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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.

Fix Medicare Now: 2024 Fee Schedule Solidifies Cut, Heightens Calls for Reform - 03/05/2024

This latest cut stems from the 2024 Medicare physician fee schedule and Congressional inaction, both of which further erode physician payment, practice viability, and patient access to care.

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.

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.

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.  

TMA to Feds: Some Proposed QPP Changes “Costly and Wasteful” - 08/23/2023

TMA letter praises the Centers for Medicare & Medicaid Services for its commitment to deregulation and outlining TMA's concerns about the proposed changes and recommendations for how to improve the QPP.

Medicare Gets It Wrong, Re-Calculates MIPS Scores and Changes 2019 Payment Adjustments - 08/21/2023

All Texas physicians should recheck their 2017 Merit-Based Incentive Payment System (MIPS) or Alternative Payment Model (APM) information to ensure the correct MIPS payment adjustment (bonus or penalty) was applied for 2019 Medicare payments.

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.

Congress Conducts MACRA Check-Up - 07/25/2023

Federal lawmakers seem to be listening to calls for reform for the Medicare Access and CHIP Reauthorization Act (MACRA), as the House Energy & Commerce Committee’s Oversight & Investigations Subcommittee recently hosted a “MACRA Checkup” hearing to examine the law’s “successes and remaining challenges.”

Make a Penalty-Free Shift From Meaningful Use to MIPS - 07/25/2023

I’m confused about the overlap of dates between the meaningful use incentive program and the Advancing Care Information reporting requirements under the Merit-Based Incentive Payment System. Is there extra work for physicians who participate in both?

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

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

Will Health Quality Improve Under New Medicare? - 06/28/2023

Medicare is revolutionizing how physicians are evaluated and paid to provide care, and patients will see changes as a result, focusing in their care quality. As Texas doctors adapt to the new Medicare payment system, many are concerned about the changes, while others are optimistic the transition will result in healthier patients. The switch to the new Quality Payment Program under the Medicare Access and CHIP Reauthorization Act (MACRA) means physicians who care for Medicare patients must change how they run their practice – and care for their patients.

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.

Congress Asks, TMA Delivers: 50 More Ways to Fix Medicare - 05/02/2023

TMA leaders presented lawmakers with 50 ways to increase physicians’ Medicare pay; reduce paperwork and hassles; measure “quality” with metrics that are meaningful to physicians and their patients; and push health information technology vendors to shoulder their fair share of the administrative burden.

The Unwinding: What the End of the COVID PHE Means for Continuous Medicaid Coverage - 02/24/2023

After nearly three years and 11 extensions, the federal public health emergency related to COVID-19 is poised to end this spring, and with it, continuous Medicaid coverage for more than 2.5 million Texans.

Marketplace Enrollment Could Help Blunt Potential Uninsured Surge as Public Health Emergency Ends - 11/11/2022

AA number of positive changes expanding access to and affordability of federal marketplace health plans could be coming just in time as Texas’ uninsured rate stands to worsen after the end of the public health emergency.

Commissioned With Change : An Interview With HHSC Commissioner Cecile Erwin Young - 11/11/2022

As leader of the state’s largest agency, Texas Health and Human Services Executive Commissioner Cecile Erwin Young is faced with some of the largest health care challenges among some of the most vulnerable patient populations. She visited the Texas Medical Association’s Winter Conference in late January to talk to Texas physicians about their concerns in caring for those patients, especially during a pandemic.