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Fix Medicare Now: 2024 Fee Schedule Solidifies Cut, Heightens Calls for Reform - 03/05/2024

This latest cut stems from the 2024 Medicare physician fee schedule and Congressional inaction, both of which further erode physician payment, practice viability, and patient access to care.


TMA to Feds: Some Proposed QPP Changes “Costly and Wasteful” - 08/23/2023

TMA letter praises the Centers for Medicare & Medicaid Services for its commitment to deregulation and outlining TMA's concerns about the proposed changes and recommendations for how to improve the QPP.


Medicare Gets It Wrong, Re-Calculates MIPS Scores and Changes 2019 Payment Adjustments - 08/21/2023

All Texas physicians should recheck their 2017 Merit-Based Incentive Payment System (MIPS) or Alternative Payment Model (APM) information to ensure the correct MIPS payment adjustment (bonus or penalty) was applied for 2019 Medicare payments.


Congress Conducts MACRA Check-Up - 07/25/2023

Federal lawmakers seem to be listening to calls for reform for the Medicare Access and CHIP Reauthorization Act (MACRA), as the House Energy & Commerce Committee’s Oversight & Investigations Subcommittee recently hosted a “MACRA Checkup” hearing to examine the law’s “successes and remaining challenges.”


Make a Penalty-Free Shift From Meaningful Use to MIPS - 07/25/2023

I’m confused about the overlap of dates between the meaningful use incentive program and the Advancing Care Information reporting requirements under the Merit-Based Incentive Payment System. Is there extra work for physicians who participate in both?


Will Health Quality Improve Under New Medicare? - 06/28/2023

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.


Congress Asks, TMA Delivers: 50 More Ways to Fix Medicare - 05/02/2023

TMA leaders presented lawmakers with 50 ways to increase physicians’ Medicare pay; reduce paperwork and hassles; measure “quality” with metrics that are meaningful to physicians and their patients; and push health information technology vendors to shoulder their fair share of the administrative burden.


New Unscored MIPS Measure Can Help You Refine Your EHR Use - 07/13/2022

Even though it won’t affect your score for 2022, a new piece of this year’s Merit-Based Incentive-Payment System (MIPS) might be worth undertaking just the same – because it can help practices make sure they’re using their electronic health record (EHR) systems safely.


CMS Reweights MIPS Cost Category to Zero Due to the Pandemic - 05/04/2022

As a result of the ongoing public health emergency, physicians will find some much-needed, if temporary, relief from burdensome reporting requirements under Medicare’s Merit-Based Incentive Payment System.


MACRA: Fix or Folly? - 05/02/2022

The Texas Medical Association has made recommendations to improve the Centers for Medicare & Medicaid Services' proposed rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA), which results in numerous compliance and administrative hassles.


Victory! Congress Finally Repeals Flawed Medicare SGR Formula - 05/02/2022

Statement of TMA President Austin I. King, MD, on the U.S. Senate vote to approve HR 2, the Medicare Access and CHIP Reauthorization Act, which finally repealed the Medicare Sustainable Growth Rate (SGR) formula. 


MIPS Participation Drops per Preliminary Report - 04/05/2022

Fewer clinicians participated in Medicare’s Quality Payment Program in 2020, and fewer participants earned incentive payments compared with 2019, according to preliminary data recently released by the Centers for Medicare & Medicaid Services.


MIPS 2021 Data Submission Now Open - 04/05/2022

Participants in the 2021 performance year of the Quality Payment Program’s (QPP’s) Merit-Based Incentive Payment System (MIPS) can now submit their data through the QPP website. You can submit and update your MIPS data until 7 pm CT on March 31.


MIPS Deadlines Approaching for 2021 Data Submission, COVID Exception - 03/28/2022

Clinicians who participated in Medicare’s Merit-Based Incentive Payment System (MIPS) in 2021 have until this Thursday, March 31, at 7 pm CT to submit and update their data for that performance year. That's also the deadline for MIPS-participating groups, virtual groups, and alternative payment model entities to apply for an extreme and uncontrollable circumstances exception for 2021 because of COVID-19.


Medicare Maintains Quality Reporting Resources for Small Practices - 03/16/2022

Despite the recent expiration of an initiative to help small, rural, and underserved practices navigate Medicare’s Quality Payment Program, the agency is still offering help to those practices through several avenues, including a new monthly newsletter geared toward small practices.


Medicare Extends MIPS Relief for Groups - 03/02/2022

Because of the COVID-19 public health emergency, Medicare has reopened applications from certain groups for its hardship exception under Medicare’s Merit-Based Incentive System (MIPS) extreme and uncontrollable circumstances policy.


New Patient Visit: Three Years Is a Key - 12/03/2021

Centers for Medicare & Medicaid Services auditors have identified claims coded for “new patient” evaluation and management services that don’t fit the definition for new patient services. Be sure to avoid this coding error.


How to Respond to a Medicare Audit - 08/27/2021

TMA Practice E-Tips editors ran across this excellent checklist of “17 tips from a lawyer” on how to respond to a Medicare audit.


Alphabet Soup: A MACRA Glossary and Acronym Guide - 08/19/2021

MACRA, the Medicare Access and CHIP Reauthorization Act of 2015,  introduced a slew of new acronyms and terms for physicians to understand. Here's our glossary.


Why, What, and Who Keys to Recoupment-Proof Documentation - 03/30/2021

The lack of a signature on specific portions of an otherwise complete documentation is enough to warrant a Medicare payment recoupment. Here’s what the Centers for Medicare & Medicaid Services found in three Comprehensive Error Rate Testing reviews.


Submit 2020 Data Now to Avoid Medicare Pay Cut - 03/23/2021

If you participated in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), the deadline to submit all data through the Centers for Medicare & Medicaid Services (CMS) portal has been extended one day to April 1. The deadline had been March 31.


CMS Increases Advanced APM Thresholds for 2021 - 11/13/2020

If you participated in Medicare’s Quality Payment Program (QPP) this year as a Qualifying Alternative Payment Model Participant (QP), you’ll need to keep an eye on your status for 2021.


Can’t Say It Enough: Document, Document, Document - 08/11/2020

When Medicare delves into claims errors, one stands out: insufficient documentation.


CMS Postpones 2019 MIPS Reporting Deadline to April 30 - 03/23/2020

With a key deadline for clinicians in the Merit-Based Incentive Payment System approaching fast amid the COVID-19 pandemic, the Centers for Medicare & Medicaid Services is giving those clinicians a month of extra time to submit their data.


AMA House Punts on Texas Plan to Fix QPP - 11/20/2019

A decision on whether the American Medical Association (AMA) will join the Texas Medical Association’s call for major changes to Medicare’s Quality Payment Program (QPP) will have to wait a few more months, the AMA House of Delegates decided at its annual meeting in Chicago last week. The QPP overhaul was just one of 11 resolutions the Texas delegation to the AMA took to the five-day meeting. Most of the other 10 received a very warm welcome.