Pay It Forward and Be an MD Mentor
You probably remember what first motivated you to become a doctor: a family legacy, an aptitude for biology, or the desire to help those in need. But do you remember who had the biggest influence on how you practice medicine? Chances are it was a physician mentor.

Sunset Review of TMB Fails to Address Disciplinary Process Improvements
In comments to the Sunset Advisory Commission on its 2016–17 review of the Texas Medical Board (TMB), TMA says one important matter is disappointingly absent from the agency's thorough and detailed report: improving TMB's disciplinary process. While TMA generally supports the sunset staff's report, the association says more could be done to ensure effective operations at the medical board.

TDI Proposes HMO Rule Rewrite
Whenever a state agency undertakes a wholesale overhaul of a set of regulations important to physicians and patients, TMA examines the proposal extremely carefully. That's why a TMA staff team spent weeks studying the Texas Department of Insurance's (TDI's) Oct. 7 proposed repeal and rewrite of the entire regulatory chapter on HMOs.

PQRS: CMS Extends Informal Review Deadline to Dec. 7
If you submitted data to Medicare's Physician Quality Reporting System (PQRS) for the 2015 program year, make sure you review your quality reports. The reports include information about your quality and cost performance and whether you'll get hit with penalties or receive bonus payments. The Centers for Medicare and Medicaid Services extended the deadline to appeal errors in your report to 10:59 pm CT, Wednesday, Dec. 7, 2016. The original deadline was Nov. 30.

Year-End Checklist for Meaningful Use
The Medicare and Medicaid electronic health record incentive programs' 90-day reporting period for 2016 ends on Dec. 31. Now is a good time to review your meaningful use data and the program requirements to make sure you're on track.

Texas Announces Local Zika Virus Case in Rio Grande Valley
The Texas Department of State Health Services (DSHS) and Cameron County Department of Health and Human Services announced the first case of Zika virus disease likely transmitted by a mosquito in Texas. DSHS is supporting Cameron County's response to the case and to the ongoing risk of Zika in the community.

Navigate Health Care’s Rocky Future as a TMA Accountable Care Leader
Accountable care made big strides this year, and TMA has set the stage for members to get ahead of the curve while demystifying the paradigm shift. Applications are now open for TMA's 2017 Accountable Care Leadership Program. Participants will earn more than 95 hours of continuing medical education.

Don't Miss First Tuesdays at the Capitol in 2017
Your patients and your profession need you to be a lobbyist for a day. Mark your calendar now to join the Party of Medicine in Austin for First Tuesdays at the Capitol during the 85th Texas Legislature on Feb. 7, March 7, April 4, and/or May 2, 2017. The March 7 event is designated the official TMA Alliance First Tuesday, and the April 4 event is dedicated to medical students and residents. Registration is now open.

2017 TMA Winter Conference: Physician Leaders Unite
Reconnect with colleagues while earning continuing medical education credit at the 2017 TMA Winter Conference at the Hyatt Regency Austin downtown, Jan. 27–28. Whether facing local or national health care challenges, physicians unite under the TMA umbrella to improve the health of all Texans. Join the conversation and your colleagues for collaboration and education.

'Tis the Season to Share Advancements in Medicine
Have you or your colleagues implemented a recent clinical success or compiled innovative research that could improve the practice of medicine in Texas? The TexMed 2017 Poster Session is the perfect stage to share your insights and analysis with a large audience of Texas doctors while getting the kudos your work deserves.

Join the Movement to Get Smart About Antibiotics
In March 2015 the White House released the National Strategy for Combating Antibiotic-Resistant Bacteria to guide public health officials in limiting the emergence of antimicrobial-resistant organisms. The U.S. Centers for Disease Control and Prevention's (CDC's) Get Smart About Antibiotics program provides information and tools to physicians and providers on optimal use of antibiotics according to evidence-based clinical guidelines. The program also helps educate patients on the appropriate use of antibiotics.

Texas Doctors See Post-Election Opportunity to Reshape Health Care
The 2016 elections brought physicians an excellent opportunity to rebuild America's health care systems, TMA officials say.

