Action: Aug. 15, 2016

TMA Action Aug. 15, 2016   News and Insights from Texas Medical Association

TMA Urges TMB to Withdraw Disciplinary Hearing Rules
Texas Reports First Zika-Related Death
PAT Transitions to Pharmacy Board; Expect Delays
Register for TMA Fall Conference: MACRA, Zika, What's Next?
TMA Committee Weighs in on Women's Health Proposals
STAR Kids Takes Effect Nov. 1; Training Available

Day of Solidarity to Prevent Med Student, Physician Suicides
Test Patients With Cyclospora Symptoms; Report Confirmed Cases
Focus on Member Services: Avoiding Risk
TMA Honors Best Health Reporting of 2016
Protect Your Online Reputation
This Month in Texas Medicine

TMA Urges TMB to Withdraw Disciplinary Hearing Rules

TMA is not impressed with the Texas Medical Board's (TMB's) proposed new rules concerning informal show compliance proceedings and informal settlement conferences (ISCs). TMA tells TMB in a letter the association wants an overhaul of the ISC process to make it more fair and transparent. TMA's letter expresses strong opposition to the proposed rule and states that "instead of allowing the process to become fairer and more transparent, the proposed rule makes ISCs more like a formal administrative hearing without the guaranteed accompanying protections." 

TMA's letter acknowledges informal show compliance proceedings and ISCs provide an alternative to costly, more formal hearings for resolving physician complaints. But TMA stresses ISCs should give physicians a "fair and meaningful opportunity to be heard and to present their defense."

TMA's letter describes TMB's current, more formal, prescriptive, regulated ISC process that is in "dire need of reform and redefinition" and that has run afoul of legislative intent, having "fallen into a grey area." The problem, TMA contends, "is that ISCs, under the guise of an 'informal conference,' allow TMB to avoid the hassle of due process or even fundamental fairness." The situation, the letter states, results in physicians "feeling forced to participate in an 'informal' conference that has no guarantees of fairness."

Specifically, TMA says the proposed rules raise questions of fairness in regard to the presentation of witness testimony in an ISC. TMA says the proposed rule limits physicians’ rights to present witness statements and removes physicians’ rights to present oral testimony by witnesses. The association adds the nature of permitted witness testimony also weighs heavily against physicians.

TMA also has concerns about the broad discretion representatives of the board have in determining what evidence to consider in an ISC. TMA says board representatives’ broad discretion could “allow bias or prejudice to be a factor,” adding panelists could employ “discretion to exclude evidence for any reason ranging from the personal disliking of a licensee to the panelist’s desire to go home early after a long day. TMA’s point is that, without some governing standard other than the board’s discretion, there is simply no way of ensuring a fair hearing.”

For these reasons and more, TMA "strongly encourages TMB to withdraw these rules" and asks the board to organize a stakeholder meeting to "formulate a more appropriate and, frankly, fair redefinition of the ISC process." 

Texas Reports First Zika-Related Death

The Texas Department of State Health Services (DSHS) confirmed an infant who recently died in Harris County had microcephaly linked to the Zika virus. The baby died shortly after birth and is the first Zika-related death reported in Texas, according to DSHS. 

DSHS says the mother was in Latin America during her pregnancy. She became infected with the virus there, and the baby acquired the infection in the womb. Recent test results confirmed the baby's condition and link to Zika, DSHS says, adding that there is no additional associated risk of Zika transmission in Texas.

Last month, Texas reported the state's first case of microcephaly linked to Zika, also a Harris County infant.

With local Zika virus cases detected in Florida and increased travel to Brazil for the Summer Olympics, DSHS says Texas is on high alert for local Zika transmission by mosquito bites. The department is urging everyone to follow precautions strictly.

DSHS says it is spending more than $6 million in state and federal funds on disease surveillance, expanded lab testing capabilities, public education and awareness, Zika prevention kits, and other efforts to build a strong infrastructure to help protect Texans from Zika. Texas Medicaid announced earlier this month it will cover the cost of mosquito repellent for eligible women who are between the ages of 10 and 45 or pregnant. 

