Patient Perception of Surgeon Reimbursement

15 Jul, 2019

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There Is a Correct Way to Address Surprise Billing

15 Jul, 2019

The 2019 Texas Legislature followed the lead of the New York Legislature by addressing surprise bills through an arbitration process that takes patients out of the middle by giving physicians an opportunity to challenge out-of-network payments made by commercial health insurance plans through an arbitration process. The New York system has worked. Click here to learn […]

Orthopaedic Residents Advocate on Capitol Hill

10 Jul, 2019

Prescription Monitoring Program

10 Jul, 2019

The prescription monitoring program (PMP) is an important tool for physicians and pharmacists to deter some forms of “doctor shopping” for the illegal or inappropriate use of prescription drugs. TOA worked with lawmakers in the 2019 Texas Legislature to: Secure funding for the Texas State Board of Pharmacy (TSPB) to acquire licenses so that the […]

TOA’s 2020 Annual Conference

14 Feb, 2019

Click here for the latest info for our upcoming 2020 Annual Conference. Sponsorship details are coming soon!

Medicare Extends Site Neutral Policy in 2019 HOPD/ASC Payment Proposal; ASC Victories

26 Jul, 2018

A discussion related to approving hip and knee replacement surgeries for Medicare payment in ASCs dominated last year’s hospital outpatient department (HOPD) and ambulatory surgery center (ASC) payment proposal for Medicare. (Ultimately, CMS simply removed TKA from the inpatient only list.) The 2019 proposal, which was released on July 25, 2018, only addressed the anesthesia […]

Texas Becomes First Legislature to Address Patient Reported Outcomes

15 Jun, 2017

Texas became the first legislature to pass a bill related to patient reported outcomes (PROs) for musculoskeletal care through SB 55, which was introduced by Senator Judith Zaffirini (D-Laredo) and Representative JD Sheffield, DO (R-Gatesville).  Governor Greg Abbott signed the bill into law on June 15. SB 55 directs the two of the state’s employee […]

Pain Relief Issues in Orthopaedics

12 Jun, 2017

Both the Texas Orthopaedic Association (TOA) and American Academy of Orthopaedic Surgeons (AAOS) have addressed the opioid crisis at recent meetings. Austin orthopaedic surgeon David Ring, MD, PhD presented at TOA’s 2017 Annual Conference: “The Opioid Crisis: The Future Role of Orthopaedic Surgeons in Solving the Crisis.” Dr. Ring shared a pain relief video at […]

Survey Results Call for a Change to ABOS MOC

12 Aug, 2016

The American Academy of Orthopaedic Surgeons (AAOS) is meeting with the American Board of Orthopaedic Surgery (ABOS) to discuss potential changes to the Maintenance of Certification (MOC) process.  The California Orthopaedic Association (COA) recently completed a survey of 612 orthopaedic surgeons (84 Texas orthopaedic surgeons participated). The results will be presented to the ABOS leadership […]

A Look at Youth Baseball Injuries with Henry Ellis, MD & Christian Balldin, MD

13 Aug, 2019

TOA recently sat down with Henry Ellis, MD of Texas Scottish Rite Hospital for Children in Frisco and Christian Balldin, MD of The San Antonio Orthopaedic Group to take a look at youth baseball injuries. TOA: Why do you think that have witnessed an epidemic of arm injuries in baseball recently?  On one end, people […]

Medicare’s CY 2020 OPPS/ASC Payment Proposal

02 Aug, 2019

The Centers for Medicare and Medicaid Services (CMS) released its proposed payment policy for the Medicare hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system for calendar year (CY) 2020 on July 29, 2019. Keep in mind that the American Association of Orthopaedic Surgeons (AAOS) is currently digging through the proposed […]

Medicare’s CY 2020 Physician Fee Schedule Proposal

02 Aug, 2019

The Centers for Medicare and Medicaid Services (CMS) released its proposal for the calendar year (CY) 2020 Physician Fee Schedule (PFS) on July 29, 2019. The American Association of Orthopaedic Surgeons (AAOS) will provide a lengthy summary of the proposal and a response in the near future. In the meantime, TOA has provided a summary […]

Carl Nunziato, MD testifying on opioids before the Texas House Public Health Committee

19 Jul, 2019

Carl Nunziato, MD is an orthopaedic resident at the University of Texas at Austin Dell Medical School. A California native, Dr. Nunziato completed medical school at the University of Vermont and received an undergraduate degree from Yale. Dr. Nunziato is a Lieutenant in the United States Navy Reserves. TOA asked Dr. Nunziato to testify before the Texas Legislature […]

TOA Strongly Supports the Prior Authorization and Utilization Review Provisions Passed by the Texas Legislature

05 Jun, 2019

The Texas Orthopaedic Association (TOA) strongly supports the prior authorization and utilization review proposals that were added to SB 1742 in the 2019 Texas Legislature. SB 1742 is now waiting for Governor Abbott’s consideration. Click here to learn more.

