Action: Feb. 1, 2016

TMA Action Feb. 1, 2016   News and Insights from Texas Medical Association

Apply for Meaningful Use Hardship Exception by March 15
Medicaid Reenrollment Deadline Pushed to Sept. 25
CDC Issues Zika Virus Health Advisory
Apply Now for Internal Medicine Preceptorship Program
Reenroll in Texas Vaccines for Children Program by Feb. 12
Don't Miss the Texas Two Step Mass CPR Event Feb. 6
TexMed 2016 Coming to Dallas April 29–30; Register Now
TexMed General Session Stars Bestselling Author, Economist
TMA PracticeEdge-Built ACOs Open for Business
Fund a Local Shot Clinic with Help from Be Wise — Immunize
March, April, May: Key Months for Helmet Giveaways
TMA Course Educates Doctors on Diabetes Prevention
TMA Minority Scholarship Program Application Is Available
Texas Physicians Lead TMAIT Board of Trustees
This Month in Texas Medicine

Apply for Meaningful Use Hardship Exception by March 15

It's no secret the Texas Medical Association has been less than thrilled with the meaningful use electronic health record (EHR) incentive program. For starters, the Centers for Medicare & Medicaid Services (CMS) did not publish the modification rule for Stage 2 meaningful use until Oct. 16, 2015. As a result, eligible professionals weren't informed of the revised program requirements until fewer than the 90 required days to attest remained in the calendar year. That left them at risk for a penalty. CMS vowed to grant hardship exemptions for 2015 for those eligible physicians who were unable to attest due to the lateness of the rule. In December, Congress adopted S 2425, known as the Patient Access and Medicare Protection Act, which allows one exception form for individual physicians and groups so they can list all physicians and other health professionals who are claiming the same exemption category.  

If the 2015 meaningful use modification rule delay prevented you from meeting the criteria for the 2015 reporting year, listen up. You need to review the hardship application categories to see if any of them apply to you. Categories include: 

  • Insufficient Internet connectivity, 
  • Extreme and uncontrollable circumstances, 
  • Lack of control over the availability of certified EHR technology, and
  • Lack of face-to-face patient interaction.  

An exemption will have an impact on your 2017 payments only. You must reapply for exemptions each year. 

You have until March 15 to submit the hardship application. CMS provided some additional information on the hardship exception instructions.  

The American Medical Association encourages all physicians participating in the 2015 Medicare meaningful use program to apply for the hardship. Applying for the hardship will not prevent a physician from earning an incentive. It simply protects a physician from receiving a meaningful use penalty. Therefore, physicians who believe that they met the program requirements for the 2015 reporting period should still apply for the hardship protection. 

If you have questions about the hardship exceptions, contact TMA's Health Information Technology Department by calling (800) 880-5720 or by email.

Medicaid Reenrollment Deadline Pushed to Sept. 25

Physicians have an extra six months to reenroll in Medicaid, thanks to lobbying from TMA and organized medicine. The Centers for Medicare & Medicaid Services has extended the deadline for most physicians to reenroll in Medicaid to Sept. 25. The initial deadline for reenrollment, driven by a provision in the Affordable Care Act, was March 24. Texas Medicaid officials say they "encourage all providers who have not yet submitted a reenrollment application to begin this process immediately to avoid potential payment disruptions." TMA also has been urging Texas physicians to get ahead of the complex process

The Texas Health and Human Services Commission and the Texas Medicaid and Healthcare Partnership (TMHP) have improved the electronic enrollment portal to make it easier for doctors to complete the reenrollment process. (Physicians newly enrolling in Medicaid can also use the portal.) The enhancements apply to applications submitted through the TMHP website on or after April 26, 2015.

The improved electronic application process allows you to: 

  • Upload supporting documentation;
  • Sign the enrollment agreement electronically (e-sign);
  • Receive guidance as you work on the application and see more accurate error messages to avoid mistakes;
  • Receive instruction on how to upload documents and submit the application using an e-signature; and 
  • Expedite processing of your application by reducing the need for printing and mailing documents. 

For physicians currently enrolled in Medicaid, the portal will pre-populate the application with demographic data pulled from the physician's current account.

