Hot Topics

CDC Issues Zika Virus Health Advisory
The U.S. Centers for Disease Control and Prevention 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.

Apply for Meaningful Use Hardship Exception by March 15
It's no secret TMA has been less than thrilled with the meaningful use electronic health record 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.

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.

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 — Immunize 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.

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 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 offering, available from TMA, which features the latest information on type 2 diabetes.

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.

Apply Now for Internal Medicine Preceptorship Program
The Texas Chapter of the American College of Physicians 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.

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 TVFC Provider Agreement form to remain an active participant in the program.

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.

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.

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.

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.

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.

Tips From TMA to Help You Survive a Meaningful Use Audit
The Centers for Medicare & Medicaid Services conducts prepayment and post-payment meaningful use audits. Some are random; some are based on complex algorithms. If you participate in meaningful use, document everything indicating that you have met all meaningful use criteria.

Take Part in New CMS Clinical Care, Social Services Model
The new Centers for Medicare & Medicaid Services (CMS) Accountable Health Communities model bridges clinical care and social services to help address Medicare and Medicaid beneficiaries' health-related social needs. Physician practices are among the list of eligible applicants who can take part in this new CMS model.

CMS Finally Releases Stage 3 Meaningful Use Rule
After much anticipation among the medical community, the Centers for Medicare & Medicaid Services (CMS) has released the meaningful use modification rule.

TMA's Accountable Care Leadership Program
Participants in the 10-month certificate program get schooled in topics like communication skills, teamwork, and population health management, meant to help physicians adapt in a rapidly changing environment that demands more accountability and proof of value for the health care dollar.

TMA Says Future Medicare Requirements Are Wasteful, Costly
The Texas Medical Association is "very concerned that many of the compliance, documentation, and reporting requirements that will be implemented in the future Medicare system are wasteful, costly, and do little or nothing to improve care quality or increase efficiency," TMA President Tom Garcia, MD, told the Centers for Medicare & Medicaid Services (CMS).

TMA, AMA Want to Lift Ban on New Physician-Owned Hospitals
TMA and the American Medical Association aren't too thrilled with legal limitations placed on the expansion of physician-owned hospitals. The organizations told Congress just that in a letter of support for HR 2513, legislation introduced by Reps. Sam Johnson (R-Texas) and Ruben Hinojosa (D-Texas) that would partially lift the ban on new physician-owned hospitals and also address limitations on the growth of existing facilities.

TMA: CMS Needs to Back Off on Medicare Penalties
An error on the part of the Centers for Medicare & Medicaid Services (CMS) penalizes some physicians, forcing those affected by the blunder to appeal a potential payment cut by Dec. 16. Last month, the agency announced it had "issues" with data submitted by physicians who participated in the CMS Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VBM) programs. CMS also had "issues" with how it used that data to calculate payment penalties. The hassle caused by CMS means those physicians who took part in PQRS and VBM have to dust off their quality and cost reports to determine whether they're among the thousands at risk of incurring payment penalties come Jan. 1, 2016.

Physicians: Reenroll in Medicaid by Sept. 25, 2016
The Affordable Care Act requires all Medicaid health professionals to reenroll in the program at least once every five years (some professionals must reenroll more frequently). Physicians are next on the list and must reenroll by March 24, 2016.  However, if you initially enrolled or reenrolled on or after Jan. 1, 2013, you will be required to reenroll by the date indicated on your enrollment letter.

TMA Educates Doctors on Vaccine Exemptions
Texas remains one of 19 states that allows medical exemptions and conscientious objections to any required vaccines for children enrolled in school. Many state legislatures have considered or passed new laws related to exemptions, including a repeal of philosophical exemptions and a requirement for exemption data to be published.