DSHS has identified and exercised eight state public health Zika response teams that are ready to deploy upon local transmission of the virus in Texas. These teams, DSHS says, will be able to help local entities investigate possible cases, evaluate environments for mosquito activity, provide door-to-door education, and offer other response efforts.

While local transmission in Texas remains likely at some point, DSHS says public health officials do not expect widespread transmission across large geographic areas of the state. Small pockets of cases are more likely. DSHS bases this assessment on the state's past experience with dengue, a similar virus spread by the same mosquitoes, and on the prevalent use of window screens, air conditioning, insect repellent, and other mosquito control efforts in Texas. 

DSHS says it has approved more than 1,200 human specimens for Zika virus testing by the DSHS laboratory and the U.S. Centers for Disease Control and Prevention (CDC). Other labs across the state now have the ability to test for Zika. In late July, DSHS added the more complex serologic testing for human specimens to detect Zika infection in people who may not have had symptoms. Texas also has the capability to test mosquito specimens for Zika, as warranted for identified high-risk areas, though DSHS says the best indicator of Zika prevalence is human case detection.

Zika poses a serious threat to unborn children, and protecting pregnant women is a central concern, the department says. Texas has reported individual casess to the CDC's Zika Pregnancy Registry. 

CDC says physicians can participate in the Zika pregnancy registry by reporting information about pregnant women with laboratory evidence of Zika to their local health department or DSHS

In updated guidance to health care professionals caring for pregnant women with possible exposure to Zika virus, CDC now recommends a longer testing period — up to 14 days — after symptoms begin in pregnant women. The guidance, released on July 25, also applies to pregnant women with no symptoms.

New research indicating the Zika virus can remain in pregnant women's blood longer than the prior seven-day testing time frame after the onset of symptoms spurred CDC to update its guidance. "Even pregnant women without symptoms can have evidence of the virus in their blood and urine," CDC's guidance states.  

As of July 27, 1,658 U.S. Zika cases and 4,750 in the U.S. territories had been reported to CDC. 

As of Aug. 2, Texas had 90 reported cases of Zika virus disease, including three pregnant women, one infant infected before birth, and one person who had sexual contact with a traveler, according to DSHS. 

To get ahead of this year's highest-profile potential public health threat, TMA formed a workgroup to strategize prevention and response to Zika. The workgroup provides experts a forum to share what they're seeing in the field with regard to Zika and an opportunity to discuss concerns surrounding the disease. The workgroup, made up of physician members from TMA's various boards, councils, and committees, helps the association provide relevant information to physicians about Zika. 

David Lakey, MD, chief medical officer and associate vice chancellor for population health in The University of Texas System and former DSHS commissioner, is the workgroup's chair. Dr. Lakey, who is also the chair of TMA's Council on Science and Public Health, will take part in a panel discussion on Zika at the TMA 2016 Fall Conference, Sept. 23–24, at the Hyatt Regency Lost Pines.

Congress has been dragging its feet on approving a Zika funding package. In a letter to the Texas congressional delegation, TMA President Don Read, MD, stresses the need for federal money to bolster monitoring travelers, keeping Texans informed about the state of the disease, and lab testing — especially of pregnant women. "We already have waited too long," Dr. Read wrote. "We need that action now. Several months from now will be too late."

On Aug. 5, Governor Abbott sent a letter to President Obama urging his administration to immediately approve the expenditure of funds for Zika virus preparedness and response. In the letter, Governor Abbott expressed concern that money for Zika preparedness and response is not flowing quickly enough to the state and local health departments. He asked the president and his administration to dispense a meaningful portion of the approximately $400 million available to sufficiently combat against the growing threat of Zika in Texas.

"In light of the mosquito-to-human transmission of the Zika virus in Florida — and rising concerns about Zika in Texas — it is imperative that the federal government act now to free up whatever funds are available to combat Zika," Governor Abbott wrote. "I express this sentiment not only on behalf of the State, but also on behalf of local government leaders seeking relief and protection from Zika. We request that immediate aid be provided to combat the spread of Zika and, in turn, protect our fellow Texans."