To be considered fully reenrolled by the Sept. 25 deadline, physicians must receive verification from TMHP that the application has been approved before that date. It currently takes about 32 days for applications to be processed. Thus, physicians should reenroll early to avoid gaps in enrollment. The reenrollment requirement also applies to physician assistants and advanced practice registered nurses.

To use the online application, you must have a TMHP user account and a user name (portal user ID). 

Refer to the TMHP Website Security Provider Training Manual for instructions on activating a TMHP user account. For more information about Medicaid provider reenrollment, visit the TMHP provider reenrollment page. 

CDC Issues Zika Virus Health Advisory

The U.S. Centers for Disease Control and Prevention (CDC) has issued a Zika virus health advisory with information and recommendations for recognizing, managing, and reporting infections in travelers returning from Central America, South America, the Caribbean, and Mexico. The advisory also provides travel guidance for pregnant women and women who are trying to become pregnant. Last month, public health officials announced the confirmed diagnosis of the mosquito-borne disease in a Houston woman who traveled in November to El Salvador.

The advisory notes physicians should consider Zika virus infection in patients with: 

  • Acute onset of fever, 
  • Maculopapular rash, and
  • Arthralgia or conjunctivitis. 

Physicians also should consider Zika virus infection in patients who traveled to areas with ongoing transmission in the two weeks before the onset of illness. 

According to CDC, clinical disease usually is mild, but during the current outbreak, Zika virus infections have been confirmed in several infants with microcephaly and in fetal deaths in women infected during pregnancy. "Until more is known and out of an abundance of caution, pregnant women should consider postponing travel to any area where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctors or other health care providers first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant should consult with their health care providers before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip," the CDC advisory states.

CDC encourages Texas physicians to report suspected Zika virus cases to the Texas Department of State Health Services to facilitate diagnosis and to mitigate the risk of local transmission. 

More Information

General information about Zika virus  
Information for clinicians  
Protection against mosquitoes 
Zika virus travel notices

Apply Now for Internal Medicine Preceptorship Program

The Texas Chapter of the American College of Physicians (TXACP) is now accepting applications from first- and second-year Texas medical students and from physicians for the summer 2016 General Internal Medicine Statewide Preceptorship Program (GIMSPP). 

Since 1992, the GIMSPP has placed Texas medical students with internists across the state for four-week preceptorships during the summer break. Students get the opportunity to observe the daily routine of their preceptor, experiencing the variety the practice of internal medicine provides. Preceptors get the chance to share their expertise and knowledge, while helping shape the next generation of medicine. The program is well-respected, and many students who have participated go on to be preceptors later in their careers. 

The program, supported in previous years by the Texas Higher Education Coordinating Board, had its grant funding cut in 2011. Administered by the nonprofit TXACP, the GIMSPP recently won renewed financial support for 2016 and beyond, allowing for stipends for participating students. Student preceptorships are available on a first come, first served basis, and students are encouraged to apply early. Only students currently enrolled in a Texas medical school are eligible to participate. 

For more information on the program, or to download the application for participation, visit the TXACP website.    

TMAIT Action Ad 6.15

Reenroll in Texas Vaccines for Children Program by Feb. 12

The 2016 reenrollment period for physicians who participate in the Texas Vaccines for Children (TVFC) Program opened on Jan. 25. 

Remember: You have until Feb. 12 to complete the Provider Agreement form to remain an active participant in the TVFC Program. The Texas Department of State Health Services created an electronic TVFC Provider Agreement form you can use during the 2016 reenrollment period. For additional information, please email or call the Vaccine Call Center at (888) 777-5320.

Don't Miss the Texas Two Step Mass CPR Event Feb. 6

Help the Texas College of Emergency Physicians, HealthCorps, TMA, the American College of Emergency Physicians, and leadership consulting firm MaveRx make history Feb. 6 by joining Texas medical students at the Texas Two Step: How to Save a Life CPR training event. The goal of the free event is to break the world record by teaching 20,000 people in one day to save a life with two simple steps: call 911 and initiate hands-only CPR. Visit the Texas College of Emergency Physicians website for locations and more information. 

Check out the Texas Two Step How to Save A Life Campaign video on YouTube.

"Heart disease is the No. 1 killer of Texans with four out of five cardiac arrests occurring at home," says Shkelzen Hoxhaj, MD, president of the Texas College of Emergency Physicians. "Research shows CPR saves lives. However, most people are unprepared to help when a loved one, friend, or colleague needs CPR."