TMA Asks CMS to Delay Meaningful Use Stage 3
TMA is "disappointed and frustrated" with the Centers for Medicare & Medicaid Services' (CMS') insistence on going forward with Stage 3 meaningful use and its resistance to significantly reform Stage 2. "These rules will only serve to penalize physicians who participate in Medicare and hinder progress on the adoption of EHRs and the exchange of information," TMA and the medical associations of California, Florida, and New York told CMS Acting Administrator Andy Slavitt in a Dec. 15 letter.

TMA: Marriage, Family Therapists Can't Diagnose
On Dec. 31, 2015, TMA filed a response brief with the Supreme Court of Texas in regard to Texas State Board of Examiners of Marriage and Family Therapists and Texas Association of Marriage and Family Therapy vs. Texas Medical Association. The brief examines whether the Texas State Board of Examiners of Marriage and Family Therapists' rule authorizing marriage and family therapists to diagnose any and all known mental disorders falls within the scope of practice set forth in state law. In the brief, TMA argues the plain meaning of the Licensed Marriage and Family Therapist Act doesn't include diagnosis.

When Disaster Strikes, Ask for a Claims Filing Extension
You know Texas weather. In 2015, floods, blizzards, tornadoes, and windstorms plagued the state. Some physician practices experienced severe damage, and they had to scramble to get back on their feet. Under Texas prompt payment laws, you may be able get an extension of the 95-day claims filing deadline if you believe you will not be able to meet it for some claims because of a catastrophic event, like a tornado.

PQRS: Report 2015 Data Now to Avoid 2017 Penalties
If you plan to participate in Medicare's Physician Quality Reporting System (PQRS) and value-based payment modifier programs for the 2015 performance period, now is the time to submit your data on quality measures. Depending on the reporting mechanism used, deadlines vary from February through March 2016.

Vaccinate Your Adolescent Patients Against HPV
During the next year, more than 1,000 Texas women will be diagnosed with cervical cancer, and nearly 400 will die from it. During Cervical Cancer Awareness Month in January, TMA is offering new tools to help physicians prevent their adolescent patients from getting this cancer down the road. A continuing medical education course and an infographic on human papillomavirus (HPV), the cause of most cervical cancers, assist physicians in urging their patients to get vaccinated against HPV.

Earn CME at TMA's Physician Health and Wellness Conference
Integrative Medicine and Physician Health is the theme of TMA's Physician Health and Wellness Training Session and 23rd Annual Retreat, which will take place Feb. 26–27 at Lakeway Resort and Spa in Austin. Presented by the TMA Committee on Physician Health and Wellness (PHW), the conference is accredited for a maximum of 11.25 AMA PRA Category 1 Credits ™, 8.25 designated as ethics and/or professional responsibility education.

HHSC Holds Information Sessions on STAR Kids Program
The Texas Health and Human Services Commission (HHSC) has scheduled information sessions at various locations around the state this month and in February to educate doctors and families on the new STAR Kids program. The new managed care program will provide Medicaid benefits to those younger than 21 who have disabilities and who receive a Medicaid waiver or Supplemental Security Income benefits in the Medicaid program.

Medicare Meaningful Use Portal Open Jan. 4 - Feb. 29
The Centers for Medicare & Medicaid Services is updating the meaningful use attestation portal to align with the modified Stage 2 measures released on Oct. 16, 2015. The portal will be open for 2015 program year attestations from Jan. 4 to Feb. 29, 2016.

Doctors Can Prohibit Handguns in Medical Offices
If you're not exactly jazzed about the thought of patients carrying handguns into your medical practice next year, you can do something to prevent it. House Bill 910 by Rep. Larry Phillips (R-Sherman) goes into effect Jan. 1, 2016, and it allows Texans with handgun licenses to openly carry their handguns in a hip or shoulder holster. TMA has received questions regarding whether physicians can post a notice at their practices prohibiting anyone from entering with a handgun – concealed or openly. The answer depends on the type of property the medical office is located on. Generally, a private property owner may post notice prohibiting the carrying of handguns   , but HB 910 contains many requirements. TMA's white paper, titled [insert title and link], has more information for physicians.