TMB-Teladoc Lawsuit on Hold
The Texas Medical Board (TMB) and Teladoc are in "negotiations," as both have filed motions to put Teladoc v. TMB on hold until April 19, 2017. The previous trial date was set for February.

TMA Fights Medicaid Anesthesia Proposal
The Texas Society of Anesthesiologists (TSA) and TMA sent a formal letter and testified in person against a Texas Health and Human Services Commission (HHSC) plan to eliminate the "Physician-Led Anesthesia Care Team Model Billing" for Texas Medicaid. The change would cut payments to anesthesiologists who supervise certified registered nurse anesthetists and anesthesia assistants.

Feds Cut Meaningful Use Reporting Period to 90 Days
The Centers for Medicare & Medicaid Services (CMS) has reduced the meaningful use electronic health record (EHR) incentive program reporting period from a full year to 90 days in 2016. In 2017, physicians participating in the Merit-based Incentive Payment System (MIPS) will have several reporting options, including reporting on one patient to prevent a penalty, 90 days for a potential incentive, and a full year to receive an incentive. Physicians participating in the Medicaid meaningful use program will continue reporting the meaningful use measures for 2017 and will have a 90-day reporting period.

Wanted: Your Best Local Health News of 2016
TMA's Anson Jones, MD, Awards will celebrate 60 years of honoring outstanding health journalism in 2017. Help TMA make the anniversary memorable by nominating outstanding stories from your local media that have caught your attention this year.

TMA PracticeEdge Is Looking to Grow
TMA PracticeEdge will expand to Dallas-Fort Worth and West Texas next year and is looking for primary care physicians and internal medicine specialists to anchor several new physician-led accountable care organizations (ACOs) there. Establishing a new physician-owned ACO from scratch typically requires a significant capital expenditure. The TMA PracticeEdge turnkey solution, however, includes the majority of the upfront financial outlay.

DSHS Issues Hepatitis A Health Advisory
A Texas Department of State Health Services (DSHS) health advisory states the International Company for Agricultural Production and Processing (ICAPP) in Egypt has recalled all frozen strawberries and frozen strawberry products it has imported into the United States since Jan. 1, 2016. According to the advisory, the recall is the result of a current hepatitis A outbreak investigation by the U.S. Food and Drug Administration, the U.S. Centers for Disease Control and Prevention (CDC), and state health departments. DSHS says Texas has one suspected case of hepatitis A.

CME Course Covers Obesity Management in Children, Adolescents
A new Texas Health Steps continuing medical education (CME) program can help to equip Texas Health Steps physicians and providers and others with best practices in the assessment, treatment, and prevention of overweight and obesity in children and adolescents.

CDC Recommends Only Two HPV Shots for Younger Adolescents

The U.S. Centers for Disease Control and Prevention (CDC) recommends 11- to 12-year-olds receive two doses of human papillomavirus (HPV) vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by HPV infections. Teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses, CDC says.

 


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.

 


Check Your EHR Certification Compliance for Meaningful Use, MACRA

It's important to make sure your systems are compliant with the electronic health record (EHR) certification requirements for the meaningful use program and the Medicare Access and CHIP Reauthorization Act (MACRA). Certification ensures the EHR has all the necessary capabilities, functionalities, and security required so physicians can successfully attest to the Centers for Medicare & Medicaid Services (CMS) programs. Physicians must use at least a 2014-certified EHR to meet the meaningful use requirements for the 2017 program year. In 2018, physicians must have an EHR that meets the 2015 certification requirements for MACRA.

 


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.

 


Texas Quality Summit Confronts the Changing Face of Medicine; Register Now

For many practices to remain successful, especially in a post-MACRA environment, effective population health management is now a primary focus. To help physicians advance quality care as a core value of their practice, with an eye toward the future of accountable care, TMA developed the interactive 2016 Texas Quality Summit.

 


Navigate Health Care's Rocky Future: Join TMA's Accountable Care Leadership Program

New Medicare Access and CHIP Reauthorization Act (MACRA) rules released last month demonstrate that value-based health care is officially here to stay. Regardless of whether the words accountable care and value-based care cause you heartburn or your heart to flutter, TMA's 2017 Accountable Care Leadership Program can help demystify the paradigm shift. Applications are now open, and participants will earn more than 95 hours of continuing medical education credit.