Texas Two Step CPR training will offer Texas health care professionals and student doctors an opportunity to work with their communities. Representatives from all nine medical schools across the state will teach the Texas Two Step. CPR training sites include high-traffic areas in Amarillo, Austin, College Station, Dallas, El Paso, Fort Worth, Galveston, Houston, Lubbock, and San Antonio. Local sponsors include Texas medical schools, county medical societies, legislators and city officials, and local emergency medical services agencies. 

TexMed 2016 Coming to Dallas April 29–30; Register Now

Join us for TexMed 2016, TMA's annual meeting, April 29–30 at the Hilton Anatole in Dallas, where we will explore Bridging the Gaps in Health Care. TexMed is a free member benefit. Register today, and review the TexMed 2016 Advance Program

You can choose from more than 80 hours of free CME programming. From business operations and the future of medicine to quality initiatives and performance improvement, TexMed offers multidisciplinary programming that encourages cross-specialty dialogue. 

Help mold TMA policy and business decisions by attending the House of Delegates and participating in Reference Committees, where all TMA members can testify on resolutions being presented before the house. 

Visit the Expo Hall, where you’ll see the newest in medical devices, technology, practice services, practice information, and pharmaceuticals. And you could win loads of exciting prizes.

TexMed is the place to reconnect with old friends while meeting new ones at the Welcome Reception, the TMA/TMA Alliance 2016–17 Presidents' Reception, and the TMA Foundation Gala, As Time Goes By, An Evening in Casablanca.

TexMed has something to offer everyone. Find out more in the TexMed 2016 Advance Program, or watch Texas Physicians — Come to TexMed

Visit the TMA webpage, email the TMA Knowledge Center, or call (800) 880-7955 for more information.

See you in Dallas!

TexMed General Session Stars Bestselling Author, Economist

TMA has secured two prestigious speakers to headline the TexMed 2016 General Session: Marty A. Makary, MD, and Mark G. Dotzour, PhD. This year's conference will take place April 29–30 at the Hilton Anatole in Dallas. 

Dr. Makary, who will speak Friday on "Art, Assassination, and America: How Transparency Disrupts an Industry," is The New York Times bestselling author of Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care, and a leading voice for physicians as a writer for The Wall Street Journal and TIME. He is also a medical commentator for NBC News and FOX News. Dr. Makary is the creator of The Surgery Checklist described in the book The Checklist Manifesto. He led the World Health Organization workgroup to measure surgical quality worldwide. 

Dr. Dotzour's Saturday presentation, "Economic Outlook: What's in Your Future?" will delve into projections for the 2016 economy and how physicians can apply business plans to anticipate future economic conditions. Dr. Dotzour is chief economist and director of research for the Real Estate Center at Texas A&M University in College Station.

Both sessions are open to all TexMed attendees. For more information or to register to attend, visit the TexMed webpage.  

Action TMLT Ad 10.15

TMA PracticeEdge-Built ACOs Open for Business

Congratulations to East Texas Regional Accountable Care Collaborative (Nacogdoches), UPSA ACO (San Antonio), Alliance ACO (rural central Texas and Kerrville), and Houston Regional ACO, all of whom kicked off their new value-based contracts on Jan. 1. Combined, these physician-led accountable care organizations (ACOs) working with TMA PracticeEdge represent more than 250 physicians and approximately 40,000 patient lives. All of these groups are accepting new physician members, and the TMA PracticeEdge team is recruiting physicians who want to set up commercial ACOs for a July 1, 2016, start date or the 2017 Medicare Shared Savings Program

The TMA PracticeEdge team is on the road with presentations to groups exploring options for developing physician-led ACOs. This surge in interest is not surprising, according to Leavitt Partners, a leading value-based care think tank, which reports, "Passage of the Medicare Access and Chip Reauthorization Act of 2015 (MACRA) has had a substantial positive impact on the projected growth of the movement." In its recently released white paper, Leavitt projects more than 105 million patient lives, or one-third of Americans, will be managed by ACOs by 2020. Medicare payment incentives offered via MACRA's alternative payment model track, beginning in 2019, has spurred this growth. For a copy of the white paper or more information, email TMA PracticeEdge.

