News

Senate Committee Weighs Medicare Physician Payment Reform - 04/22/2024

Following a months-long, full-court press by the Texas Medical Association and others in organized medicine, Congress recently considered bolstering Medicare physician payment to ensure vulnerable patients’ access to care for chronic conditions during a Senate Finance Committee hearing on April 11.

RSVP For TMA Sections Business and Networking at TexMed - 04/22/2024

Prepare for TexMed 2024, the Texas Medical Association’s largest annual meeting, by RSVPing for section activities by April 26 and reviewing resolutions for sections to discuss.

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.

Practice Viability Consequences of Cyberattack Weighed by House Subcommittee - 04/19/2024

The Feb. 21 cyberattack on Change Healthcare – and its consequences for physician practice viability, industry consolidation, and patient access to care – were the subject of the first of several anticipated congressional hearings on the topic. UnitedHealth Group – notably absent from the hearing – faces mounting pressure to account for the attack.

Fingerprinting Services to Be Offered at TexMed - 04/18/2024

Because many Texas physicians now are required to provide fingerprints to renew their medical licenses, the Texas Medical Association has contracted with Idemia to make these services available onsite at TexMed 2024 for registered conference attendees.

New Federal Rules Limit Short-Term Insurance Plans, Enhance Protections - 04/17/2024

Following advocacy by the Texas Medical Association, the U.S. departments of Health and Human Services, Labor, and the Treasury recently issued final rules that strengthen consumer protections related to short term, limited duration insurance.

TMA Spotlights Access Threats Posed by No Surprises Act to House Committee - 04/17/2024

Following a recent congressional field hearing on emergency care in rural and underserved communities, the Texas Medical Association emphasized in written comments how federal regulators’ flawed implementation of the No Surprises Act has exacerbated access challenges.

TMA Pushes for Prior Authorization Limits, Clarity - 04/16/2024

After hearing story after story of delays and denials, the Texas Medical Association is pushing the Texas Legislature to sign off on measures that would significantly curb insurers’ ability to require prior authorization on needed care, as well as clarify for both physicians and patients what it means when prior authorization is required.

CMS Finalizes 2025 Medicare Advantage Payment Rates - 04/16/2024

Despite a 0.16% reduction in base pay rate, Medicare Advantage plans are projected to see a 3.7% growth in revenue in 2025 thanks to a rising average patient risk score.

Novitas Solutions Warns of Top 10 Medicare Claims Errors - 04/15/2024

Novitas Solutions, the Medicare administrative contractor for Texas, has released a top 10 list of errors made between January and March 2024 physicians should be aware of to mitigate billing problems in their practices.

Cigna Launches Digital Newsroom for Payer Updates - 04/12/2024

Physicians and practice staff looking for updates from one of Texas’ major payers, Cigna Healthcare, can now refer to the company’s new digital newsroom.

CMS to Test Prior Auth Requirements for Certain ASC Procedures - 04/10/2024

Texas physicians soon may encounter new Medicare prior authorization requirements for certain services that double as cosmetic procedures when provided at an ambulatory surgical center.

CMS to Debut Primary Care Payment Model - 04/10/2024

In an effort to address financial barriers to accountable care organizations’ provision of primary care services, Medicare will test a new value-based payment model for approximately 130 starting in 2025 and running through 2029.

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.

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.

TMA to IRS: Direct Primary Care, Health Care-Sharing Ministries Aren’t Insurance - 04/05/2024

The Texas Medical Association is urging the IRS to reconsider a proposed rule that would classify direct primary care (DPC) arrangements and health care-sharing ministries (HSMs) as insurance.

New TMA Section Leaders to be Appointed at TexMed - 04/05/2024

Now is the time to apply for one of several open positions available for section leadership as TexMed 2024 approaches, May 2-4, at the Omni Dallas Hotel.

Texas Expands Tobacco Cessation Services - 04/05/2024

With the help of a $2 million funding increase approved by state legislators in 2023 and backed by the Texas Medical Association, the Texas Department of State Health Services will expand its tobacco cessation services, giving physicians additional resources to help patients struggling with nicotine addiction.

Testify Online on TMA Business Items by April 12 - 04/03/2024

As delegates prepare for the Texas Medical Association’s annual policymaking meeting next month, members have until April 12 to submit online testimony on business items to be considered by the House of Delegates at TexMed in Dallas, May 2-4.

Revamped Newsletter Highlights your TMA Foundation in Action - 03/29/2024

The TMA Foundation this week unveiled an updated version of its newsletter, Solutions.

TMA Vaccination Grants Connect Hard-to-Reach Patients; Apply by May 1 - 03/28/2024

Dozens of patients in the Lubbock area are up to date on their vaccinations thanks to a local impact grant from the Texas Medical Association, which has opened the latest 2024 application cycle for vaccine outreach programs until May 1.

Aetna Set to Pay Medicare Advantage G2211 Claims - 03/27/2024

The list of health plans providing payment for Medicare’s new add-on “G” code continues to grow with Aetna as the latest insurer to cover G2211 for Medicare Advantage claims Aetna confirmed with Texas Medical Association coding experts that its Medicare Advantage claims platform was updated in March to allow payment for the code, used to document the coordination of care for patients with complex or serious conditions. For now, the plan’s policy is only accessible through a physician’s Aetna portal.

MedPAC Backs Medicare Physician Payment Increase – Again - 03/26/2024

Echoing advocacy by the Texas Medical Association and others in organized medicine, the Medicare Payment Advisory Commission recently reupped its recommendation that Congress increase Medicare physician payment by tying such payment to inflation, among other factors.

State to Update Trauma, Emergency System Rules - 03/25/2024

For the first time in 20 years, the Texas Department of State Health Services is updating the state’s emergency medical system and trauma care rules.

TMA Scholarship Cultivates a Diverse Workforce; Apply by May 31 - 03/25/2024

Are you sharing in the excitement of someone who's just been accepted to medical school?