 


DSHS Reminds Pregnant Women Who Travel to Mexico About Zika Testing

The Texas Department of State Health Services (DSHS) has issued a health alert to remind pregnant women who cross the border into Mexico that Zika testing is available to them. DSHS encourages them to discuss testing with their physicians. Current U.S. Centers for Disease Control and Prevention guidelines recommend Zika testing for any pregnant woman who has traveled to a country with ongoing Zika transmission, including those who regularly cross the U.S.-Mexico border.

 


TMF Announces 2016–17 Physician Practice Quality Improvement Award

Physician practices continue to make great strides in providing reliable preventive services by using health information technology and effective care management methods. TMF Health Quality Institute wants to recognize practices for their hard work. TMF is once again sponsoring the Physician Practice Quality Improvement Award program.

 


Tools Help Reduce Inappropriate Prescribing of Antipsychotic Medications
Antipsychotic prescribing for patients with dementia has received intense scrutiny lately. Data suggest that in some Texas facilities physicians add new diagnoses, such as schizophrenia, to residents' clinical records to justify antipsychotic use, even in residents without a history of mental illness. According to the Texas Health and Human Services Commission (HHSC), inappropriate use of antipsychotic medications can harm people with dementia, as noted in the Food and Drug Administration's black box warning, which appears on a prescription drug's label and is designed to call attention to serious or life-threatening risks.

Nominate a Gifted Texas Science Teacher Who Deserves Recognition
TMA is giving away $24,000 in cash prizes. Help spread the word. Three Texas science teachers will receive $5,000 each and an all-expense paid trip to TexMed 2017 in Houston for the award ceremony. Their schools will receive a $2,000 award to use for the science curriculum. Second-place winners receive $1,500 and another $1,000 for their schools.

TMA Supports JUA's Ability to Write New Business
On Oct. 5, TMA sent a letter urging Texas Department of Insurance (TDI) Commissioner David Mattax to prevent the Texas Medical Liability Insurance Underwriting Association (JUA) from suspending the writing of new business. The JUA, established in 1975, is "critically important as a last stop gap to assure that licensed physicians and health care providers are able to continue to provide medical and dental care for their Texas patients," TMA wrote.

Will Health Quality Improve Under New Medicare?
Medicare is revolutionizing how physicians are evaluated and paid to provide care, and patients will see changes as a result, focusing in their care quality. As Texas doctors adapt to the new Medicare payment system, many are concerned about the changes, while others are optimistic the transition will result in healthier patients. The switch to the new Quality Payment Program under the Medicare Access and CHIP Reauthorization Act (MACRA) means physicians who care for Medicare patients must change how they run their practice – and care for their patients.

ICD-10 Update Creates Problems for PQRS Reporting, Value Modifier
As if physicians don't have enough headaches and hassles to deal with to keep their practice doors open, the latest news from the American Medical Association is not good. It turns out the Oct. 1 ICD-10 update will negatively affect some physicians who participate in quality reporting for the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. To determine whether the update affects your specialty, review the list of affected quality measures.

Be in the Know When You Purchase an EHR
The recently updated TMA EHR Vendor Comparison Tool provides TMA member physicians access to an assessment of EHR products that have a solid Texas market base. It gives physicians a view of company information, product functionality, pricing, and interoperability capabilities when comparing EHR systems.

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.

TMF Launches Quality Payment Program Network
The TMF Quality Innovation Network Quality Improvement Organization (QIN-QIO) has created a new network to help physicians and clinicians make the transition under the Medicare Access and CHIP Reauthorization Act (MACRA) to participate in Medicare's new Quality Payment Program and its Merit-Based Incentive Payment System (MIPS). To learn more and create a free account, visit the TMF Quality Payment Program web page.

What Happened to 2017's Half-Percent Medicare Fee Hike?
Zero. That's how much physicians' overall Medicare fees will go up next year, according to the Centers for Medicare & Medicaid Services' (CMS') complex rule on the 2017 proposed Medicare Physician Fee Schedule.

TMA Offers New 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.

