Supervise an APRN or PA? What You Need to Know
Delegating duties to an advanced practice registered nurse (APRN), physician assistant (PA), or other nonphysician can be an excellent way to enhance your practice and improve your patients' access to quality medical care. But, a newly updated TMA white paper cautions, you have to do it right. Your license to practice may be at risk.

Update: Medicare Delays New Bundled Payment Models Until 2018

Medicare won't expand its bundled payment program for orthopedic surgery and won't start several similar programs for cardiac care until Oct. 1 — and maybe later — the Centers for Medicare & Medicaid Services announced.

MACRA Resource Center
The Sustainable Growth Rate is gone, so now what's next? Is your practice ready for quality-based payment? Is that even the right direction for you to go? With the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) taking effect and the Merit-Based Incentive Payment System on the horizon, making no changes may cost you, but implementing changes (the wrong way) may cost you more. Evaluate what direction your practice should take and then do it right with these tips and tools.

TexMed 2017 Roundup: TMA to Fight Medicaid Funding Caps
The Texas Medical Association will continue to fight federal lawmakers' attempts to cap funding for the state’s Medicaid recipients, as proposed in the American Health Care Act, TMA's House of Delegates decided at TexMed 2017 last week.

Texas Medicine Pushes Through Final Legislative Flurry
Earlier this month, at the final First Tuesdays at the Capitol event of the 2017 legislative session, TMA lobbyist Darren Whitehurst told physicians he could see the light at the end of the tunnel, but that he'd have to wait until session was over to say "whether it's a train or not." Whether it turns out to be a train or a shining, promising new destination for Texas medicine, that mysterious light is now even closer as just two weeks remain until the session adjourns.

TMA: Process to Remove SSNs from Medicare ID Cards Will Cause Confusion, Delays
Removing patients' Social Security numbers from their Medicare ID cards is needed to protect their privacy, TMA and other medical societies say, but the way it's being handled will cause unnecessary confusion and delays in care.

Zika Virus Testing — New Medicaid Instructions for Laboratories and Ordering Physicians
Laboratories must use a U4 modifier when submitting Medicaid claims for Zika virus testing, the Texas Medicaid and Healthcare Partnership announced on May 5.

MIPS-Exempt? Check Online
Physicians can now go online to determine whether they are exempt from the Merit-Based Incentive Payment System (MIPS) for the 2017 performance period. Remember, your 2017 MIPS scores can affect your 2019 Medicare payments.

TMA Fights for Physician Named in Civil Rights Suit
A civil rights ruling against a Houston physician exposes medical examiners and other government employed physicians to undue liability lawsuits, and should be overturned, according to a brief filed by TMA and other groups.

Reminder: Physicians No Longer Need Controlled Substances Registration
TMA reminds its members they no longer need a Department of Public Safety controlled substances registration.

Internist Mentors Needed STAT in Major Metro Areas
Are you a primary care physician practicing in Houston, Dallas, Fort Worth, San Antonio, Austin, El Paso, or the Rio Grande Valley? If so, medical students in your community need your support.

Get the Tools You Need to Treat Postpartum Depression
Texas clinicians now have a comprehensive online resource for screening, diagnosing, and treating postpartum depression.

Three Organizations Get Early Approval to Prescribe Cannabis
The Texas Department of Public Safety has conditionally approved three physician organizations to prescribe low-THC cannabis to patients diagnosed with intractable epilepsy.

How to Submit the Bare Minimum to Avoid 2019 MIPS Penalty

Under the new Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rules, physicians submit data on their 2017 performance, and that data will affect their 2019 Medicare payment rates. TMA has compiled some easy steps you can take now to avoid the 4-percent Medicare penalty in 2019.

State Issues Meningococcal Disease Alert
The Texas Department of State Health Services (DSHS) is investigating a case of possible exposure to meningococcal disease at a Houston event in mid-April that had thousands of attendees, DSHS announced in an alert through the Texas Public Health Information Network.

Federal Tort Reform Bill Should Mirror Texas Law, Groups Say
Physicians, hospitals, and other health care providers throughout Texas would lose substantial protections against frivolous medical lawsuits if a bill working its way through the nation's capital becomes law, two Texas medical groups say.

Beware of Buying, Prescribing Illegal and Unlicensed Drugs
TMA reminds physicians and providers that buying medical devices and drugs from illegal or unlicensed sources not only puts patients in danger but also can result in criminal charges, fines, and jail time.

Feds Give Texas Millions to Fight Opioid Addiction
Texas is set to receive an injection of federal dollars as part of a nationwide effort to fight opioid addiction.

