Stories written by Amy Lynn Sorrel

Surprise Billing Rules Garner More Legal Action - 12/06/2024

Pressure is mounting on federal authorities with several legal actions now aiming to stop what physicians and hospitals say is an unfair arbitration process outlined in rules implementing the No Surprises Act, legislation passed in 2020 to address surprise medical bills.

Medicare Pays for End-of-Life Consults - 12/05/2024

As of January, Medicare pays physicians for advance care planning as a separate service, a long-sought victory that promotes educating patients and physicians on the issue. The Centers for Medicare & Medicaid Services created two new payment codes that cover it as a separate service in physician practices and facilities, including hospitals.

Texas Influences Policy at AMA House of Delegates - 12/05/2024

Physician representatives of the Texas Medical Association last week took their expertise to an American Medical Association House of Delegates meeting punctuated this year by passionate discussions on scope of practice, health plan practices, COVID-19, telemedicine, diversity in medicine, and more.

On Guard for the Patient-Physician Relationship: 2023 Legislative Preview - 12/05/2024

A pandemic wind-down, a U.S. Supreme Court ruling, a possible recession, a national surprise-billing law. The 2023 Texas legislative session is one shaping up to be defined by a host of federal forces, some of them potentially contentious. Nevertheless, the House of Medicine stands steadfast in its legislative priorities. At the heart of the Texas Medical Association’s agenda for this session: protecting the practice of medicine and the patient-physician relationship, whether from criminalization, interference from insurers and other nonmedical entities, or public health threats.

Senate Committee Tackles Scope of Practice in Access-to-Care Hearing - 11/18/2024

In a hearing packed with representatives from medicine, nursing, pharmacy, behavioral health, licensing boards, and academia, the Senate Health and Human Services Committee tackled Texas’ health care workforce shortages with the Texas Medical Association delivering its message loud and clear: Expanding scope of practice is not the answer to helping patients in rural and underserved areas.

TMA Considers Next Steps in Split Victory Over Payment Calculations in Surprise-Billing Arbitrations - 11/15/2024

After winning half the battle when the federal government dropped its appeal of two major components of the Texas Medical Association’s lawsuit early on, TMA is considering next steps after an appeals court upheld a portion of federal rules governing qualifying payment amount calculations in surprise-billing disputes that medicine says conflict with federal law and unfairly favor health plans.

Reform Can’t Wait: Medicine Prescribes Urgently-Needed Improvements to Flawed Medicare Payment System - 11/13/2024

When the Centers for Medicare & Medicaid Services (CMS) in July proposed a fifth consecutive round of cuts to physicians’ Medicare payments – contributing to a nearly 30% lag behind inflation growth since 2001 – medicine immediately mobilized.

Health Plans Begin Implementing Prior Auth Exemption Process - 11/07/2024

With an Oct. 1 deadline on the horizon, health plans have begun implementing Texas’ new prior authorization exemption process requiring them to issue the first so-called “gold cards” by that date.

Beware of Phony TMB, DEA Agents and Other Scams - 11/06/2024

The Texas Medical Board (TMB) is warning physicians and pharmacies of a scam involving criminals who sometimes pose as TMB officials. TMB passed along a report from the U.S. Drug Enforcement Administration (DEA) that says physicians registered with the DEA are receiving calls and emails from criminals who identify themselves as DEA personnel or other law enforcement agents.

Send TMA Your Prior Authorization Nightmare Stories - 11/06/2024

Arbitrary. Confusing. Frustrating. Never-ending. Maddening. Those are some of the terms we can actually print that describe physicians’ experience with insurance companies’ prior authorization requirements and approval processes.

Beryl-Affected Practices Automatically Eligible for MIPS Hardship Exemption - 08/19/2024

Due to the impact of Hurricane Beryl on Texas physician practices, the Centers for Medicare & Medicaid Services has automatically applied a hardship exemption within the 2024 Merit-Based Incentive Payment System performance period to eligible clinicians in “designated” areas.