HHSC Offers STAR Kids Webinar for Physicians
If you participate in Medicaid, don't forget about the STAR Kids managed care program coming Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 years and younger who have disabilities.

TMA, California, Florida Form Joint Venture
TMA and the medical associations of California and Florida have formed PSO Services, LLC, a physician services organization with a national scope. The new company will offer a suite of market-based services to support physicians who want to remain independent during this time of increasing government regulation and changing payment models. Working to leverage the trust that physicians place in their state associations, PSO Services will focus initially on developing physician-owned networks to enter into value-based care contracts and manage population health.

Texas Hits Record for New Physician Applications
The Texas Medical Board (TMB) finished is fiscal year last month having received a record number of new physician applications. TMB received 5,544 new applications, up 3 percent from the previous year's record 5,377 applicants.

TMA Backs Definition of Emergency in Obstetrical Case
Last month, TMA signed on to the Texas Alliance for Patient Access' (TAPA's) friend-of-the-court brief to support the application of the willful and wanton standard in a lawsuit involving emergency obstetrical care. TMA, TAPA, and other signatories contend emergency care provisions apply to medical care provided in an obstetrical unit without the pregnant patient first having been evaluated in a hospital's emergency department.

TMA, AMA Oppose Bill That Would Threaten Patient Safety
TMA and the American Medical Association have serious concerns about proposed federal telemedicine legislation that would preempt state laws governing medical licensure, medical practice, and professional liability. The legislation would change the originating site of care from the patient's location to the physician's location, ostensibly to enable telemedicine across state lines for patients in the TRICARE program. TMA signed on to AMA's letter to Congress to object to the serious threat to important and demonstrated patient safety protections provided by adherence to licensure and medical practice laws in the state where the patient receives services.

TMB Adopts Call Coverage Rules
At its Aug. 25 meeting, the Texas Medical Board (TMB) voted to adopt without change its recently proposed call coverage rules. The rules outline requirements for two models for call coverage: a reciprocal call coverage arrangement for physicians in the same or similar specialty and a nonreciprocal arrangement that does not require reciprocal call coverage.

I.C. System Helps You Collect More Patient Payments
Patient debt collection can severely hamper a practice's productivity and diminish your bottom line. Recent studies show that only 21 percent of patient balances not collected up front, at the time of service, are ever collected. When staff spends valuable time on collections, practices stand to lose even more. In fact, practices would have to cut costs by roughly 31 percent to make up for lost patient revenue.

Focus on Member Services: Future-Proofing Your Practice
As medical practices collect and store more information electronically, physicians will encounter more frequent technology breaches. The cost of a breach can be huge: an average of $402 per compromised record, plus fines. TMA makes robust security for your practice easy through education and services designed to manage the worst technology risks.

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).

Is MACRA Worth Your While?
Does it make financial sense for your practice to participate in the Medicare Access and CHIP Reauthorization Act (MACRA) programs?

PAT Transitions to Pharmacy Board; Expect Delays
Effective Sept. 1, you will no longer be able to log in to the Prescription Access in Texas (PAT) website  with your login information. That's because the Texas Prescription Monitoring Program will transfer from the Texas Department of Public Safety to the Texas State Board of Pharmacy (TSBP) and will transition to a new type of software. TSBP advises there will be a delay in prescription history of up to two weeks during the transition.

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.

TMA's Medicaid Recommendations Can Improve Care, Reduce Costs
As state lawmakers begin preparing for the 2017 legislative session, TMA and four state specialty societies delivered a detailed, five-page document with significant recommendations to improve the Texas Medicaid program.

Walking Goes Viral With the U.S. Surgeon General
On Oct. 5, U.S. Surgeon General Vivek Murthy, MD, plans to release a two-week #StepItUp challenge to celebrate his call to action on walking and walkability. TMA wants you and your patients to participate. Join Walk With a Doc Texas leaders by getting moving during the two-week period. You can prepare now.

TMA Tries to Lift New Medicare Burden From Small Practices
According to Texas Medicine magazine, the new government requirement is putting a strain on smaller medical practices — and over time, could force some doctors to retire or surrender their small medical practice. That could reduce patients’ access to doctors’ care.

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.