TMA Weighs in on Proposed TMB Rules
TMA has been busy submitting comments on proposed Texas Medical Board rules. TMA President Tom Garcia, MD, signed three separate comment letters, which pertain to out-of-network claim dispute resolution; a monitoring, proctoring, or supervising physician/professional's recommendation for competency assessment; and visiting physician temporary permits.

Participate in the Texas Two Step Mass CPR Event
Help the Texas College of Emergency Physicians, HealthCorps, TMA, and the American College of Emergency Physicians make history Feb. 6 by joining Texas medical students at the Texas Two Step CPR training. The goal of the 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.

Doctor's Recommendation Key in HPV Vaccination
When it comes to human papillomavirus (HPV) vaccination among children and adolescents, a physician's recommendation really does make a difference. That's according to The University of Texas MD Anderson Cancer Center's detailed assessment, or "environmental scan," on HPV vaccination in Texas pediatric care settings.

TMA Accountable Care Leadership Program Enrolling for 2016
Are you ready to lead in the new health care landscape? TMA is now accepting applications for the 2016 Accountable Care Leadership Program. Applications are due Jan. 15. View the sample curriculum, get more information, or apply on the TMA website.

TMF Helps With Value-Based Improvement, Outcomes
The TMF Quality Innovation Network Quality Improvement Organization's Value-Based Improvement and Outcomes Network offers free consultants and tools to help you better understand and meet the goals of the Centers for Medicare & Medicaid Services Physician Quality Reporting System and value-based payment modifier programs. In addition, participants can attend live and on-demand webinars and conferences and visit online forums that allow peers and community leaders to share successful improvements and best practices.

Congress Expedites 2015 Meaningful Use Stage 2 Exemptions
In December, Congress adopted S. 2425, known as the Patient Access and Medicare Protection Act, which included a provision granting the Centers for Medicare & Medicaid Services (CMS) the authority to expedite applications for exemptions from meaningful use Stage 2 requirements for the 2015 calendar year.

Teladoc's Antitrust Suit Against TMB Moves Forward
Teladoc's lawsuit against the Texas Medical Board (TMB) is heating up. On Dec. 14, U.S. District Judge Robert L. Pitman refused to dismiss telemedicine provider Teladoc Inc.'s antitrust challenge of TMB's rule requiring, in most circumstances, a defined physician-patient relationship (including a physical examination either in person or face-to-face via telemedicine with a presenter) before  prescribing a dangerous drug or a controlled substance.

EPCS Permitted in Texas
The start of the New Year is a good time to remind you of a Texas law that permits physicians to electronically prescribe controlled substances. If you regularly write prescriptions for controlled substances, you may find value in upgrading your technology to comply with the federal and state regulations.

Take Action to Avoid a Medicare Meaningful Use Penalty
While Medicaid does not penalize physicians who are not meaningful users of their electronic health record, Medicare does.

Free PDR App Puts Latest Drug Information at Your Fingertips
Stay up to date on the latest pharmaceutical drug information with the new official PDR drug information app, mobilePDR. It's free for physicians and medical students and is now available for Apple and Android devices.

Tell ONC Your EHR Complaints
Electronic health records (EHRs) are becoming ubiquitous, with 69 percent of Texas physicians now using them to record patient visits. Physician satisfaction varies with EHRs, and sometimes it depends on the product purchased or leased.

Renew Your TMA Dues Automatically; Write Off Expense
Do you have funds remaining in your 2015 continuing medical education or dues budget allotment? If so, you can renew your 2016 TMA membership now, before your funds expire. TMA estimates 83 percent of your membership dues may be deductible as ordinary and necessary business expenses.

Learn More About TMF's Behavioral Health Network
The TMF Quality Innovation Network Quality Improvement Organization's new Behavioral Health Network offers tools and training to help increase screening rates for Medicare beneficiaries receiving care at primary care practices. With depression screenings and annual behavioral assessments now routinely covered under the Affordable Care Act, primary care physicians now will be paid adequately for these essential preventive services.