For more information, read "Zika: Fighting a Potential Epidemic" in the August issue of Texas Medicine

Zika Resources

TMA Zika screening guidance for physicians 

General information about Zika virus

Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016

Information for clinicians

Protection against mosquitoes

Zika virus travel notices

DSHS Zika toolkit  

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 (DPS) 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.   

Additionally, effective Aug. 21, DPS will no longer accept orders for Schedule II prescription pads. However, official prescription forms issued by DPS before Sept. 1, 2016, will be considered valid prescription forms. Official prescription pad orders received after Aug. 21, 2016, will be returned to customers.

When you log in to the new system for the first time, you will be prompted to update your profile information. TSBP says missing or incorrect demographic information (address or phone number) on your PAT profile will not prevent your account from being preloaded. 

TSBP has these important reminders regarding access to the new system:

  • You will have access to the new system beginning Sept. 1.  
  • You will receive an email on Sept. 1 that includes a short training tutorial on how to perform a query, along with instruction on how to log in.  
  • Do not register for a new account.  

If you have any questions or concerns, call (844) 489-4767. Technical assistance is available Monday through Friday, 7 am to 7 pm CT. 

For more information about the transition to TSBP, call (512) 305-8050, or email texaspmp[at]pharmacy[dot]texas[dot]gov. 

 Action TMLT Ad 10.15

Register for TMA Fall Conference: MACRA, Zika, What's Next?

It’s not too late to register for the 2016 TMA Fall Conference at Hyatt Regency Lost Pines Resort and Spa, Sept. 23–24. This free member benefit offers you the opportunity to reconnect with colleagues and learn more about new developments like the Medicare Access and CHIP Reauthorization Act (MACRA), telemedicine, and the Zika virus.  

Online registration for the conference ends Friday, Sept. 16, but you can also register when you arrive starting on Friday, Sept. 23. For more information about the conference, sleeping room availability, the onsite flu shot clinic, and the full agenda for the General Session, check the TMA Fall Conference website. Questions? Email the TMA Knowledge Center, or call (800) 880-7955, Monday-Friday, 8:15 am-5:15 pm CT. 

TMA Committee Weighs in on Women's Health Proposals

TMA's Committee on Reproductive, Women's, and Perinatal Health has submitted two comment letters to the Texas Department of State Health Services (DSHS) concerning DSHS' plans for some women's health services.  

TMA's Aug. 1 letter, written by committee Chair Shanna Combs, MD, a Fort Worth obstetrician-gynecologist, and cosigned by and developed in conjunction with the Texas Hospital Association (THA), pertains to DSHS' proposed rules on the definition, treatment, and disposition of special waste from health care-related facilities. If enacted, the proposed changes would change how physician practices and facilities handle fetal tissue.  

TMA and THA's joint letter poses seven questions about the proposed rules' practical implications for patients, hospitals, and doctors: 

  1. Is "incineration followed by interment" a viable alternative for disposal of fetal tissue?
  2. Will the disposition of fetal tissue require a death certificate and subsequent care by a funeral director in each case?
  3. If a death certificate is required to be issued, under what circumstances will the report be publicly available?
  4. How should the special waste rules address the disposition of fetal tissue resulting from spontaneous miscarriages, ectopic pregnancies, or molar pregnancies?
  5. How would cases of spontaneous miscarriage be addressed when this occurs outside the physician's office or other health care setting?
  6. Who would be responsible for paying for the costs of cremation and/or interment of fetal tissue?
  7. Has the department performed an analysis of the impact of this rule from a compliance and cost standpoint? 

TMA and THA reiterated in the letter that their members have diverse opinions on issues of life and death. The letter's intent was therefore to get clarification on the points raised.