Training to Focus on Opioid Prescribing Guidelines
The U.S. Centers for Disease Control and Prevention (CDC) has launched an online training series to help clinicians apply its opioid prescribing guidelines for adults with chronic pain.

Are You MIPS Exempt? Word Coming Soon
Physicians, check your mailboxes to find out whether you are eligible or exempt from the Merit-Based Incentive Payment System (MIPS) for the 2017 performance period and what that may mean for your 2019 Medicare payment rates.

Empower Future Physicians in Three to Four Weeks
Follow in the footsteps of the physicians who influenced your work in primary care. Sign up to serve as a physician mentor for the 2017 General Internal Medicine Statewide Preceptorship Program (GIMSPP), hosted by the Texas Chapter of the American College of Physicians (ACP).

Medicine's Priorities Advancing as Legislature Enters Home Stretch

Less than a month-and-a-half remains until the Texas Legislature adjourns, and recent weeks provided encouragement for many of medicine's foremost interests in the 2017 session.

New White Paper Helps You Stay HIPAA Secure
TMA and DocbookMD are offering a new, free white paper to help answer your HIPAA questions about the proper use of mobile technology in health care.

Your Video Guide to Texas' New Prescription Drug Monitoring Program

In an effort to address the very real and debilitating crisis caused by the misuse of opioid pain medicines, the Texas Sunset Advisory Commission has recommended a mandate that all prescribers and pharmacists check the state's Prescription Drug Monitoring Program before prescribing any controlled medication.

Feds Delay Office-Based Lab Financial Reporting
The Centers for Medicare & Medicaid Services has pushed back to May 30 the deadline for physician office-based laboratories to meet new financial reporting requirements.

Focus on Member Services: Getting Paid
TMA's Hassle Factor Log recouped more than $1.8 million in unpaid insurance claims for physician members last year. If you have unresolved payment issues, know that your TMA membership gives you access to help to get you paid.

Physicians, Public Put on Alert as Texas Mumps Cases Reach 20-Year High
State health officials are advising physicians and providers to stay on alert for mumps as statewide cases of the highly contagious disease reach a 20-year high.

Mitigate and Minimize EHR-Related Safety Hazards
The Office of the National Coordinator for Health Information Technology recently released updated SAFER Guides to help health care organizations assess and optimize the safe use of electronic health records (EHRs).

What Makes a Good Practice Website?
TMA has dozens of resources available to help you answer this question. These include TMA-endorsed vendor Officite, which provides practice websites and online marketing services to TMA physician members at exclusively discounted rates. TMA members can save up to 37 percent on these services.

A Bad West Nile Season Coming to North Texas?
The Dallas County Department of Health and Human Services has detected the year's first West Nile virus-infected mosquitoes in the county and warns that could be a bad sign.

State Calls for More Zika Testing in South Texas
The Texas Department of State Health Services has expanded its Zika Testing Criteria for residents of the Lower Rio Grande Valley in an effort to quickly identify and respond to new infections of the mosquito-borne virus.

TMA Asks Feds to Delay Next EHR Upgrade Mandate

TMA joined with the American Medical Association and 104 other medical societies in asking the Centers for Medicare & Medicaid Services (CMS) to defer implementation of the 2015 Edition of certified electronic health record technology (CEHRT).

Directory Measure Aims to Tackle Surprise Bills; TMA Continues Push for Public Health Priorities

The 60-day bill-filing deadline for the Texas Legislature has come and gone, allowing one thick puff of smoke to finally clear from the 2017 legislative fire. Now, medicine can focus on the hottest logs in the fire pit. For TMA, that means more than 1,400 pieces of legislation to track, with measures that address such smoldering topics as the network inadequacies that fuel surprise-billing issues; public health issues like vaccination exemptions and tobacco use; proper definition and regulation of telemedicine; and troubling scope-related legislation that would allow other practitioners to infringe on the practice of medicine.

Texas Wins Tort Border Battle

The New Mexico Supreme Court ruled Monday in favor of a Lubbock physician entangled in a question of whether Texas or New Mexico law should apply in a liability case involving care that was provided in Texas but for a New Mexico patient.

New Form Required for All Medicaid EHR Incentive Program Participants

Starting April 1, all participants of the Medicaid electronic health record incentive program for program year 2017 or later must complete a Third Party Attestation Authorization Form indicating whether you intend to use a third party to complete your meaningful use attestation.

Famed Texas Pathologist's Records Released

Fort Worth pathologist May Owen, MD, blazed many a trail during her long career in medicine. Now, digital versions of the papers and records that document her path are available in the Portal to Texas History.