Contact Kim Harmon by phone at (888) 900-0334 or by email to find out more about opportunities in your area.

Fund a Local Shot Clinic with Help from Be Wise — Immunize

TMA can help you with community outreach while boosting your local vaccination rates. TMA's Be Wise — ImmunizeSM program is accepting applications until March 1 for grants to support local vaccination events. Grants of up to $2,500 are available to TMA member-physician practices/clinics, county medical societies, TMA Alliance chapters, and medical student chapters. 

The funds can be used for new or expanded shot clinics to vaccinate children, adolescents, and/or adults. Applicants should apply for a grant at least four months before their project is scheduled to begin, and grantees have up to 12 months to use the funds. TMA will accept applications on July 1 and Nov. 1 for shot clinics in late 2016 and early 2017. 

In 2015, TMA's Be Wise — Immunize program awarded a record 20 Local Impact Grants for projects to vaccinate Texans against flu, meningococcal disease, pertussis, and other vaccine-preventable diseases. Since 2012, TMA has given more than $80,000 through the Local Impact Grants program to ensure Texans who are uninsured or underinsured — or who face other obstacles — receive needed vaccinations.

To plan your free or low-cost vaccination event, check out the Be Wise — Immunize Quick Start Manual: A Step-by-Step Vaccination Outreach Guide. For more information, contact Tammy Wishard, TMA's outreach coordinator, at (512) 370-1470 or (800) 880-1300, ext. 1470.

TMA actively works to improve vaccination rates in Texas through its Be Wise — Immunize program. More than 300,000 shots have been given to Texas children, adolescents, and adults since the program began in 2004. 

Be Wise – Immunize is a joint initiative led by TMA physicians, medical students, and the TMA Alliance. It is funded by the TMA Foundation in 2016 thanks to major gifts from H-E-B and TMF Health Quality Institute, along with generous contributions from physicians and their families. 

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

March, April, May: Key Months for Helmet Giveaways

Three great times to host a TMA Hard Hats for Little Heads bicycle helmet giveaway are fast approaching. March is Brain Injury Awareness Month, April is Texas Child Safety Month, and May is Bike Month. 

TMA encourages physicians, county medical societies, medical students, and TMA Alliance members to give free helmets to children in their communities. TMA provides everything needed for a local event, from helmets to publicity and educational materials to media support. And TMA sends statewide media advisories in March, April, and May, announcing all events across the state.     

TMA provides free helmets for your event in addition to the ones you purchase. For example, if you buy 50 helmets, we give you 50 more at no cost. Helmets purchased through TMA cost $7.60 per helmet, including shipping. 

Additionally, the Texas Academy of Family Physicians (TAFP) and the Texas Pediatric Society (TPS) offer their members a unique benefit. TAFP and TPS will cover the cost of up to 25 helmets for their members, and TMA matches that. Family physicians and pediatricians can get up to 50 helmets at no cost. And you can buy more helmets at TMA's low price.

Check out these ideas for events and start planning your event now. To find out how you can sponsor a helmet giveaway, contact Tammy Wishard, TMA outreach coordinator, at (512) 370-1470 or (800) 880-1300, ext. 1470. 

The TMA Foundation funds TMA's Hard Hats for Little Heads program in 2016 with generous gifts from Blue Cross and Blue Shield of Texas, an anonymous physician and spouse, Make-A-Difference donors, the Baptist Health Foundation of San Antonio, individual physicians and their families, and other friends of medicine.

TMA Course Educates Doctors on Diabetes Prevention

Help your diabetic patients improve diet and lead a healthy lifestyle. A shocking 29.1 million Americans have been diagnosed with diabetes, and an estimated one in four people do not know they have the disease. Prevention is key. Texas A&M University researchers and physicians developed a continuing medical education (CME) offering, available from TMA, that features the latest information on type 2 diabetes.

Frontiers in Type 2 Diabetes: The Role of Nutrition in Health covers: 

  • Guidelines and recommendations for medical nutrition therapy;
  • Screening methods, including clinical measurements for diagnosis;
  • Practical approaches to discuss and counsel diabetic patients; and
  • Collaboration among medical specialties, working with a registered dietitian. 

This CME offering is available to TMA members and non-TMA members for 1 AMA PRA Category 1 CreditTM and 1 ethics credit in two different formats: an on-demand webinar and a downloadable PDF self-study module. Register for this unique CME opportunity, or purchase the PDF.  