On July 29, TMA submitted a comment letter to DSHS on the proposed revision of A Woman's Right to Know (WRTK), a booklet developed in 2003 that state law requires doctors to give women at least 24 hours before an abortion procedure. TMA has commented numerous times on the need to revise the booklet with scientifically accurate information. TMA respects physicians' varying opinions on the sensitive topic. The goal of the letter, also written by Dr. Combs, is to ensure information provided by physicians to their patients is accurate and unbiased. TMA and THA's letter cites concern with "the biased terms and inferences throughout the pamphlet, on almost every page": 

  • The use of non-neutral terms such as "your baby," "the baby," and "unborn child" instead of referring to the fetus and fetal development — the terms recognized to describe this period of human development;
  • Details about the fetal development period that are meant to evoke a response and are not used in other DSHS materials on pregnancy;
  • Weighted information on abortion risks for which there is questionable evidence as well as great detail on medical procedures associated with abortion … without noting that the risks associated with the procedures or that deaths from abortion are rare and that no deaths have been reported in Texas in years; and
  • Highlighting a limited number of social and medical resources available for women during pregnancy and childbirth without noting that not all women will be eligible. 

TMA's letter expresses disappointment that DSHS "has not taken even minimal effort to obtain public input before updating the WRTK information." The letter concludes with TMA's offer to contribute to the booklet's revisions.

STAR Kids Takes Effect Nov. 1; Training Available

If you participate in Medicaid, don't forget about the implementation of the STAR Kids managed care program on 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 and younger who have disabilities.  

According to the HHSC, participation in the STAR Kids program is required for those who are 20 or younger, covered by Medicaid, and meet at least one of these criteria: 

  • Receive Supplemental Security Income (SSI);
  • Receive SSI and Medicare;
  • Receive services through the Medically Dependent Children Program (MDCP) waiver;
  • Receive services through the Youth Empowerment Services (YES) waiver;
  • Live in a community-based intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) or nursing facility;
  • Receive services through a Medicaid Buy-In program;
  • Receive services through any of the Department of Aging and Disability Services (DADS) intellectual and developmental disability (IDD) waiver programs: Community Living Assistance and Support Services (CLASS); Deaf Blind with Multiple Disabilities (DBMD); Home and Community-based Services (HCS); or Texas Home Living (TxHmL). 

STAR Kids will provide acute care services, such as physician office visits, hospitalizations, and prescription drugs, as well as long-term care services and support. Those who enroll in the STAR Kids program will choose a health plan, as well as a primary care physician or clinic that will provide basic medical services and provide referrals to a specialist when needed, HHSC says.  

STAR Kids managed care organizations (MCOs) must offer contracts to any physician designated by HHSC as a significant traditional provider, a physician who cares for a substantial number of STAR Kids-eligible children. However, physicians may choose whether to contract, and if so, with which plans. For physicians who care for children across the state, MCOs may contract with them or enter into single-case agreements for particular patients.

HHSC will be conducting physician and family training sessions on the program this month and in September. For training dates and locations, visit the website.

Physician Resources

STAR Kids Provider Frequently Asked Questions

STAR Kids Provider Frequently Asked Questions (PDF)

Provider Tips (PDF)

Provider Training – STAR Kids Provider Information Session (PDF) 

STAR Kids Billing Matrix and Crosswalk (XLS)  

      TMAIT Action Ad 6.15       

Day of Solidarity to Prevent Med Student, Physician Suicides

The United States loses an estimated 400 physicians to suicide every year. On Aug. 20, medical professionals will stand together in solidarity to say "no more." 

You can join medical students, doctors, administrators, friends, and family across the nation on Aug. 20 at 7:30 pm CT on the south lawn of the Texas Capitol to help raise awareness of the medical community's suicide epidemic. The event will show those suffering in silence that they are not alone, starting conversations to create change within our medical schools and hospitals, and paying tribute to those who have lost their lives.

Speakers from the medical community will share their experiences, observations, and ideas for how to combat the suicide epidemic. You can share your own personal story or ideas during the open mic portion of the event. And you can join in the event's closing candlelight vigil to remember those who have lost their lives to suicide.

If you would like your story or ideas to be heard, but do not want to speak yourself, send a written piece to DayOfSolidarityStories[at]gmail[dot]com. Please include your city and state and whether you would like to remain anonymous or have your name shared during the event.

If you are part of the medical community, please wear your white coat. If you are not, please wear a white shirt. Signs and candles will be provided by event organizers.

This event is sponsored by and may be filmed as part of the "Do No Harm" documentary produced by award-winning filmmaker Robyn Symon.

