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TMA Sues Feds Over Unfair Rule for Surprise Billing Law - 03/22/2024

The Texas Medical Association filed a lawsuit in federal district court in Tyler, Texas, after the Biden administration failed to follow clear direction from Congress about how to implement the dispute resolution process set forth in the No Surprises Act, legislation that was passed in 2020 to protect patients from surprise medical bills.


TDI Proposed Rules for State Network Adequacy Law Raise Strong Concerns - 03/20/2024

After securing network adequacy reform during the 2023 regular state legislative session, the Texas Medical Association has shifted its focus to ensuring the Texas Department of Insurance’s network adequacy rules conform to the plain language and intent of the law.


Power Data: Texas' Claims Database Will Help Clarify Care Costs - 03/15/2024

Texas is building an all-payer claims database, which will provide a clearer view of opaque health care costs.


New Law Prohibits Employer COVID-19 Vaccine Mandates, With Exceptions - 02/28/2024

Thanks to advocacy by the Texas Medical Association, guardrails for patient safety and practice viability are included in a new state law that prohibits employers, including physician offices and health care facilities, from mandating COVID-19 vaccines among employees.


New Poster Encourages Flu Vaccination Amid COVID-19 - 02/28/2024

“COVID-19 is here, but so is the flu.” That is the message of a new downloadable poster available from the Texas Medical Association’s Be Wise – Immunize program to help you stress the need for flu vaccination, this year more than ever.


Comprehensive Prior Authorization Reforms Needed, Medicine Tells Feds - 11/30/2023

As the Centers for Medicare & Medicaid Services (CMS) seeks ways to relieve the burdens of prior authorization on health care, it should not rely solely on automation of electronic health records. Instead, CMS should seek comprehensive reforms that include transparent PA requirements and protections of continuity of care as well as automation, the Texas Medical Association, American Medical Association, and a host of other medical societies wrote in a letter to CMS Administrator Seema Verma last week.


FDA Approves New RSV Vaccine, COVID-19 Booster - 10/19/2023

Physicians will have a new vaccine in their arsenal to help protect against respiratory syncytial virus (RSV), a timely development as cold, flu, and COVID-19 illnesses tend to converge and ramp up this time of year and become difficult to differentiate.


Leading in Crisis: Diana L. Fite, MD, Carried TMA During COVID-19 Pandemic - 10/03/2023

Diana L. Fite, MD, carried TMA during the height of the COVID-19 pandemic.


Putting the AI in Paid: Payer Use of Artificial Intelligence Sparks Physician Concerns - 10/02/2023

Physicians - worried about payers' increasing use of artificial intelligence to process prior authorization requests, enable value-based care models, and systematically deny coverage - are seeking transparency on behalf of their patients and practices.


Urge Texans to Get Flu Vaccine Early, Officials Say - 09/06/2023

With flu season on the horizon – and the COVID-19 pandemic expected to continue – Texas physicians should strongly encourage patients to receive a flu vaccination as early as possible.


Talk to Patients About: Breakthrough Infections for COVID-19 Vaccinations - 09/06/2023

 The new mRNA vaccines for COVID-19 are highly effective at giving people immunity against the disease. But as with all other vaccines, that immunity is not 100% for everyone who receives them.  


Humana Claims Issues Require Resubmission Due to Technical Error - 09/01/2023

Practices that used Mimecast's secure message portal to submit claims issues, questions, or appeals to Humana between July 17 and Aug. 28 will need to resubmit those reports due to a technical error.


Tune in Saturday to Watch TMA’s 155th President Take Office - 08/31/2023

Although TexMed 2020 has been canceled, and the Texas Medical Association House of Delegates meeting has been suspended, Diana L. Fite, MD, still will take office as TMA’s 155th president Saturday. Visit TMA’s Facebook page at noon Saturday to watch a live broadcast of her installation and address.


TMA Suspends 2020 House of Delegates Meeting - 08/31/2023

Because of the evolving COVID-19 pandemic, the Texas Medical Association Board of Trustees has voted to suspend the 2020 TMA House of Delegates meeting, either virtual or in-person, until an appropriate time in the future when the crisis has subsided.


TMA Wins Fourth Lawsuit Challenging Payment Calculations in Surprise Billing Arbitration - 08/28/2023

Marking a fourth victory for the Texas Medical Association in as many lawsuits, a court struck down a large portion of the regulations setting forth a methodology insurers use to calculate the qualifying payment amount, or QPA, used in surprise-billing disputes – part of a series of federal rules TMA has long argued skew the arbitration process in insurers’ favor.


TMA Welcomes New Court Ruling in NSA Lawsuit - 08/25/2023

Statement by Rick W. Snyder II, MD, Texas Medical Association (TMA) president, in response to the ruling by the U.S. District Court for the Eastern District of Texas regarding TMA’s third No Surprises Act (NSA) lawsuit.


TMA Resumes In-Person Meetings with Major Texas Payers - 08/25/2023

After a pandemic-induced hiatus, the Texas Medical Association recently resumed in-person meetings with Texas’ major payers to solve physicians’ payment policy problems, a practice that dates back more than 25 years.


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.


Report: Most Private Payers Have Stopped COVID Cost-Sharing Waivers - 08/21/2023

Private health insurance plans have largely stopped waiving patient cost-sharing for COVID-19 treatment, according to a recent report by the Peterson Center on Healthcare and Kaiser Family Foundation. The data represent an overwhelming shift from payer cost-sharing policies during 2020 as indicated by previous research.


United Will Eliminate Prior Authorization Requirements for Certain Procedures - 08/11/2023

Physicians have long complained about onerous prior authorization requirements, which often delay care and sometimes have catastrophic consequences. One payer seems to be listening.


Court Delivers TMA Win Against Fee Hike, Batching in Surprise Billing Arbitration - 08/10/2023

The court struck down a 600% administrative fee increase and certain unfair rules that narrowed the law’s provisions on combining or “batching” surprise-billing arbitration claims. The decision is one of several victories TMA has won against federal regulators tasked with implementing the federal No Surprises Act.


TMA Pleased Court Strikes Down Steep Fee Hike and Batching Rules in NSA Cases - 08/08/2023

Statement by Rick W. Snyder II, MD, Texas Medical Association (TMA) president, in response to the ruling by the U.S. District Court for the Eastern District of Texas on TMA's fourth No Surprises Act lawsuit. TMA challenged a 600% hike in administrative fees and batching rules used in arbitration cases governed by the federal law.


TMA Opposes Congressional Proposal to Cap Office-Based Physician Pay - 08/07/2023

A recently filed federal bill would recycle a controversial formula that TMA has waged several lawsuits against in the federal surprise billing regulatory context to limit payments for health care services furnished in physician offices.


Patient Care Protected: Prior Authorization Reforms - 08/04/2023

Carrying the torch from last session, the Texas Medical Association followed up on its 2021 gold-card success with a new prior authorization reform for vulnerable patients and other insurance-related policy wins this session.


New TMA Lawsuit Challenges Big Fee Hike in “No Surprises Act” Arbitration - 08/04/2023

The Texas Medical Association (TMA) is challenging a 600% hike in administrative fees for seeking federal dispute resolution in No Surprises Act (NSA) situations. TMA seeks relief by filing a fourth lawsuit in the U.S. District Court for the Eastern District of Texas.