levels are self-nominating, and all who meet the criteria will receive recognition. A selection committee of TMA member physicians chooses the sole Platinum-level winner each year from among Gold-level recipients. Gold-level recipients remain eligible for the annual Platinum award for three years, with no need to reapply during that period.

All award recipients receive a printed certificate and recognition by the TMA Council on Medical Education and Subcommittee for Academic Physicians at that year's TexMed meeting. The Platinum winner also receives a $5,000 cash award. In addition, winners are recognized in TMA's award-winning newsmagazine, Texas Medicine, and monthly e-newsletter, It's Academic, and in the Handbook for Delegates at the TMA House of Delegates' annual meeting.

You can download applications Oct. 1 through Dec. 6 at The deadline to apply is Dec. 6, 2013.

If you have questions, email Jennifer McHaney at TMA or call her at (800) 880-1300, ext. 1451, or (512) 370-1451. 

Managing Childhood Concussion

Nearly 60 percent of high school students in the United States participate in organized sports, and the number of younger athletes increases annually. Because back to school means back to sports for most Texas children, the identification and management of concussion is becoming an even bigger public health issue than in years past.

Thanks to a generous grant from the TMA Foundation, TMA offers a new on-demand webinar: Hard Knocks: An Update on Concussion and Texas Law. Presented by Shane Miller, MD, a pediatric sports medicine specialist at The University of Texas Southwestern Medical Center, this new course fully explains the signs and symptoms of a concussion, initial evaluation and management of sports-related concussion, and Texas law as it relates to concussion management and Texas physicians.

Hard Knocks is accredited for 1 AMA PRA Category 1 Credit™ in ethics/professional responsibility and is available for viewing at your convenience, so register now and watch it at your leisure. 

Keep Those Anson Jones Nominations Coming

The TMA Anson Jones, MD, Award honors outstanding health journalism, and we need your help to find the best stories of 2013. If you've seen, heard, or read an outstanding story this year, nominate it for an award.

This is the first time members of the TMA family (physicians, medical students, TMA Alliance members, and county medical societies) can nominate journalists for the Anson Jones awards. Categories cover print, broadcast (television and radio), and online media. Any story from 2013 is eligible.

When you nominate a journalist, you give him or her a pat on the back for a job well done. Simply email your nomination: the reporter's name, name of article (if available), date of broadcast or publication, and the media outlet. Please try to include a URL.

TMA will send the reporter a postcard with a handwritten note. We'll let the reporter know you nominated him or her and for which story or broadcast.

Visit the Anson Jones webpage for complete nomination details and contest rules and categories. If you have questions, call Tammy Wishard, TMA Outreach Coordinator, at (800) 880-1300 ext. 1470, or (512) 370-1470, or email her.  

This Month in Texas Medicine

The October issue of Texas Medicine  explains why physicians across the state are frustrated with the Medicaid managed care program. It also tells you what you need to do to prepare for the coming of ICD-10 a year from now, why you need to pay attention to tougher new privacy laws, and how physicians help shape public health policy in Texas. You'll also meet the new commissioner of the Texas Department of Insurance.

Check out our digital edition.

Texas Medicine RSS Feed

Don't want to wait for Texas Medicine to land in your mailbox? You can access it as an RSS feed, the same way you get the TMA Practice E-Tips RSS feed.

E-Tips RSS Feed

TMA Practice E-Tips, a valuable source of hands-on, use-it-now advice on coding, billing, payment, HIPAA compliance, office policies and procedures, and practice marketing, is available as an RSS feed on the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases and for Blogged Arteries, the feed for Action.  

This Just In ...

Want the latest and hottest news from TMA in a hurry? Then log on to  Blogged Arteries.  

TMA Education Center 

The TMA Education Center offers convenient, one-stop access to the continuing medical education Texas physicians need. TMA's practice management, cancer, and physician health courses are now easier than ever to find online. 

Live Seminars  

11/5      Austin 
11/6      Abilene 
11/12    Dallas 
11/13    Tyler 
11/14    Fort Worth 
11/19    McAllen 
11/21    San Antonio 
12/3      Houston 
12/4      Houston 


Hi-TechPatient Engagement  
10/15    Noon  

Hard Knocks: An Update on Concussion and Texas Law

Physician Health and Wellness, Ext. 1342  

Healthy Physicians: Healthy Patients
10/26 San Antonio  

About Action       

 Action, the TMA newsletter, is emailed twice a month to bring you timely news and information that affects your practice

To change the email address where you receive Action, go to Member Log-In on the TMA website, then click on "Update Your TMA Demographic Information (including newsletter subscriptions and preferences)."

To unsubscribe from Action, email TMA's Communication Division at tmainfo[at]texmed[dot]org.

If you have any technical difficulties in reading or receiving this message, please notify our managing editor, Shari Henson. Please send any other comments or suggestions you may have about the newsletter to Larry BeSaw, Action editor.

Last Updated On

January 27, 2016