AMA, TMA Tell Feds to Speed Up Release of MACRA Funds
The federal government needs to kick it in gear and release funds for "the development of quality measures and technical assistance to small practices" authorized by the Medicare Access and CHIP Reauthorization Act (MACRA). That's the gist of an Oct. 7 letter from the American Medical Association to Centers for Medicare & Medicaid Services Acting Administrator Andrew Slavitt. TMA signed on to the letter in support of expeditious release of the critical funding.

TMA Wants Meaningful Use Hardship Exception
TMA President Tom Garcia, MD, told U.S. Rep. Tom Price, MD (R-GA), in a letter that TMA supports his H.R. 3940, the Meaningful Use Hardship Relief Act of 2015. The bill authorizes a meaningful use significant hardship exception for the 2015 reporting period due to the delay in timely publication of the Stage 2 meaningful use rule. Support for HR 3940 is part of TMA's advocacy efforts to put the meaning back in meaningful use.

TMA Tells DOJ Aetna-Humana Merger Would Be Bad for Texas
With a highly concentrated health insurance market in Texas, the acquisition of Humana by Aetna would result in less competition in the state. And that would be bad for physicians and consumers. That's what the Texas Medical Association told William Baer, assistant attorney general in the Department of Justice's Antitrust Division.

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

Workers' Comp Fee Conversion Factor Up 1.1 Percent in 2016
The Texas Department of Insurance has posted the annual change to the Medical Fee Guideline conversion factors affecting workers' compensation system participants. Fee guidelines adopted by TDI's Division of Workers' Compensation for non-network services and approved out-of-network services are based on the most current reimbursement methodologies, models, and values or weights used by the federal Centers for Medicare & Medicaid Services.

TMF Offers Help Navigating Medicare Requirements
Physicians looking for free help navigating the Centers for Medicare & Medicaid Services requirements for the Physician Quality Reporting System, meaningful use, and value-based payment modifier programs can benefit from three networks from the TMF Quality Innovation Network Quality Improvement Organization.

Group Reaches ACO Pact With TMA PracticeEdge, BCBSTX
TMA PracticeEdge signed an agreement to provide accountable care organization (ACO) services to UPSA ACO, LLC, a group of San Antonio physicians, in conjunction with a Blue Cross and Blue Shield of Texas (BCBSTX) value-based agreement beginning Jan. 1, 2016.

Physicians Benevolent Fund Helps Physicians, Families
When Texas physicians and their families have needed support because of poverty, infirmity, disability, accident, or other adversity, the TMA Physicians Benevolent Fund has stepped in to help for the past 53 years.

Review Your PQRS Feedback Report and QRUR Now
If you submitted data to Medicare's Physician Quality Reporting System (PQRS) for the 2014 reporting period, now is the time to 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. You must act quickly, as the deadline to appeal any errors is Nov. 9, 2015.

UPSA ACO Reaches ACO Pact With TMA PracticeEdge, BCBSTX

TMA PracticeEdge today announces the signing of an agreement to provide ACO Services to UPSA ACO, LLC (UPSA), a group of San Antonio physicians, in conjunction with a Blue Cross and Blue Shield of Texas (BCBSTX) value-based agreement beginning Jan. 1, 2016. 

You Don't Have to Pay to Get Paid
Would you pay $50 to deposit $1,000 into your back account? You might be doing just that when health plans pay you with a virtual credit card (VCC). Many are paying that way, and you could be losing as much as 2 percent to 5 percent per transaction. For example, if you receive a $1,000 VCC payment from a health plan, you could lose $20 to $50 in processing fees. In essence, your charge for your services from that payer shrunk by that amount.