Meaningful Use Hardship Exemption Application Due by July 1

Physicians who are not participating in the Medicare electronic health record incentive program, also known as meaningful use, will be penalized by Medicare beginning Jan. 1, 2018. To prevent the penalty, physicians must have either attested to meaningful use by March 13, 2017, or applied for a hardship exemption by July 1, 2017.

TMA and Health Plans Tackle Medicaid Credentialing Hassle

TMA and the Texas Association of Health Plans announced a joint effort to reduce red tape and administrative burdens for physicians and providers who participate, or want to participate, in the Texas Medicaid program. The two organizations selected Aperture, LLC, for a statewide credentialing verification organization contract to be used by all 20 Medicaid health plans in Texas to streamline the credentialing process.

Houston Heart Surgeon Wins Millions in Defamation Claim

A Harris County jury has awarded $6.4 million in damages to a Houston cardiothoracic surgeon whom TMA supported in his years-long battle with Memorial Hermann Health System over a defamation claim.

Texas Medicaid EHR Incentive Program Attestation Deadline Extended
The Texas Medicaid Electronic Health Record (EHR) Incentive Program extended the deadline for physicians to attest to receive incentives for program year 2016. The new deadline is May 15, 2017.

TMA Outlines EHR Concerns for House Chair
The potential for electronic health records (EHRs) to transform health care remains constrained by the lack of effective health information exchange technology, TMA says in a letter to U.S. House Ways and Means Committee Chair Kevin Brady (R-The Woodlands).

TMA Foundation Grants Support Collaborations to Prevent Illness
Improving the health of all Texans through prevention is the focus of two grants recently approved by the TMA Foundation Board of Trustees.

Practice Websites Targeted in ADA Shakedown
An Austin attorney is sending demand letters to physicians and providers across the state alleging that their websites are not accessible to people with visual disabilities and that he will personally sue them unless they pay him $2,000 plus attorney fees.

Sunset Commission Calls for Mandatory Pain Med History Checks
In its Report to the 85th Legislature the Sunset Advisory Commission recommends breathing 12 more years of life into the Texas Medical Board and goes into great detail about TMB's oversight of physicians who prescribe "extremely addictive and dangerous drugs, particularly drugs designed for patients with chronic pain, as some of these drugs contribute to an epidemic of addiction and overdose throughout the country." The commission recommends "the board target its inspections of pain management clinics toward the top prescribers, that the board more effectively monitor prescribing patterns through the newly enhanced Prescription Monitoring Program (PDMP), and that physicians and physician assistants be required to search the program and review a patient's prescription history before prescribing dangerous pain medications."

Victory: Anthem-Cigna Merger Blocked by Court
In a significant win for organized medicine and the nation's patients, federal judge Amy Berman Jackson blocked the proposed Anthem-Cigna merger. She found that the merger would have substantially lessened competition for the sale of health insurance to national employers, resulting in higher prices and diminished prospects for innovation. Anthem Inc. planned to take over Cigna for $50 billion. American Medical Association findings show the Anthem-Cigna merger would enhance market power in 85 metropolitan areas within 13 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, and Virginia.

Comptroller Releases Health Care Spending Report
Texas Comptroller Glenn Hegar issued a report examining health care-related spending by 68 state agencies and higher education institutions from 2011–15.

Challenges in Austin, Change in Washington
One month into Texas' 2017 legislative session, the ramp-up is beginning as medicine and lawmakers ready for what's certain to be a flurry of activity related to health care.

Confused About Quality Reporting? Get Help From TMF and TMA
Reporting deadlines for the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS), Value-Based Payment Modifier, and meaningful use programs are fast approaching. This data submission timeframe is happening at the same time CMS is rolling out the new Quality Payment Program, Merit-Based Incentive Payment System (MIPS), and advanced alternative payment models required by the Medicare Access and CHIP Reauthorization Act (MACRA). Are you confused about the alphabet soup of quality reporting? If so, get help from the TMF Quality Innovation Network and TMA Practice Consulting.

Registration Open for the Texas Primary Care and Health Home Summit
This year’s Texas Primary Care and Health Home Summit will be the fifth annual statewide conference focused on expanding access to high-quality, person-centered primary care for Texans and their families. Sponsored by TMA, the summit will offer stakeholders the opportunity to learn about innovative primary care models, including the health home. Attendees will become conversant with best practices for innovation in primary care and will have opportunities to interact with program experts at various stages of implementation. Register now to attend the summit May 11–12 at the Sheraton Gunter in San Antonio.

