The Trump Administration's new rule seeking to limit access to green cards for immigrants who receive Medicaid and other government benefits will discourage people from seeing their physicians, worsening medical problems and harming public health.
Our U.S. senators and representatives are back home in Texas for the August recess, and Texas Medical Association President David Fleeger, MD, says their physician-constituents need to contact them to make sure they stop the surprise medical billing epidemic in a way that helps our patients – not big insurance companies.
TMA went into this session looking to attack insurer network inadequacy and health plans’ use of care-impeding prior authorization demands.
On both fronts, medicine scored solid legislative wins that will make it easier for patients and physicians to know who’s in network, and provide needed transparency on preauthorization requirements. And on surprise billing, medicine turned what could’ve been a disastrous bill into something more palatable.
Thanks to incessant lobbying from physicians, hospitals, organized medicine, and the Physicians Advocacy Institute, a key congressional committee today made significant revisions in a bill to reduce the strain of surprise billing on patients. “This certainly sounds like an improvement,” said Texas Medical Association President David Fleeger, MD, “but the devil will be in the details.”
TMA’s Hassle Factor Log® helps you resolve insurance-related problems. TMA meets regularly with Medicare, Medicaid, health plans, and large insurers to discuss the specific problems that you bring to our attention.
Many physicians assume that attempting to negotiate a health plan contract is hopeless — but that is a myth. Survey data from TMA show that physicians’ negotiation attempts often are successful. Respondents report winning both payment and term changes in their contracts.
Health care is the toughest living expense for most Texans to afford, and many skip or postpone tests, medications, and basic procedures because of the cost. And that very well could be bad for their health, especially for the millions who lack insurance. Those are the findings of a statewide poll on the affordability of and access to health care in Texas published last month by the Episcopal Health Foundation.
As Texas prepares to implement an arbitration process to address surprise medical bills, Texas physicians are helping the U.S. Congress work on a federal solution. The House Committee on Energy and Commerce’s Subcommittee on Health tackled surprise billing in a hearing last week to consider the No Surprises Act, draft legislation put together by two committee members.
New Medicare rules on local coverage determinations may make physicians reluctant to speak their minds.
Every day, patients pay a hefty price for their health care, and many are quick to blame rising costs and climbing insurance premiums on the first person that comes to mind: usually the “well-paid physician.”
Don’t let your patients place blame on you unfairly.
Credentialing with the government and health insurance companies continues to be a complex and time-consuming management function for practices of all sizes. At Nationwide Credentialing, we work with you from start to finish on the credentialing process, which allows physicians and their staff to focus on patients and other important aspects of their practice.
Medicare For All is becoming popular among Democratic lawmakers and the public. But, as popular as the concept is, the details are lost in the simple slogan of “Medicare for All.”
The Texas Medical Association’s Healthy Vision 2025 – released this week – seeks to draw a roadmap for how legislators can hold insurance companies accountable for the products they sell to patients.
Expanding Medicaid coverage under the Affordable Care Act (ACA) would help put a substantial dent in the number of uninsured Texans, a new report by the Kaiser Family Foundation (KFF) shows.
A nationwide survey released this week by the American Medical Association documents the growing, negative effects insurance companies’ prior authorization demands have on patients’ health and physicians’ time.
TMAIT offers medical, life, income protection, office overhead, and ancillary insurance to TMA member physicians and their group managers. We work with you online, on the phone, or in person to determine the right plan to meet your current career needs. That’s coverage you can count on. Phone: (800) 880-8181
In reference pricing, a payer or employer sets a standard, maximum price that it will pay for a specific service or procedure. Patients are responsible for any costs above the reference price.
TMLT is a unique, not-for-profit health care liability claim trust owned by its physician policyholders, and is the only professional liability carrier exclusively endorsed by the Texas Medical Association. Created in 1979, TMLT has grown to be the largest medical liability provider in the state, protecting more than 14,500 Texas physicians. Phone: (800) 580-8658
Fix Surprise Billing and You’ll Fix the Need to Report CollectionsJason Terk, MD on Senate Bill 1037April 23, 2019
Medical Debt and Credit ReportsDavid Bryant, MD on House Bill 2732April 16, 2019
Transparency in Prior Auth and Physician ReferralsJohn Flores, MD on House Bill 3828April 16, 2019
Eliminate Prior Auth for In-Network PhysiciansJohn Flores, MD on House Bill 3232April 16, 2019
Require Network Directory AccuracyJohn Carlo, MD,on Senate Bill 1742 April 9, 2019
Require Timely Updates to Network DirectoriesJohn Scott, DO, on House Bill 1880 April 9, 2019
Protecting Patients From Balance BillsRay Callas, MD, In SUPPORT of CSHB 2967 by Oliverson and CSHB 3933 by Martinez Fischer April 2, 2019
Enforce Network AdequacyRay Callas, MD In SUPPORT of HB 3911 April 2, 2019
Prohibit PA on Mandated BenefitsDr. Debra Patt, MD on House Bill 2408 March 26, 2019
Take Patients Out of the Middle of Balance Billing – The Right WayDr. Ray Callas on House Bill 3933 March 26, 2019
Bring Transparency to Prior AuthorizationDr. Doug Curran on House Bill 2327 March 26, 2019
Utilization Reviews Should Be Done by Texas-Licensed PhysiciansDr. Doug Curran on House Bill 2387 March 26, 2019
Plans Should Inform Patients of Network Status When Requiring PADr. Debra Patt on House Bill 2520March 26, 2019
Plan Directories Should Cross-Reference Physician Network StatusDr. Rick Snyder, MD on House Bill 2630March 26, 2019
Prevent Non-Medical Switching by PlansWritten Testimony on House Bill 2099 March 26, 2019
Free Market Insurance Solutions Must Protect TexansDr. Ray Callas, Hearing to Review Interim Charge 2: Health Insurance Market Stability,Jan. 24, 2018
Information Accuracy and Oversight Will Minimize Surprise BillingDr. Ray Callas, Testimony on Interim ChargeJan. 23, 2018
TMA Asks Legislators to Make Sure New Step Therapy Law WorksDr. Arlo Weltge, Testimony on Interim Charge No. 6Dec. 6, 2017
Understanding Limitations on Price TransparencyDr. David Bryant, Interim Hearing on Data Collection and Price Transparency March 21, 2017
Some Texans receive medical bills they did not anticipate, even though they have health insurance. Their insurance might not cover that care or provide as much benefit as they assumed.
More On Surprise Bills
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