Sign the Care2 petition demanding concrete policies to prevent physician and medical student suicides. 

Test Patients With Cyclospora Symptoms; Report Confirmed Cases

The Texas Department of State Health Services (DSHS) encourages health care professionals to test for Cyclospora in patients who have diarrheal illness lasting more than a few days or diarrhea accompanied by severe anorexia or fatigue.  

Diagnosis of cyclosporiasis requires submission of stool specimens for ova and parasite testing with additional specific orders for Cyclospora identification. The department stresses a single negative stool specimen doesn't exclude the diagnosis; three specimens are optimal. 

Symptoms of cyclosporiasis usually begin two to 14 days after ingestion of oocysts in contaminated food or water. DSHS says profuse diarrhea can last weeks to months and may relapse. Additional symptoms may include anorexia, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting, and low-grade fever.

Health care professionals and laboratories should promptly report confirmed cyclosporiasis cases to their respective local health department or DSHS by calling (800) 705-8868 or faxing (512) 776-7616.

Within the past month, DSHS has received reports of 55 cases of Cyclospora infection. The department is investigating the increased number of cases of Cyclospora infections to identify possible common exposures. 

A common exposure source for this increase hasn't yet been identified. Past U.S. outbreaks have been associated with consumption of imported fresh produce, including fresh cilantro, prepackaged salad mix, raspberries, basil, snow peas, and mesclun lettuce. 

For more information about Cyclospora, visit the CDC website.  

Focus on Member Services: Avoiding Risk

Managing a medical practice comes with inherent risks, and physicians can face serious consequences for violating privacy, fraud, or abuse statutes. That's why physician members turn to TMA for help in establishing effective compliance programs, understanding the latest regulations, and navigating advancements in health information technology.  

As a TMA member, you have access to a variety of resources designed to help you avoid practice risks:  

  • Access to timely regulatory information: Stay up to date on MACRA, HIPAA, and medical record compliance requirements with TMA's comprehensive information centers and handy Deadlines for Doctors alerts.  
  • DocbookMD: Equip yourself with tech tools like DocbookMD, a collaborative, physician-centered, HIPAA-secure messaging application available free to TMA members (members only).
  • CME on Risk Management: Avoid common practice pitfalls with convenient, on-demand continuing medical education covering the latest developments on topics like the Stark law or E&M coding.
  • Insurance: Protect yourself personally and professionally using exclusive products and services from TMA-endorsed vendors like Texas Medical Liability Trust (members only). 

For more information on all the ways TMA can help you minimize your risks and maintain a compliant practice, visit the TMA website.   

PC Action Ad Nov 13

TMA Honors Best Health Reporting of 2016

Chagas disease, concussions, mental health: Texas journalists expertly covered these and other topics to take top honors in the TMA 2016 Anson Jones, MD, Awards. TMA physicians presented the awards to journalists in newsroom ceremonies or at local county medical society meetings this spring.  

Each year, TMA recognizes print, broadcast, online, and physician journalists with the TMA Anson Jones, MD, Awards. Work is under way for the 2017 Anson Jones Awards, so please help TMA find this year's best news coverage by nominating a local news report

Your nomination is a great way to recognize hometown journalists for their work and encourage quality health news reporting. TMA will alert the journalist of your nomination and enter him or her into the competition. Physicians and other members of the family of medicine nominated several of this year's winners.

The 2017 contest will feature 12 award categories, with the addition of "Online Single Article/Blog" to recognize a single news article or blog that appears online only on a web-based news outlet. 

Do you report health news or know someone who does? One category, "Physician Excellence in Reporting," recognizes physicians and medical students who write a medical column for a local newspaper or a health care blog, host a radio health show, or do a weekly medical segment on TV. If that describes you or a colleague, TMA is seeking entries.

For nearly 60 years, TMA has honored Texas journalists with the awards, named for pioneer physician Anson Jones, MD, the last president of the Republic of Texas. TMA's Council on Health Promotion oversees the awards.

If you have questions, contact Tammy Wishard, TMA outreach coordinator, by email or by phone at (800) 880-1300, ext. 1470, or (512) 370-1470. 