Medicine Urges 4 Steps to Reform Medicare Pay - 08/13/2024

In the face of an increasingly unsustainable Medicare physician payment system, hundreds of state and national medical associations collectively exhorted congressional leaders to adopt a four-point reform plan they say can “no longer be delayed without severe repercussions for patient access and quality of care.”

TMA Wins Appeal Upholding Its Challenge to Skewed Federal Surprise Billing Rule - 08/05/2024

A federal appeals court handed a victory to medicine affirming the district court’s decision to strike down federal provisions that run counter to Congress' intent for implementing a key piece of the No Surprises Act: to operate an arbitration process that does not skew dispute resolutions and unfairly advantage health plans. Read more.

Dues Increase, Independent Practice Committee Approved by TMA House - 05/09/2024

With an eye toward strengthening the Texas Medical Association and the Texas physician practices it represents, the House of Delegates approved a handful of new policies that include a phased-in dues increase and a standing committee on independent practice.

TMA Moment in Time: SGR Repeal - 04/09/2024

The historic victory has roots in TMA advocacy and may provide a playbook for future Medicare reform.

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.

Senate Moves Toward Medicare Pay Fix - 02/28/2024

After hundreds of physician leaders from across the country, including Texas, gathered in Washington, D.C., in mid-February, U.S. senators appear to be moving toward a Medicare pay fix alongside House efforts.

TMA Supports Evidence-Based Gender-Affirming Care in Lawsuit - 01/24/2024

As the Doe v. Abbott lawsuit heads to a hearing today over whether to block state investigations involving certain care provided to transgender youth, among other issues, the Texas Medical Association has filed a friend-of-the-court brief in the case in support of medically necessary, gender-affirming care, and opposing the criminalization of such treatment.

TMA in Talks With State Leadership on Gender-Affirming Care - 01/24/2024

In a series of meetings with state leadership, the Texas Medical Association has reiterated its opposition to the criminalization of medically necessary gender-affirming care and emphasized the need for protecting the patient-physician relationship with transgender youth and adolescents.

Patient Care Protected: TMA Secured Big Legislative Wins With a New Strategy - 01/11/2024

Guided by a set of priorities and girded by grassroots physician advocacy, the Texas Medical Association entered the 2023 legislative session with a laser focused approach and came out hitting targets in every area of medicine’s agenda.

All in Good Faith: No Surprises Act Requires Practices to Provide Good Faith Estimates of Charges - 12/04/2023

No Surprises Act transparency provisions require practices to provide patients good faith estimates of expected charges – on strict timelines

Feds Extend Telemedicine Prescribing Flexibilities Through 2024 - 11/10/2023

With permanent telehealth prescribing policies still under consideration, the U.S. Drug Enforcement Administration (DEA) again has extended temporary pandemic-era telehealth flexibilities to allow physicians to virtually prescribe certain controlled medications, now through Dec. 31, 2024.

Help Promote National Drug Prescription Take Back Day on Oct. 28 - 10/19/2023

Prescription Drug Take Back Day, which allows people to dispose of prescription drugs safely and anonymously, is scheduled for Oct. 26 at locations throughout the state.

TMA Wins Two More Surprise Billing Lawsuits; CMS Suspends Arbitrations - 10/03/2023

Marking a fourth victory for the Texas Medical Association in as many lawsuits, a court on Aug. 24 struck down a large portion of the regulations setting forth a methodology insurers use to calculate the qualifying payment amount, or QPA, used in surprise-billing disputes – part of a series of federal rules TMA has long argued skew the arbitration process in insurers’ favor.

Medicine, Congressional Leaders Strategize to Expedite Medicare Physician Pay Reform - 09/17/2023

TMA and other physician and congressional leaders from around the country convened an advocacy summit to build momentum for legislation to finally help Medicare payments keep pace with inflation. With nearly 40 co-sponsors signed on, and another pay cut on the way, medicine and lawmakers urged physicians to ramp up their advocacy now.