Lawmakers Get Head Start on 2017 Health Care Issues
The 140 days the Texas Constitution allocates every other year for a state legislative session is never enough time for lawmakers to study and grasp all they need to do with the most complex issues. House and Senate committees use the time between sessions — the interim — to conduct research, hold hearings, and draft bills. Lt. Gov. Dan Patrick and House Speaker Joe Straus have laid out their interim charges to the committees; health care issues will get a share of legislators' attention.

Dr. John Hellerstedt Is the New DSHS Commissioner
Austin pediatrician John Hellerstedt, MD, is returning to state government as the new Texas health commissioner. He will begin his new duties on Jan. 1, 2016

AMA Group Aims to Reduce Inappropriate Opioid Prescribing
Physicians have a professional obligation to reverse the nation's opioid epidemic. That's the message of the American Medical Association Task Force to Reduce Prescription Opioid Abuse. The task force focuses on reducing the inappropriate prescribing of opioids and the growing crisis of heroin overdose and death. The task force, chaired by AMA Chair-Elect Patrice A. Harris, MD, includes physician leaders and staff from across the nation. For more information, AMA members can log in and download the Task Force Overview document.

TMA Wants Improvements in Medicaid and Medicaid Managed Care
TMA and the Texas Pediatric Society submitted 16 recommendations to the Texas Health and Humans Services Commission (HHSC) that would improve the Medicaid and Medicaid managed care "provider and patient experience," per HHSC Commissioner Chris Traylor's invitation.

Be One of Tomorrow's Physician Leaders
The TMA Accountable Care Leadership Program graduated its inaugural class this month. The program helps ensure physicians are leading the charge in health care transformation and supports the development of physician-led organizations. The program is recruiting for the 2016 class now. If you're interested in participating, email The next class is expected to begin in the first quarter of 2016.

New Resource for Children With Special Health Care Needs
Do you see children with special needs in your practice? There's a new resource you can share with their parents. The state's Task Force for Children with Special Needs website, Navigate Life Texas, assists families, caregivers, doctors, and other medical professionals with information about the availability of services for children with disabilities and special health care needs.

Register for DSHS Infectious Disease Response Workshops
The Texas Department of State Health Services (DSHS) Health Emergency Preparedness and Response Section will host eight three-day workshops — one in each of the DSHS health service regions — to share in-depth, Texas-specific infectious disease preparedness and response information. The workshops will provide current strategies, assess individual levels of preparedness and response, and identify gaps in service.

Be a Preceptor; Help Shape the Next Generation of Medicine
The Texas Chapter of the American College of Physicians is seeking physician mentors for the summer 2016 General Internal Medicine Statewide Preceptorship Program.

Meaningful Use? Or Meaningless Abuse
The federal government never seems to tire in its campaign to heap more useless requirements onto physicians' practices. Despite the hard work of the Texas Medical Association and organized medicine, the Centers for Medicare & Medicaid Services insists on moving ahead with Stage 3 of the meaningful use electronic health record incentive program.

Medicaid Congress Tackles Physicians' Ire
Capturing the frustration of all the physicians in the room, San Antonio radiologist Adam Ratner, MD, asked a simple question with a very complicated answer at the Oct. 16 Texas Medicaid Congress meeting. "Why can't we just make this all simpler?" Dr. Ratner asked Texas Health and Human Services Executive Commissioner Chris Traylor. "It's like unraveling a bowl of spaghetti," responded Commissioner Traylor, whose administration of the $30 billion-a-year program is bound by federal and state laws and dozens of contracts with Medicaid HMOs.

Texas Negligence Case to Proceed in New Mexico
Texas physician Eldo Frezza, MD, is facing a negligence lawsuit filed in New Mexico, but he has organized medicine on his side. Frezza v. Montaño has reached the New Mexico Supreme Court after lower courts ruled New Mexico law should apply to the case. Texas Alliance for Physician Access, New Mexico Medical Society, TMA, the American Medical Association, and many others, including several county medical societies, are joining to submit a friend-of-the-court brief to the Supreme Court on behalf of Dr. Frezza's effort to stop New Mexico law from applying to the case. Texas Medical Liability Trust is also submitting an amicus brief.

