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TMA Moment in Time: SGR Repeal - 04/09/2024

The historic victory has roots in TMA advocacy and may provide a playbook for future Medicare reform.

Straight Shooter: Incoming TMA President Ray Callas, MD, Aims for Practice Protections, Membership Gains - 04/01/2024

Incoming Texas Medical Association President Ray Callas, MD, an anesthesiologist from Beaumont, cites as his top priorities preventing scope-of-practice creep, defending physician autonomy, and bolstering the TMA's membership.

Medicare Sunsets Beleaguered Appropriate Use Criteria Program - 03/14/2024

After longstanding opposition from the Texas Medical Association and others, the Centers for Medicare & Medicaid Services finally nixed the appropriate use criteria program for advanced diagnostic services as part of the 2024 Medicare physician fee schedule.

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.

Medicine’s MIPS Win: 2024 Medicare Physician Fee Schedule Stabilizes Program - 03/05/2024

The Centers for Medicare & Medicaid Services yielded to the Texas Medical Association’s concerns about its proposal and the impact of constant changes to MIPS on its participants.

Revenue Cycle Assessment - 01/22/2024

A TMA consultant will conduct a review of your business office operations that focuses on front desk procedures, billing, collections and revenue cycle improvement. We will identify opportunities for improvement of billing processes and procedures.

Practice Operations Services - 01/22/2024

With the many challenges that face today's medical practices, business operations remain at the core of a practice's ability to be successful and profitable. Work with a TMA practice management consultant to identify and assess key or problematic areas of your practice.

Financial Management Services - 01/22/2024

Having sound financial policies and processes can help your practice attain a steady cash flow, maintain healthy collection ratios, increase staff efficiencies, and boost your overall bottom line.

Your Billing and Collections Checklist for 2024 - 12/19/2023

TMA’s Reimbursement Services staff work year-round with physicians and health plans to help make sure you get paid correctly and on time. They’ve put together a list of practical actions you can take at the start of 2024 to keep your billing and collections on track throughout the year.

Bipartisan Legislation Would Prohibit Electronic Funds Transfer Fees - 12/08/2023

Recently introduced federal legislation could spare physicians from electronic funds transfer (EFT) fees, which payers routinely charge as a condition of electronic payment.

CMS Strengthens Price Transparency for Hospitals - 11/29/2023

A new Centers for Medicare & Medicaid Services final rule aims to strengthen hospital price transparency regulations for 2024, a move physicians hope will address weaknesses in prior policy that hindered them and patients from making informed health care decisions.

“We Can Compete:” Direct Payment Models Present Opportunity for Independent Practices - 10/13/2023

Rising health care costs. Declining outcomes. Restricted patient access to care. Rampant consolidation. Incessant physician payment cuts. Excessive prior authorization. Creeping scope-of-practice attacks.

AMA Launches National Study of Physician Practice Expenses - 10/11/2023

With the backing of the Texas Medical Association and 172 other health care organizations, the American Medical Association recently launched a survey of U.S. physicians to better understand practice expenses and to support its advocacy for physician payment reform.

TMA Pushes for Elimination of Excessive Electronic Funds Transfer Fees - 09/22/2023

Payers routinely charge physicians the fees as a condition of electronic payment, often without consent. Alongside declining physician payment, the fees add to the threat to practice viability, and ultimately patients’ access to care. Read more.

Here’s What Medicare Pays for Flu Shots This Season - 08/23/2023

The Centers for Medicare & Medicaid Services recently published 2019-20 payment rates for personal flu vaccines and their administration. The effective dates for these rates are Aug. 1, 2019, to July 31, 2020.

Is Medicare’s Chronic Care Management Program for You? - 08/21/2023

Interested in the possibility of getting paid as much as $75,000, or even more, for something you already more or less do? Medicare now pays separately for chronic care management services. To help you decide if this new opportunity is right for your practice, TMA created a new online resource center.

Don’t Forfeit Your APM Incentive Payment; Act Now - 08/14/2023

If you participated in an advanced alternative payment model in the 2021 Quality Payment Program and haven’t yet received your 2023 incentive payment, you have until Sept. 1 to update your billing information – or forfeit the payment.

TMA Fights Another “Devastating” Medicare Physician Pay Cut Threat - 08/04/2023

Despite medicine’s calls for comprehensive reform, the recently proposed 2024 Medicare physician fee schedule would continue the worrying trends of deepening physician pay cuts and increased risk associated with the Merit-Based Incentive Payment System.

Congress Weighs Medicare Payment Reform During Health Care Consolidation Hearings - 07/25/2023

Federal lawmakers in both chambers recently took up the issue of increasing consolidation – and, with it, decreasing competition – in the health care industry. Surfaced as possible solutions were several of the Texas Medical Association’s legislative priorities, including Medicare physician payment reform.

Preauthorization Denial: What’s Your Recourse? - 07/25/2023

So a health plan has denied your preauthorization request for a patient’s treatment. What options do you have?

5010 Deadline Extended; Dual Eligible Problem Not Fixed - 07/25/2023

Acknowledging that many physicians and billing entities still aren't ready, federal officials are giving physicians three more months before it begins enforcing the use of Health Insurance Portability and Accountability (HIPAA) 5010 transaction standards. The new deadline is June 30.

TMA Offers Remedies to Ease Surprise Billing - 06/28/2023

Texas patients sometimes feel the pain from unexpected out-of-pocket costs not covered by their health insurance, known as “surprise billing” or “balance billing.” The Texas Medical Association (TMA) is taking aim at the problem, which occurs when a health insurance company pays less than what a doctor charges, leaving the patient to pay the balance of the bill.

Relief in Site: Physicians Say Setting Should Not Determine Medicare Payments - 06/07/2023

Physicians want to reform a Medicare policy that allows hospital-owned outpatient clinics to charge more than medical practices and ambulatory surgical centers for most medical procedures. This pay discrepancy pressures medical practices to merge in order to protect themselves from hospitals hot to acquire medical practices that, once bought, can collect much higher fees.

A Shelter From the Practice Viability Storm: TMA Braces Physicians Amid Economic Headwinds - 05/31/2023

TMA is here to help all practices – regardless of setting or payment model – thrive, remaining steady in its advocacy at the state and federal levels to protect physician autonomy and to defend against the corporate practice of medicine.

Cigna Delays Problematic Modifier 25 Policy - 05/31/2023

Cigna will delay its demanding requirement for physicians to submit additional documentation for routine, minor procedure claims after the Texas Medical Association, American Medical Association, and dozens of other medical organizations urged the payer to immediately rescind the policy in April.