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Dawn Duster Examines “Rubik’s Cube” of New DNR Law - 04/23/2024

The in-hospital DNR law, codified as Senate Bill 11 in the 2017 Texas Legislature, went into effect on April 1, 2018. Ms. Atwood and Jason Morrow, MD, medical director of inpatient palliative medicine at University Health System in San Antonio, examined the legal requirements of the complicated law and associated ethical considerations.

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.

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. 

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

Legislative Hotline March 4, 2021: TMA Opposes End-of-Life Care Bill That Poses Threat to “Do No Harm” - 07/17/2023

The Texas Medical Association is once again working to stop legislative attacks on a physician’s sacred creed to “do no harm,” which includes taking care of patients in their last days.

State Working to Clear Confusion with TxEVER - 07/17/2023

Although an official with the Department of State Health Services (DSHS) last week said the new TxEVER system should be operating smoothly, the agency on Friday acknowledged some of the difficulties physicians are experiencing.

TMB Won’t Penalize Physicians For Technical Problems With Vital Registry - 07/17/2023

The Texas Medical Board confirmed Saturday that it will not take action against physicians who experience technical issues with Texas’ new vital statistics registry, TxEVER.

Medicare Pays for End-of-Life Consults - 07/17/2023

As of January, Medicare pays physicians for advance care planning as a separate service, a long-sought victory that promotes educating patients and physicians on the issue. The Centers for Medicare & Medicaid Services created two new payment codes that cover it as a separate service in physician practices and facilities, including hospitals.

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.

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.

OIG: Physicians Incorrectly Billing for End-of-Life Care Planning - 01/05/2023

Advance care planning (ACP) services were meant to give patients the opportunity to choose the care that is right for them at the end of their lives or during medical crises that could render them unable to make personal health decisions.

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.

Voice of Reason: TMA’s Board of Councilors Tackles Ethical Policymaking - 06/08/2022

Established in 1903, the Board of Councilors renders and updates opinions on matters of medical ethics, from abortion and medical use of cannabis to physician-assisted suicide and restrictive covenants, among other responsibilities.

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.