New Mexico Court Urged to Heed Texas Tort Reforms
A medical liability case involving a Texas physician who provided care to a New Mexico resident in Texas should not be governed by New Mexico's far weaker tort laws, TMA, the Texas Alliance for Patient Access, the New Mexico Medical Society, and dozens of other physician groups in both states wrote in a brief to the New Mexico Supreme Court. Access to health care is already challenging enough for New Mexico patients seeking care. New Mexico doctors and hospitals have long relied on referring or transferring sick and injured patients to Texas for specialized care.

How Will Your Practice Thrive in Post-SGR Medicare?
The Sustainable Growth Rate (SGR) 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 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.

Pharmacy Delivery Option for Clinician-Administered Drugs
An optional delivery method, referred to as "white bagging," is available to physicians dispensing clinician-administered drugs in an outpatient setting for Medicaid patients. The white bagging option eliminates the up-front costs of buying the medication and then billing for it. White bagging allows physicians and other health professionals to submit prescriptions to pharmacies, which then ship or mail the prescription to the physician's office. The delivery method is voluntary for Medicaid-participating physicians. Medicaid managed care organizations can't require the use of white-bagging for clinician-administered drugs.

Medicine Fights Federal Mandates on Physicians
Since TMA's last visit to Capitol Hill, Congress has repealed the Medicare Sustainable Growth Rate formula, and House Speaker John Boehner's announced retirement has created a free-for-all battle for House leadership positions. But TMA and the Coalition of State Medical Societies are still fighting to pry some of the regulatory burdens off of physicians' backs.

TMA Calls Out Insurance Companies Over Balance Billing
The national health insurance lobby and their cronies in the Texas Association of Health Plans released their annual "report" citing physicians for what they called "exorbitant" bills for out-of-network services. TMA challenged the allegations publicly and earned some positive news media coverage.

High Court to Hear Tobacco Tax Case
The Texas Supreme Court has accepted an appeal of a lower court ruling that invalidated a tax the legislature applied to so-called "small tobacco." Back in 1998, the nation's five largest tobacco companies settled a case with Texas and 45 other states over the health care costs of cigarette smoking. They agreed to pay $10 billion a year indefinitely to the states.

Fist-Bump Your Doctor During Cold and Flu Season
Looking for a way to greet your patients but limit the spread of cold and flu? Citing a study published in American Journal of Infection Control, TMA member Jason Marchetti, MD, has your answer!

TMB Seeks Doctors to Serve as Advisory Committee Members
Senate Bill 202 by Sen. Jane Nelson (R-Flower Mound), which passed this legislative session, transferred to the Texas Medical Board (TMB) licensing and regulation of medical physicists, medical radiologic technologists, perfusionists, and respiratory care practitioners. The legislation calls for advisory committees to be formed for licensing of perfusionists and medical physicists. The members of the committees must be appointed by TMB President Michael Arambula, MD. TMB is now accepting applications for those interested in member positions on those committees.

OIG Focuses Fraud Efforts on Physician Compensation
A recent U.S. Office of Inspector General (OIG) fraud alert warns that physician compensation arrangements may result in significant liability.

TMA Tells Feds to Scrap Meaningful Use Rule
TMA's comments to the Centers for Medicare & Medicaid Services on proposed meaningful use Stage 3 rules offer a number of suggestions, including dismantling the program and "adopting reasonable baseline rules that physicians can meet to avoid penalties under the meaningful use program and additional requirements they may meet to receive incentive payments."

DSHS to Host Infectious Disease Response Workshops
The Texas Department of State Health Services (DSHS) Health Emergency Preparedness and Response Section will host eight three-day workshops — one in each of the DSHS Health Service Regions — to share in-depth, Texas-specific infectious disease preparedness and response information. The workshops will provide current strategies, assess individual levels of preparedness and response, and identify gaps in service.