 PC Action Ad May 13

TMA Minority Scholarship Program Application Is Available

TMA will be able to award 11 students with $10,000 scholarships through the TMA Minority Scholarship Program for 2016 incoming medical students. The program helps minorities who are underrepresented in Texas medical schools and the state's physician workforce. TMA increased the award amount from $5,000 to $10,000 for scholarship winners beginning this year. To be considered for a scholarship, TMA must receive applications by 5 pm on Tuesday, Feb. 16, 2016. 

The funds will be disbursed directly to the school in increments of $2,500 annually during the first four years of a student's matriculation. These scholarships are made possible through generous donations solicited by the TMA Foundation, the philanthropic arm of TMA. 

Applicant Requirements
  • Applicants must be African-American, Hispanic/Latino, or Native American.
  • Students already attending medical school are not eligible.
  • Applicants must be an incoming freshman at the school awarding the loan during fall 2016.
  • One scholarship is awarded annually per Texas medical school. (If a recipient chooses to matriculate elsewhere, he or she loses the scholarship, and a new recipient is chosen.)
  • Applicants must complete an application.
  • Applicants must provide confirmation they have accepted an offer for admission to a Texas medical school.
  • Applicants must write an essay, not to exceed 750 words, explaining how they would "improve the health of all Texans." 

The winning candidates will be notified in March. A scholarship certificate will be presented at TexMed 2016 in Dallas on April 29. (Attendance is required.) 

Please share this information with eligible minority students in Texas, and encourage them to visit the program website and to apply. For more information, call (800) 880-2828, ext. 1600, or email Gail Schatte.   

TMA's 2016 Minority Scholarship Program is made possible with a grant from the TMA Foundation (TMAF) thanks to the TMAF Trust Fund of Dr. Roberto J. and Agniela (Annie) M. Bayardo; the TMAF Patrick Y. Leung, MD, Minority Scholarship Endowment; and generous gifts from H-E-B and physicians and their families.

Texas Physicians Lead TMAIT Board of Trustees

At its May meeting, the TMA Board of Trustees approved the nomination of Richard L. Noel, MD, of Houston, to serve on the TMA Insurance Trust (TMAIT) Board of Trustees until 2018. Roberto San Martin, MD, of San Antonio, will serve a final three-year term to end in 2018. 

At the September annual TMAIT meeting, Jack L. Cortese, MD, of Corpus Christi, was reelected to a second three-year term on the board to end in 2018. Bernard M. Gerber, MD, of Bellaire, was reelected to a final three-year term on the board to end in 2018. The TMAIT Board of Trustees unanimously approved the nominations of Drs. Gerber and San Martin to serve as chair and secretary, respectively, for the 2015–16 term.

This Month in Texas Medicine

The February issue of Texas Medicine Symposium on Medical Education, guest edited by Surendra K. Varma, MD, and John Jennings, MD, covers residency training costs, the Next Accreditation System, graduate medical education in rural Texas, Texas' physician workforce needs, the current state of education reform, and efforts to retain medical graduates in Texas. Dr. Varma is executive associate dean for graduate medical education and resident affairs, Ted Hartman Endowed Chair in Medical Education, university distinguished professor, and vice-chair of pediatrics at Texas Tech University Health Sciences Center. He is a member of the Texas Medicine Editorial Board. Dr. Jennings is the immediate past president of the American College of Obstetricians and Gynecologists. He is professor of obstetrics and gynecology at Texas Tech University Health Sciences Center at the Permian Basin. He is chair of the Texas Medicine Editorial Board.

Click to launch the full edition in a new window.  

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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.  

Deadlines for Doctors

TMA's Deadlines for Doctors alerts you and your staff to upcoming state and federal compliance timelines and offers information on key health policy issues that impact your practice.  

Last Day for PQRS Registry Reporting

Last Day for PQRS Qualified Clinical Data Registry Reporting (using XML format)

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.   

On-Demand Webinar

Financial Policies Do's and Don'ts
Medicare Now and Tomorrow
Physician Impairment Is More Than You Realize

Conferences and Events

TexMed 2016
April 29-30
Dallas Hilton Anatole

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Last Updated On

December 08, 2016