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2025 Legislative Wrap-Up: Texas Medicaid Enrollment Could Benefit from Modernization Funding - 08/28/2025

The Texas legislature preserved Medicaid allotments that TMA advocated for in the 2023 session, while providing funding to support two important online systems.

Texas Organization Leads Medicare Quality Improvement Program - 08/20/2025

Chronic disease management, behavioral health, and patient safety are among the priorities of a renewed Medicare program led by TMF Health Quality Institute. Prospective participants chosen can receive access to consulting services and resources.

Flood-Impacted Texas Physicians Granted New MIPS EUC Exception - 08/14/2025

In response to severe storms and flooding affecting Texas in July, physicians in impacted counties will receive automatic adjustments to their Merit-Based Incentive Payment System scores. Some physicians will still have the option to report data and receive a corresponding payment adjustment.

“Administrative Churn” Could Cost Texas Medicaid Patients Their Coverage When PHE Ends - 08/08/2025

Nearly half of the 15 million Medicaid patients across the U.S. at risk of losing coverage when the COVID-19 public health emergency (PHE) ends may fall prey to “administrative churning.” That is, they could lose coverage despite remaining eligible because of difficulties navigating the renewal process, address changes, and other administrative challenges.

Address Delayed Care Pileup, TMA Tells House Panel - 08/08/2025

The COVID-19 pandemic strained an already overburdened primary health care system in Texas, making it vital that state lawmakers back measures that encourage patients to see a physician and catch up on delayed care before it gets even worse, Tyler pediatrician Valerie Smith, MD, told the Texas House of Representatives Select Committee on Health Care Reform.

Texas Leads National Charge for Medicare Physician Payment Reform - 08/08/2025

The Texas Delegation to the American Medical Association led the charge for more concrete action to achieve comprehensive Medicare physician payment reform , resulting in new AMA policy calling for less “talk” and more “action” to ensure access to care for patients.

New Tool Assists with Medicaid Enrollment Challenges - 08/06/2025

Medicaid enrollment may now be easier for Texas physicians to navigate, thanks to an online tool that answers questions on the spot and lets users schedule troubleshooting appointments. TMA will monitor its performance and is seeking input from physicians who test it out.

CMS Delivers Temporary Bump to Medicare Pay in 2026, Among Sweeping Changes in Proposed Fee Schedule - 07/16/2025

A temporary, one-year 2.5% Medicare payment update across the board reflects requirements Congress approved in its final budget. The proposal also includes, for the first time, two separate conversion factors with slight, albeit permanent, updates aimed at promoting value-based care.

Now is the Time: Texas Delegates to AMA Make a Strong Push for Fixing What Ails Medicare - 06/23/2025

Texas Medical Association members made their voices heard at the American Medical Association’s three-day National Advocacy Conference (NAC), Feb. 10-12, 2025, calling for a long-term Medicare payment fix.

Multiple Choice: How Two APMs Are Contributing to Cost-Conscious Health Care - 06/17/2025

The Medicare Shared Savings Program and ACO REACH program provide physicians with two viable payment models incentivizing better patient care outcomes.

TMA Vigilant of New Medicare Advantage Audits - 06/17/2025

The Centers for Medicare and Medicaid Services has begun what the agency itself calls an “aggressive” new strategy to audit all Medicare Advantage plans annually to review whether insurers and their networks are inflating patients’ illnesses, leading to overpayments – and the additional compliance burdens and possible repayments could fall on physicians.  

Who Can Do the Face-to-Face Encounter for Home Health? - 06/12/2025

Medicare won’t pay home health agencies to care for Medicare patients without a physician’s certification, which must include a face-to-face encounter with the patient. Here’s who can perform that encounter.

HHSC Extends Medicaid Revalidation Another Six Months - 06/12/2025

The state is providing physicians with additional time to take a key step in caring for Medicaid patients. It’s also providing a reentry pathway for physicians disenrolled last year.

Texas Medicaid Delays Online Enrolling and Credentialing Integration - 05/22/2025

In April, the Texas Medicaid & Health Partnership had announced physicians could enroll and get credentialed in a one-stop, two-step process. The pause means the status quo remains for now.

MedPAC Calls for Tying Medicare Payment to Inflation with a Permanent Update - 04/22/2025

The agency advising Congress on Medicare issues calls for a physician payment structure tied to the Medical Economic Index, in line with TMA advocacy. The recommendation calls for a permanent payment update in 2026 and beyond.

Medicaid Funding Streams Crucial in State, Federal Advocacy Discussions - 04/17/2025

In the chance the federal government moves forward with proposed cuts that could negatively impact Medicaid, TMA is here to help Texas physicians understand and navigate Medicaid’s funding complexities. Read more.

TMA’s Top Legislative Priorities: Enhance Medicaid Payments and Coverage - 04/17/2025

TMA will work to enhance Medicaid payments and coverage this legislative session

TMA Signs Letter Calling for Congress to Protect Medicaid Funding - 04/17/2025

As the U.S. House of Representatives considers $880 billion in cuts from the committee overseeing Medicaid, TMA and all 50 state medical societies detailed the impacts such a cut would make to patient care and practice viability.

Medicine Backs New Legislation Halting Latest Medicare Payment Cut - 04/14/2025

Led by physician lawmakers, the proposed legislation would cancel the most recent physician pay cut and provide some extenuating relief for the remainder of the year. TMA recently joined the American Medical Association’s national advocacy conference to take their efforts to lawmakers’ doorsteps in D.C.

CMS Issues New MIPS Hardship, Extension Tied to IV Fluid Shortage - 03/28/2025

The 15-day window opens today, March 31, and comes in response to medicine’s advocacy. TMA encourages affected physicians to document those shortages and the impact on their practices.

UPDATE: Submit 2024 MIPS Data by April 14 to Avoid 9% Pay Cut - 03/28/2025

The data submission period for Medicare’s 2024 Merit-Based Incentive Payment System (MIPS) performance year is underway and closes on April 14 at 7 pm CT. At stake is a pay cut of up to 9% in the 2026 payment year.

Congress Extends Medicare Telehealth Flexibilities for Another Six Months - 03/24/2025

Several pandemic-era Medicare telehealth and payment flexibilities will now last through Sept. 30 following recent action by Congress, including those that waive geographic site restrictions for mental health telemedicine services provided without an in-person visit.

Advancing Primary Care: Medicare Rolls Out New Payment Codes for Treating Chronic Conditions - 03/04/2025

Though the Centers for Medicare & Medicaid Services (CMS) has introduced another acronym into the Medicare mix, some physicians express optimism this particular one could help practices stay viable.   For Greg Fuller,

Without Congressional Action, Medicare Telehealth Waivers Will End March 31 - 02/26/2025

Medicare telehealth waivers previously extended by Congress will expire March 31, meaning Medicare patients will no longer be able to have telemedicine visits while in their home and physicians will again be required to meet with patients in-person before a telemedicine mental health consultation.

Medicare Payment Cuts Drive Physician Shortage, TMA Tells AARP - 02/24/2025

After an AARP Bulletin article connected the current physician shortage to a wider health care crisis, TMA joined the Physicians Advocacy Institute to co-author a response focusing on the role that Medicare payment cuts play.