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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.


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.


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


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.


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.


Deal or No Deal: Negotiating Contracts - 11/28/2022

Maximize your leverage when negotiating a health plan contract.


New FAQ Offers Information on Virtual Credit Card Payments - 07/20/2022

Federal authorities are clarifying the legality of health plans paying claims through virtual credit cards, which typically result in fees for practices.


Contract Do’s and Don’ts: How to Negotiate From a Place of Strength - 06/29/2022

By leaning on Texas Medical Association resources and their own health care attorney, physicians can gain confidence and better negotiate favorable terms to secure their economic success.


Ten Tips for Getting a Good Deal From Your Tech Vendor - 04/13/2022

Technology is an integral part of modern health care. But how can you pursue the best possible deal from your technology vendor? Larry Chu, MD, a member of the Texas Medical Association’s Committee on Health Information Technology, says you need to sweat the details of your vendor contract.


A Long-Overdue Fix: Comprehensive Medicare Reform Could Halt Pay Cuts - 03/31/2022

Physicians say Medicare reform is the only solution to the problem of periodic pay cuts  – and they’re prepared to fight for it.


Reminder: Provider Relief Fund's Second Reporting Period Ends March 31 - 03/28/2022

If you received Provider Relief Fund distributions greater than $10,000 from July 1, 2020 to Dec. 31, 2020, this Thursday, March 31, is your deadline to report how you used those funds.


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.