Protect Your Online Reputation

Google yourself. You might be surprised to see what comes up. Open a web browser, and type your name in the search box. Do you like what you see? Does it make your blood boil? Is there anything there? If your name is not that unique, do the results actually refer to you? 

Chances are physician-rating sites dominate the first page of search results. These ratings can influence consumers' choice of physicians. A 2014 article in the Journal of the American Medical Association reported 35 percent of prospective patients chose a physician based on good reviews from a ratings site. About the same percentage went elsewhere based on negative physician reviews. Even more — 43 percent — say they don't trust those sites and prefer recommendations from friends and family.

What do you do if a patient slams you and your practice on Yelp or Healthgrades or Vitals or Zodcoc? If the complaints even hint that the patient is considering legal action, the Texas Medical Liability Trust urges you to contact your attorney and your medical liability insurance company. Anything you say in response to the noxious post could come back to haunt you in court.

Otherwise, consider taking these steps:

  • Examine the complaint closely. Can you determine directly or indirectly who wrote it? Is it really from a patient, or could it be a disgruntled former employer? Are there any details that help you recognize a specific patient or incident? 
  • Once again, be very wary of responding directly. HIPAA requires physicians to protect the identity of their patients. According to the Dallas Medical Journal, "privacy laws in health care will not allow physicians to defend themselves in the same manner. The fact that even a patient's identity is protected information directly hinders the physician's ability to refute a complaint. Simply acknowledging publicly that the complaining party is a patient breaches confidentiality and violates HIPAA laws." 
  • Contact the site owner. Some review sites allow you to flag reviews as inappropriate and then will consider removing them. Others will respond to a level-headed note asking them to decide if the post complies with the site's terms-of-use policy.
  • Take the conversation offline. If you can positively determine who wrote the post, contact the person as quickly as possible by phone or schedule an appointment to discuss it. (Stay away from email, as that could easily get copied and pasted into further online complaints.) Find out exactly why the patient is upset. Just as you would in dealing with other legitimate complaints about your practice, you should show good customer service and work to resolve this one. Apologize, explain, or offer a refund if any of those options is appropriate. But take care of the problem quickly. Patients who do not get a response using social media initially are likely to continue to discuss the issue online until there is a resolution. If you help the patient, he or she may follow up with a positive post to share the good news. 

Regardless of whether you want to be "on the internet," chances are you and your practice are being discussed online, and your digital reputation is being established. Set up Google Alerts for your name, practice name, and any other possible way you could be found online. Google will send you free email alerts when you have been mentioned. This will trigger the next step of how to further engage with that post or review. Or it may make you aware of something you can easily change to improve your practice for all of your patients.

To learn more, purchase the TMA publication Get Social: Put Your Practice on the Social Media Map. Learn how to build an online presence and manage your online reputation. The publication offers 1.75 Ethics and AMA PRA Category 1 Credits™.

This Month in Texas Medicine

The August issue of Texas Medicine features a cover story on Zika virus and TMA's advocacy to urge lawmakers in Washington, D.C., to agree on a funding package to combat the spread of the disease. In the issue, you'll also find a profile of Stuart D. Flynn, MD, the inaugural dean of the new Fort Worth allopathic medical school. The August issue highlights information on TMA and AMA's call for a federal patient safety center that would collect reported data on electronic health record-related adverse events; graduate medical education expansion grant awards; TMA's fight to keep sleep apnea diagnosis and screening within the scope of practice for physicians; and steps physicians can take to prevent cyber attacks.

Click to launch the digital edition in a new window.

Texas Medicine RSS Feed

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

E-Tips RSS Feed

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


This Just In ...

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

Deadline 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.   

Medicaid Reenrollment Deadline

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.  


Medical Records: Most Wanted Answers  
Straight From a Lawyer's Mouth: Answers to Your Legal Questions
Human Resources Seminar
E&M Coding Made Easy 

Conferences and Events

TMA Fall Conference 2016
Sept. 23-24
Hyatt Regency Lost Pines

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Last Updated On

December 06, 2016