Having ICD-10 Problems? TMA Wants to Know
Oct. 1 was the mandatory date to switch to the ICD-10 coding system. The government's paltry "grace period" notwithstanding, all claims to Medicare, Medicaid, commercial insurers, and other payers with a date of service on or after Oct. 1 must use ICD-10. If you run into problems submitting claims, email, or send a report to TMA's Hassle Factor Log. TMA staff will monitor the reports and contact health plans, Medicare, or Medicaid.

TMF Resources Can Help You Navigate CMS Requirements
Physicians looking for help navigating the Centers for Medicare & Medicaid Services (CMS) requirements for the Physician Quality Reporting System (PQRS), meaningful use, and value-based payment modifier programs can benefit from TMF's Quality Innovation Network.

TMA Opposes TMB Proposal to Revise Disciplinary Sanctions
In a letter to the Texas Medical Board (TMB), TMA outlined its concerns with the board's proposal to revise the standard disciplinary sanctions that apply to violations of the Medical Practice Act. Of particular concern to TMA is the board's proposal to increase the "High Sanction" penalty for a standard of care violation and more than one prior standard-of-care or care-related violation from $3,000 per violation to $7,000 per violation.

Physicians Now Have Expanded Access to Naloxone
Senate Bill 1462 by Sen. Royce West (D-Dallas), supported by TMA during the legislative session, gives physicians authority to prescribe the lifesaving opioid antagonist naloxone not only to patients but also to family members or friends of those who may be at risk of an overdose. The law, effective Sept. 1, also allows a person or organization acting under a standing order to distribute an opioid antagonist and allows pharmacies to dispense the drug.

Another Post-Tort Reform Record for New Texas Physicians
As it has for four of the past seven years, the Texas Medical Board licensed a record number of new physicians for the fiscal year that ended Aug. 31, surging past the 4,000 mark for the first time in history.

Start the PQRS GPRO Registration Process Now
The Physician Value-Physician Quality Reporting System (PV-PQRS) registration system is open through June 30. This registration applies to group practices with two or more eligible professionals interested in participating in the 2015 PQRS program year under the group practice reporting option (GPRO).

Feds to Reduce Meaningful Use Reporting Burden
Responding to pressure from TMA and organized medicine, the Centers for Medicare & Medicaid Services announced Jan. 29 it plans to modify rules for the Electronic Health Record Incentive Programs to reduce the reporting burden on physicians.

Updated Federal HIT Plan Contains Strategies TMA Supports
The Office of the National Coordinator for Health Information Technology has published its final Federal Health IT Strategic Plan 2015-2020, which lays out the federal government's health information technology (HIT) priorities. In February, when the plan was in its draft stage, TMA submitted a comment letter to Karen DeSalvo, national coordinator for HIT.

New TMF Network Aims to Improve Adult Immunization Rates
Despite the availability of effective vaccines to help prevent influenza, pneumonia, and shingles, immunization rates for adults remain significantly low. To help boost these numbers for Medicare beneficiaries, the TMF Quality Innovation Network Quality Improvement Organization has established the Immunizations Network for physicians and other health care professionals.

The Value Modifier Program: Improve Performance, Payment
As the Centers for Medicare & Medicaid Services continues to refine and expand the physician value-based payment modifier program, physicians and health care providers must understand and stay current with the new methodology in order to achieve performance goals for better payment. The value modifier combines Physician Quality Reporting System (PQRS) quality measures, cost measures, and a payment adjustment for physicians.

TMA Says Involve Physicians in Medicaid 1115 Waiver
Texas' five-year 1115 Medicaid Transformation Waiver will expire Sept. 30, 2016, unless the government grants a renewal or extension. TMA President Tom Garcia, MD, told Texas Health and Human Services Commission Executive Commissioner Chris Traylor in a letter the association "absolutely supports renewal of the waiver beyond its initial five years," but with more physician involvement.

