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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.

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.

CPAN CME Bolsters Phone Consult Service - 10/17/2023

As children continue to experience trauma due to COVID-19, the Child Psychiatry Access Network (CPAN) can help physicians address the consequences. Along with its phone consult service – which physicians can access any time – CPAN offers virtual CME on various issues physicians are likely to encounter when treating young patients.

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.

988 Suicide Hotline Remains Unfamiliar One Year Post Launch - 09/08/2023

Suicide hotlines frequently are underused by those who need them most because people are simply unaware of them, says Austin obstetrician-gynecologist Kimberly Carter, MD.

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.

Proposed Mental Health Payment Parity Rules Could Restrict Treatments, TMA Tells TDI - 09/06/2023

Proposed rules that would require insurers to cover mental health and substance use disorders at the same rate as other medical procedures could actually exclude or restrict all benefits for certain treatments.

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.

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.

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.

CPAN Improves Access to Child Mental Health Care - 12/22/2022

Physicians are using the Child Psychiatry Access Network (CPAN) in steadily growing numbers, but many more can – and should – take advantage of this free behavioral health service, says Nhung Tran, MD, a developmental-behavioral pediatric specialist in Austin who serves as CPAN’s pediatric consultant and the Texas Pediatric Society’s liaison to CPAN.

Evidence-Based Strategies Key to Fighting Texas Suicide Rates - 11/29/2022

As 34.2% of adults in Texas report symptoms of anxiety and depression, Texas physicians are calling for the support and expansion of evidence-based strategies and telemedicine services to bolster mental health care across the state.

Physicians Serve as Lead Clinicians to Support Mental Health Intervention - 11/17/2022

The impact of adverse childhood events (ACEs) can be lasting and costly on patient health and medical outcomes. In the United States, more than 20% of adults report experiencing three ACEs during their youth, potentially increasing the risk of negative, chronic health consequences and challenges such as alcoholism, depression, unemployment, heart disease and substance abuse, among many others.

Behavioral Health, Suicide Prevention the Focus of TMA’s Next Distinguished Speaker Series - 11/15/2022

Join experts on Nov. 17 from noon to 1 pm to learn how to improve the behavioral health care systems that strengthen Texas communities and reduce suicide risk at the next Distinguished Speaker Series hosted by the Texas Medical Association and Texas Public Health Coalition (TPHC).

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.

Suicide Risk in Kids With Adverse Childhood Experiences Exacerbated by Pandemic - 11/11/2022

Suicide and suicidal thoughts among high school students who have accumulated adverse childhood experiences became a concern among health care professionals before 2020. But the “social and educational disruptions during the COVID-19 pandemic have exacerbated concerns about adolescents’ mental health and suicidal behavior,” according to a study by the Centers for Disease Control and Prevention.