Related Stories

Medicare May Seek Payment Recoupment for 2023 Claims - 04/09/2024

A new report by the Government Accountability Office shows physicians may face possible recoupments – or additional payment – for claims filed in 2023 as a result of over and underpayments by Medicare, Medicaid, and other federal programs.

Physicians May Face Lower Payment as CMS Resumes Lab Data Collection - 03/11/2024

The Centers for Medicare & Medicaid Services will continue to collect data from physician-owned laboratories to inform private payer rates despite pushback from the Texas Medical Association.

Blue Cross Says MOC Not Needed for BlueCompare - 02/28/2024

Physicians across the state reacted strongly to a March 5 letter from Blue Cross and Blue Shield of Texas (BCSTX) that implied the state’s largest insurance company is now using maintenance of certification (MOC) to rate physicians. That was not the intent, the company’s president says.

Practice E-Tips on Billing and Collections - 02/20/2024

Practice E-Tips on Billing and Collections

Spending Growth Rate for Physician Services Slows - 01/09/2024

Although spending on physician and clinical services increased 2.7% year-over-year to $884.9 billion in 2022, the spending growth rate fell, due in part to a slowdown in the use of such services and in physician prices. In comparison, spending on physicians and clinical services grew 5.3% in 2021.

How to File a Medicare Extended Repayment Plan - 12/06/2023

  Extended repayment plans (ERPs) are an option for returning overpaid money to Medicare. Ideally, you should request an ERP immediately after receiving the initial demand letter. However, you can request an extended payment plan any time while the overpayment is outstanding. 

Noncompete Concerns Spark Ongoing TMA Advocacy, Resources - 09/19/2023

The Texas Medical Association continues to receive reports of physician concerns over noncompete agreements, underscoring medicine’s ongoing legislative and regulatory advocacy efforts to strike a balance that works for physician employers and employed physicians alike.

CMS to Recoup Chronic Care Management Payments - 08/21/2023

Some Texas physicians and outpatient facilities might have to refund payments they received for chronic care management services performed during 2015 and 2016 under the Medicare Physician Fee Schedule, federal officials said.

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.

What Stimulus Means to Texas Health Care - 07/25/2023

State health officials have released preliminary information on major health and human services allocations for Texas in the $789 billion economic stimulus bill President Obama signed. The largest portion is $5.45 billion for Medicaid through the first quarter of 2011.

Help Patients Make Wise Choices About Treatment Options - 07/20/2023

Tools are emerging to help physicians overcome the time constraints that can preempt discussions with patients.

Quality Improvement: Practice Awards and Free Webinars - 07/20/2023

TMA, the Texas Osteopathic Medical Association (TOMA), and the TMF Health Quality Institute are collaborating again to provide the Physician Practice Quality Improvement Award program. The award formally recognizes physician practices for their dedication and commitment to providing high-quality patient care and improving outcomes.

Practice e-Tips on Claims - 07/20/2023

Appeals Appealing Claims Can Have Appealing Results   Claim Forms Multiple Place-of-Service Codes on a Single 1500 Claim Form   Fees New Laws Require Billing Di

Practice e-Tips on Reimbursement - 07/20/2023

Billing & Fees Claims Coding & Documentation Collections Copayments & Deductibles Medicaid & Medicare Workers' Comp Billing & Fees Are You Missing Out on Your Money?    Billi

You Can Get Paid for Medicaid Emergency Services - 07/20/2023

You Can Get Paid for Medicaid Emergency Services

Driving the Quality Train: TMA Physicians Lead the Way, From Measures to Standardization - 07/10/2023

In a proactive effort to resolve physician complaints, TMA and its members are deeply involved in quality issues, from participating in the development of new measures to pushing payers for standardized quality programs and supporting physicians who are curious about value-based care.

Texas Physicians Push to Improve Health Care for LGBTQ Patients - 06/28/2023

Lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) patients face unique barriers that put them at greater risk for mental and physical health problems. Often, their health disparities result from a lack of family support, public prejudice, and fear of the health care system. Texas physicians have launched a new workgroup and are adapting their practices to treat this underserved population.

Judgment Calls: Court Victory Highlights Importance of Corporate Practice of Medicine Laws - 06/07/2023

Hospital Internists of Texas was pitted against a multibillion-dollar company in a corporate practice of medicine lawsuit. At the trial court level, a Travis County district court jury awarded the Austin medical practice more than $10.2 million.

TMF Offers Resources to Navigate CMS Requirements - 05/16/2023

TMF has launched three physician-focused networks designed to save time, improve patient care, and reduce costs associated with meeting these requirements. These programs, focused on immunizations, behavioral health and value-based improvements, are designed to help physicians benefit from—and not be penalized by—these mandates.

Congress Weighs Legislation Tying Medicare Physician Payments to Inflation - 04/26/2023

Heeding advocacy by the Texas Medical Association and others in organized medicine, Congress is weighing bipartisan legislation that would index Medicare physician payments to inflation, overriding cuts scheduled to take effect in 2024.

TMA to Congress: Tie Medicare Physician Payment to Inflation - 03/29/2023

As part of a broader push for Medicare payment reform, the Texas Medical Association, along with the American Medical Association and 133 national specialty and state medical associations, recently called on Congress to index Medicare physician payments to inflation.

Labs – Including Those Run by Physicians – Face New Reporting Requirement in 2023 - 03/14/2023

Starting Jan. 1, medical laboratories – including physician-owned labs – face a reporting requirement from the Centers for Medicare & Medicaid Services that will create a paperwork burden and could negatively affect payment rates.

TMA Analyzes FTC Proposed Ban on Noncompetes - 03/09/2023

The interplay between federal and state efforts to ban noncompete agreements remains unclear as Texas Medical Association experts analyze a proposed Federal Trade Commission (FTC) rule on the matter.

Here’s Your Billing and Collections Checklist for 2023 - 01/06/2023

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 2023 to keep your billing and collections on track throughout the year.