CDC Data Show Decrease in Some Vaccines for Young Texans
Coverage of young children aged 19 months to 35 months receiving the recommended vaccine series in Texas fell to 64 percent in 2014, down from 72.5 percent in 2013, according to the Centers for Disease Control and Prevention (CDC).

Share Your Successes in the TMA Quality Poster Session
The TMA Council on Health Care Quality and TMF Health Quality Institute are happy to announce the fourth annual TMA Quality Poster Session — a platform on which physicians and medical students can share their breakthroughs and best practices that enhance patient care, especially in one or more of the six aims of quality care: that it be safe, timely, effective, equitable, efficient, and patient-centered.

Loan Repayment Available to Physicians
The Texas Higher Education Coordinating Board is accepting applications from primary care physicians and psychiatrists for the state's Physician Education Loan Repayment Program.

Cyber Attacks Plague Health Care Organizations, Study Shows
Eighty-one percent of health care executives say their organizations have been compromised by at least one malware, botnet, or other cyber attack during the past two years, and only half feel they are adequately prepared to prevent attacks, according to the 2015 KPMG Healthcare Cybersecurity Survey.

Know a Deserving Minority Medical Student Applicant?
The TMA Minority Scholarship Program has provided scholarships to underrepresented minority medical students since 1998. This scholarship supports TMA's vision, "to improve the health of all Texans," and its long-standing priority of addressing health disparities.

Tell Congress to Continue, Expand Conrad 30 Program
Congress is back to work after its annual August recess, and the continuation of the Conrad 30 Program is on the "to-do" list. Without congressional action, the Conrad 30 Program will expire on Sept. 30, 2015. This program allows certain international medical graduate physicians who trained in the United States on J-1 visas to obtain a waiver of the two-year home residence requirement. In exchange for the waiver, the physician must work for at least three years treating medically underserved populations in the United States. Many communities rely heavily on international medical graduate physicians for their primary care needs.

Fight the Flu With Tools From TMA
Flu season is just around the corner, and TMA's Be Wise — Immunize has tools you can use to protect yourself, your staff, and your patients.

TMA: Medicare Should Pay Docs for Added Hassles
In comments on the proposed 2016 Medicare physician fee schedule, TMA told the Centers for Medicare & Medicaid Services (CMS) that "the growing Medicare administrative burden, added to the recent history of and future plans for inadequate fee updates, is making Medicare participation and compliance increasingly difficult and costly for practicing physicians, and will impair access to care for Medicare beneficiaries." TMA adds that "when Medicare adds administrative burdens, those added burdens should be accompanied by RVU [relative value unit] or conversion factor increases to offset the added costs." CMS published the proposed fee schedule rule in the July 15 Federal Register.

AMA Analyzes Potential Aetna-Humana, Anthem-Cigna Mergers
The combined impact of proposed mergers among four of the nation's largest health insurance companies would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within Texas and 16 other states, according to new special analyses of commercial health insurance markets issued by the American Medical Association.

Changes to Syphilis Testing Requirements for Pregnant Women
Effective Sept. 1, every pregnant woman must be tested for syphilis at her first prenatal visit and again during the third trimester, no earlier than 28 weeks gestation. Pregnant women had previously been required to be tested at their first prenatal care visit and at delivery. The testing requirement changes became law with passage of Senate Bill 1128 by Sen. Judith Zaffirini (D-Laredo).

DSHS, CDC Urge Vigilance for Cases of Acute Flaccid Myelitis
From August to October 2014, the U.S. Centers for Disease Control and Prevention (CDC) received an increased number of reports of acute flaccid myelitis (AFM) among children. Since then, CDC has continued to receive sporadic reports of the illness. The apparent increase in AFM cases in 2014 coincided with a national outbreak of severe respiratory illness among children caused by enterovirus-D68, which resulted in an increased number of children hospitalized.























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