Federal Court Order Blocks Aetna-Humana Merger
U.S. District Judge John Bates sent a clear message last month when he issued an order imposing an injunction on Aetna's $37 billion acquisition of Humana, which focused largely on buying up Humana's Medicare Advantage business. The judge found the merger would "be likely to substantially lessen competition" in the Medicaid Advantage market. Indeed, it would have a significant impact across Texas — and 13 other states — likely enhancing Aetna's market power to concerning levels per the federal government's own standards, according to a comprehensive American Medical Association analysis.

TMA Offers Cyber Security and Ransomware Tools
Ransomware has reached Texas, and its emergence highlights the importance of up-to-date security. Health care is particularly vulnerable to the ransomware threat. KPMG's 2015 Health Care and Cyber Security Survey, which polled 223 U.S.-based health care executives, found four-fifths of respondents said cyber attacks had compromised their information technology.

AMA Publishes Newly Updated Code of Medical Ethics
Completely updated after an eight-year modernization project, a revised edition of the Code of Medical Ethics is available from the American Medical Association in hardcover or e-book. The revised edition contains ethical guidance improved for relevance, clarity, and consistency to help physicians keep pace with emerging demands they face with new technologies, changing patient expectations, and shifting health care priorities.

TMA Is 50,000 Members Strong and Growing
TMA is proud to announce the association ended 2016 with more than 50,000 members! Reaching this major milestone is an first for any state medical association, and the achievement is much more than a feather in TMA’s cap.

Court Sides With TMA in Final Ruling on Chiropractic Scope of Practice Lawsuit

We won! In a final judgment by Travis County District Court Judge Rhonda Hurley, TMA prevailed in its long-held declaration that the Texas Board of Chiropractic Examiners' (TBCE's) rules permitting chiropractors to make medical diagnoses and perform other medical procedures exceed the chiropractic scope of practice.


TMA Wins MACRA Improvements, Wants More
Medicine won some relief in the Centers for Medicare & Medicaid Services' (CMS') final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA). Responding to medicine's vehement concerns, CMS decided physicians who at least try to comply with the new rules    next year will see no penalty in their payments in 2019, the first year the penalties were set to apply. That's because starting in 2017, physicians' performance on various quality, cost, technology use, and practice improvement measures determines cuts or bonuses in their payments two years later.

TMA Offers Health System Reform List to House Leaders
In response to outreach from U.S. House Majority Leader Kevin McCarthy (R-Calif.), House Ways and Means Committee Chair Kevin Brady (R-The Woodlands), and other House Republican leaders, TMA provided a list of nine health care policy suggestions for the next Congress to consider.

HIT Tools and Resources at Your Fingertips
TMA works diligently to give you the tools you need to tackle the challenges of technology. Whether you need help selecting an electronic health record (EHR) or understanding the EHR incentive program or information on e-prescribing, TMA has the resources. You can find links to all of these tools on the Technology page of the TMA website.

Updated TMA White Paper Delves Into Corporate Practice of Medicine Doctrine

"The Corporate Practice of Medicine," TMA's latest white paper, focuses on the development of the corporate practice of medicine prohibition, current applications and prohibitions, potential exceptions to the law, key considerations in relevant corporate practice of medicine court cases, and penalties for violations of the corporate practice of medicine doctrine.


Half of All U.S. Physicians Say They Are Burned Out
U.S. physicians love their patients and hate paperwork. Unfortunately, a newly released survey by The Physicians Foundation finds that the paperwork is winning. Fifty-four percent of physicians surveyed say their morale is somewhat or very negative, and 49 percent say they either often or always feel burned out.

TMA Survey Documents the State of EHRs in Texas
TMA's biennial Physician Survey identifies emerging issues, tracks the impact of practice and economic changes, assesses physician priorities, and develops data to support TMA advocacy efforts. TMA has distilled the preliminary findings of one part of that survey into a two-page infographic that highlights Texas physicians' perceptions of the pros and cons of electronic health records (EHRs).

New Rules Say You Must Address Language Barriers
Oct. 16, 2016, brings a new requirement for a sign to post on your practice walls, as well as a plan for fulfilling its promise. TMA’s new white paper has all the details about accommodating your patients with limited English proficiency.

Delegating and Supervising Prescribing Privileges for APRNs/PAs
New state law governing the delegation and supervision of prescribing privileges for advanced practice registered nurses and physician assistants went into effect Nov. 1.  MembersOnlyRed

Find It, Fix It, Keep It: Patient Protection and Affordable Care Act
Affordable Care Act: Find What’s Missing. Keep What Works. Fix What’s Broken.