Feb 29, 2012

Bills Would Repeal IPAB

With Medicare's Sustainable Growth Rate still in effect, the U.S. House of Representatives is considering legislation to repeal another federal mechanism to drive down Medicare payments to physicians – the Independent Payment Advisory Board (IPAB). Created by the Affordable Care Act, IPAB is a 15-member panel appointed by the president that would recommend cuts in fees to physicians if federal spending on health care reaches certain levels.

Feb 25, 2012

Get CME Easier From TMA Education Center

Something good is now even better. TMA's practice management, cancer, and physician health courses are now easier than ever for you to find online. The new TMA Education Center offers convenient, one-stop access to the continuing medical education (CME) Texas physicians need. Log in using your TMA website user name and password to automatically receive member pricing.

"We are especially excited about the center's mobile-friendly capability," said Carl O. Trusler, MD, chair of the TMA Council on Practice Management Services. "You can start an online course on your office computer, and finish it at home on your iPad or smart phone. You can take up where you left off.

Feb 24, 2012

Making Meaningful Use Meaningful

Don't lose out on your Medicare or Medicaid incentive payment for meaningful use of an electronic health record (EHR). For physicians who qualify, reaching meaningful use can mean up to $63,750 in incentives from Medicaid or $44,000 from Medicare.

Turn to TMA's Meaningful Use Achievement Toolkit for detailed instructions about what you must do, specific to your EHR product, to meet any one of the 25 meaningful-use criteria defined by the Centers for Medicare & Medicaid Services.

Feb 23, 2012

Penalized for Not E-Prescribing in 2011?

To prevent a 2012 penalty, physicians should have successfully e-prescribed 10 times and reported G8553 on the claim form before June 30, 2011. Physicians also could have filed for an exemption with the Centers for Medicare & Medicaid Services (CMS) before Nov. 7, 2011.


Some physicians did take the required action but CMS penalized them anyway. If you are one of them, here are two possible reasons.

Feb 16, 2012

United UCR Lawsuit Payments Coming

Physicians who filed claims against UnitedHealthcare in the lawsuit over its usual, customary, and reasonable (UCR) claims payment system will soon receive payments. A federal judge has approved the release of payments from the 2009 settlement of the case. Physicians are expected to receive $200 million of the $250 million settlement fund.

Feb 14, 2012

Exhibit Honors Pioneer Texas Black Physicians

The struggles of early African-American physicians in Texas are on display on the TMA website in the exhibit "Courage and Determination — A Portrait of Pioneering African-American Physicians in Texas."

Tell Congress to Fix the SGR

It's SGR crunch time again. In about two weeks, the Sustainable Growth Rate (SGR) formula will drive a 27.4-percent cut in physicians' Medicare payments unless Congress steps in first. Hopes that Washington would finally repeal the SGR seem to wax and wane daily, as the issue is tied up with the partisan debate over extending Social Security tax cuts and extending unemployment benefits.

One thing we know for sure is that members of Congress react to real stories from their constituents far more than to form letters or emails. You have an excellent story to tell. You know what the constant threat of the Medicare Meltdown has meant to your patients and your practice. Please pick up the phone today and share your story with Sens. John Cornyn (202) 224-2934 and Kay Bailey Hutchison (202) 224-5922, and your representative. See the TMA Grassroots Action Center for the number.

Feb 13, 2012

TMA Teaches ICD-10 Essentials

The ICD-10 code sets will soon be medicine's new coding language. Is your practice ready to take on the challenge?

Preparing for ICD-10 is more than learning a new code set and upgrading office technology. Start your smooth and successful transition to ICD-10 by attending TMA's half-day seminar "ICD-10 Essentials."

TrailBlazer Review Causes Claims Denials

The Centers Medicare & Medicaid Services has ordered all of its contracting administrators to review Medicare Part A/B claims for completeness and documentation related issues. Trailblazer, the administrator for Texas, announced late last year it would review knee and hip joint replacement surgery, among other procedures. Trailblazer says its review showed cases where the necessary information is missing or the documentation is otherwise insufficient. This means TrailBlazer will deny payment for both Part A and B services and ask physicians subject to the review to return any amount already paid for the service.

Feb 10, 2012

Sonogram Law Enforcement Begins

State health officials began enforcing the state's sonogram law Feb. 6 after a federal judge in Austin reluctantly dismissed a lawsuit challenging it. Texas Health Commissioner David Lakey, MD, notified physicians that the Department of State Health Services (DSHS) will review physicians' documentation to make sure they comply with the law.

Feb 9, 2012

Chiropractic Board Withdraws Scope Rules

Ongoing opposition from TMA and others to the Texas Board of Chiropractic Examiners' (TBCE) attempts to expand chiropractors' scope of practice caused the board to shelve those plans. The board's executive director said the board intends to stay within its statutory authority in the future. The proposed rules, that would have permitted chiropractors to perform some procedures that state law only allows physicians to perform, were withdrawn.

Feb 8, 2012

Texas Suffers in GME Redistribution

Texas was one of the biggest losers in the federal government's August 2011 redistribution of unused Graduate Medical Education (GME) positions eligible for Medicare GME funding, a TMA analysis found. The state lost 50.08 Direct Graduate Medical Education slots and 39.8 Indirect Medical Education positions from 21 hospitals.

The TMA Council on Legislation and Council on Medical Education are working to identify opportunities for educating state legislators before the 2013 legislative session about the need to grow GME and the important role of state government in facilitating this process. TMA is planning a legislative forum this year to educate legislators about the critical role of GME in meeting the state’s physician workforce needs.

Feb 2, 2012

New Patient Visit Not “Incident-to”

If a new Medicare patient comes into the office and sees the physician assistant (PA) only, can we bill Medicare for the PA’s services as “incident to” the physician?


Get the answer to this and many other coding questions from TMA Practice E-Tips.

Feb 1, 2012

One Month Left to Claim 2011 Medicare Incentive Payment

Physicians have until Feb. 29, 2012, to register and attest to meeting meaningful use requirements to receive payments for 2011 through the Medicare & Medicaid EHR Incentive Program Registration and Attestation System.

Feb. 29 also is thedeadline to submit any pending Medicare Part B claims from 2011.