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Feds Extend Marketplace Special Enrollment Amid Medicaid Unwinding - 04/19/2024

Texas patients who have been disenrolled from Medicaid in the wake of the COVID-19 public health emergency now have more time to find alternative coverage on the federal marketplace. The extension could mitigate a coverage cliff about which the Texas Medical Association has long raised concerns.

Postpartum Coverage Extension Brings Payment Complexities - 04/05/2024

As the 12-month postpartum coverage Texas legislature approved took effect March 1, physicians and their practice staff should take note of subsequent payment complexities, Texas Medical Association experts caution.

Did You Receive an Email Requiring Registration to the State’s PMP? - 02/28/2024

TMA can confirm that an email sent Friday afternoon asking physicians to register for a PMP Aware account are indeed legitimate; however, there is no deadline to register.

Medicaid, CHIP Postpartum Coverage Extension Will Take Effect March 1 - 02/08/2024

After a multi-session advocacy effort by the Texas Medical Association, specialty societies, and women’s health advocates, Texans who are enrolled in Medicaid or the Children’s Health Insurance Program and who are pregnant or become pregnant will see their postpartum coverage automatically extended starting March 1.

Cannabidiol Takes a Big Step Toward Respectability - 01/25/2024

In September, the DEA issued an order listing all drugs approved by the U.S. Food and Drug Administration that contain cannabidiol but no more than 0.1 percent of the chief psychoactive agent in cannabis as Schedule V drugs — those with the least potential for abuse. So far, Epidiolex is the only medication that fits that description.

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.

CMS Introduces Electronic Documentation Submission Tool - 01/02/2024

The Centers for Medicare & Medicaid Services (CMS) has developed a free service to help physician practices of varying sizes and documentation workloads upload and submit medical documents, including prior authorization requests, electronically.

EHR Systems Must Give Practices Export Functionality - 12/13/2023

Practices and patients will be able to export electronic health information more easily thanks to a 21st Century Cures Act requirement that all certified electronic health records systems provide such functionality by Dec. 31.

On the Mend: Maternal Care Wins Encourage Better Outcomes in Texas - 11/05/2023

Twelve months of postpartum coverage and other maternal wins encourage physicians for better outcomes.

First Steps: TMA Secures Medicaid Physician Rate Increases With Hopes for Momentum - 11/05/2023

TMA helped secure the first Medicaid physician rate increases in decades in hopes it will build momentum for future gains.

Report Aims to Catalyze Texas Medicaid’s Shift to Value-Based Care - 11/02/2023

A new report aims to accelerate Texas Medicaid’s transition from a fee-for-service payment model to a value-based one, a shift that has been underway for 25 years.

Coming Unwound: Mass Disenrollments Hurt Patients and Physicians Alike - 11/02/2023

The end of continuous Medicaid eligibility has led to mass disenrollments, hurting patients and physicians alike.

Reminder: Revalidate Your Medicare and Medicaid Enrollment - 09/25/2023

Starting Nov. 1, physicians must use a revised Medicare enrollment application. On the Medicaid front, physicians who were due to re-up their enrollment during the COVID-19 public health emergency get a grace period to complete this requirement, but all physicians must review and update their practice addresses. Read more.

TMA Pushes Back Against Planned Vaccine Payment Cuts - 09/06/2023

As the influenza virus continues to spread statewide, the Texas Medical Association and other specialty societies have taken a stand against a plan to cut by almost 36 percent payments to physicians who administer a flu vaccine in their offices.

Zika Reminder: Mosquito Repellent Covered Under Medicaid - 09/06/2023

To protect against Zika, mosquito repellent prescriptions are covered through Medicaid and other state programs, including the Children’s Health Insurance Program.

How to Identify Dual-Eligible Patients - 08/23/2023

The Centers for Medicare & Medicaid Services has been working to rein improper billing of Qualified Medicare Beneficiary program-enrolled patients, who have both Medicare and Medicaid coverage. You can verify patient status in several ways.  

Medicaid Drops Thousands of Texans; Many Still Qualify - 08/07/2023

Texas’ effort to “unwind” continuous Medicaid coverage – a pandemic-era benefit – has resulted in a steep coverage cliff. State officials and advocates urge physicians to help soften patients’ falls. Read more.

EHR Data Entry – There’s a Better Way - 07/25/2023

Electronic Health Record (EHR) data entry is a part of the job, but for most physicians it’s a chore. Not only does it take time away from your patients, it adds to the hours you spend in the office (or to the work hours you spend at home). Fortunately, many physicians have found ways to save time doing data entry.

Use EHR to Improve Patients’ Vaccination Rates - 07/25/2023

If you are working to improve the vaccination rates among your patients, don’t underrate your electronic health record (EHR) as a tool.

Mastering Quality Reporting: Ease the Challenge of Quality Reporting - 07/10/2023

Understanding the maze of quality reporting pathways may help ease the challenge.

Physician-Led Results: Medicaid Rate Increase - 06/28/2023

Texas physicians aimed to win a focused Medicaid rate increase in this year’s Texas legislative session, one designed to improve coverage for children and young mothers. For the first time in more than a decade, they got it.

Medicare Part B Inflation Rebate Takes Effect, Lowering Copays - 06/27/2023

A new federal law requires drug companies to rebate Medicare if they raise certain drug prices higher than the rate of inflation, which has translated into lower copays for some Medicare patients.

At Your Service: Practices focus on patient experience and convenience - 06/05/2023

Practices focus on patient experience and convenience to compete in an ever-changing medical landscape.

How to Renew Your Electronic Prescribing Hardship Waiver - 03/24/2023

Physicians and other prescribers in Texas must now electronically prescribe controlled substances (EPCS). However, prescribers who demonstrate financial or technical hardships, or other exceptional circumstances, are eligible for a waiver from the Texas Medical Board (TMB) that, if approved, grants a one-year delay. If the hardship persists, prescribers must renew that waiver annually.

QHINs Mark a Step Toward Interoperability - 03/07/2023

Physicians likely don’t need another acronym in their vocabulary, but “QHINs” bring some good news that translates to greater access to patient information.