TOA Supports HB 3284 

05 Jun, 2019

The Texas Orthopaedic Association (TOA) recently offered its support for HB 3284, which passed out of the 2019 Texas Legislature. The bill, which is authored by Rep. JD Sheffield, DO and Sen. Jane Nelson, would delay the state’s prescription monitoring program (PMP) mandate by several months to ensure that physicians’ electronic health record (EHR) programs […]

Texas Orthopaedic Surgeons Visit the Texas Congressional Delegation

03 Jun, 2019

Over a dozen Texas orthopaedic surgeons will visit Capitol Hill on June 6 to discuss issues related to out-of-network balance billing, hospital monopolies, and antitrust regulations related to commercial health insurance plans. The orthopaedic surgeons will discuss initiatives that can lower health care costs for patients. The Texas Orthopaedic Association (TOA) will sponsor four orthopaedic […]

Musculoskeletal Injuries & the Scooter Experience in Austin

14 May, 2019

TOA recently sat down with Austin orthopaedic surgeon Austin Hill, MD, MPH of the Dell Medical School at the University of Texas to discuss the orthopaedic trauma department’s experience with scooter injuries in Austin. TOA: What were your thoughts when the scooters first went live and you first started seeing injuries? Austin Hill: The first […]

TSAOG Interview with Chris Kean

26 Apr, 2019

The San Antonio Orthopaedic Group (TSAOG) recently opened its WorkSmart Industrial Rehab Clinic, which focuses on physical and behavioral rehabilitation of injured workers. TOA recently conducted a Q&A with Chris Kean, the chief operating officer of TSAOG, to learn more about the clinic. TOA: What is the “WorkSmart Industrial Rehab Clinic”? Chris Kean: WorkSmart Industrial […]

TOA Supports Initiative to Dispose of Unused Drugs

17 Apr, 2019

The Texas Orthopaedic Association (TOA) is supporting HB 2088, which would direct the Texas State Board of Pharmacy (TSBP) to maintain and publish a list of drop-off locations for unused drugs. The legislation by Rep. Jay Dean (R-Longview) was heard in the House Public Health Committee on April 10, 2019.

TOA Supports HB 2367 by Rep. Greg Bonnen, MD

16 Apr, 2019

The Texas House Committee on Pensions, Investments & Financial Services will consider HB 2367 by Rep. Greg Bonnen, MD in a committee hearing on April 18. The bill would prohibit health plans from bidding on the state’s contracts if the plans participate in the practice of dropping a physician from a plan for notifying a […]

TOA Supports SB 2316 to Strengthen the PMP

09 Apr, 2019

The Texas Orthopaedic Association (TOA) testified in support of SB 2316 in both the House and Senate as a bill that would enhance the state’s prescription monitoring program (PMP). Offered by Senator Chuy Hinojosa and Representative Senfronia Thompson, SB 2316 would create an advisory committee of physicians, pharmacists, and electronic health record companies to provide […]

TOA Sports Bill to Protect Out-of-State Team Physicians

02 Apr, 2019

The Texas Orthopaedic Association will speak in support of Rep. Bobby Guerra’s legislation – HB 2299 – which would protect out-of-state team physicians when they travel with their teams to Texas. The bill would direct the Texas Medical Board to recognize the out-of-state licenses for those physicians while they are assisting their teams for competitions […]

Texas Bill Would Create “Timeshare ASC” Model

14 Mar, 2019

State Rep. Mary Gonzalez (D-El Paso) introduced HB 3468, which would allow multiple ASCs to operate within a single ASC on different days. Medicare recently approved the “timeshare ASC” model. However, Medicare indicated that state legislatures must approve the concept at the state level.

Kevin L. Kirk, DO

05 Mar, 2019

Kevin L. Kirk, DO is a board-certified orthopedic surgeon specializing in disorders of the foot, ankle and lower leg. Although he treats all general orthopedic conditions, he has a special interest in foot and ankle joint replacement, arthroscopy, reconstruction and trauma surgery. Dr. Kirk received his Doctor of Osteopathic Medicine from the Philadelphia College of […]

Texas Lawmakers Introduce Bills to Make Health Care More Efficient for Texans

04 Mar, 2019

Texas lawmakers recently introduced several bills that would address the health plans’ unnecessary delays that are resulting in delays for patients. The Texas Orthopaedic Association strongly supports the bills that have been introduced by Sen. Dawn Buckingham, MD, Rep. Greg Bonnen, MD, Rep. Julie Johnson, and Rep. Sarah Davis. Make the prior authorization process easier […]

Prescription Monitoring Program

14 Feb, 2019

Click here to view the Prescription Monitoring Program

TOA Supports HB 1005’s Efforts to Strengthen Medical Causation Reports

07 Feb, 2019

TOA issued support for HB 1005 by State Rep. Nicole Collier, which would direct Workers’ Compensation carriers to reimburse physicians for medical causation narrative reports. Bobby Hillert, TOA’s executive director, stated: “The medical causation report is an important tool that helps injured workers receive the care that they need. It is critical to have qualified […]

TOA Asks Lawmakers to Fund the Prescription Monitoring Program Licenses

23 Jan, 2019

The Texas Orthopaedic Association (TOA) is encouraging Texas lawmakers rely on the Legislature’s supplemental funding package to fund the Texas State Board of Pharmacy’s request to acquire physician licenses to access the prescription monitoring program (PMP) database. The September 1, 2019 mandate for physicians to check the PMP is seven months away, and it is […]

Texas House Speaker Dennis Bonnen Announced the Committee Assignments

23 Jan, 2019

Texas House Speaker Dennis Bonnen announced the committee assignments for the 86th Texas Legislature today. Click here to view the assignments.  

Texas Legislature’s Committee Releases Prescription Monitoring Program Recommendations

19 Dec, 2018

The Texas Legislature created a joint committee of the two bodies following the 2017 Legislature to address the future of the state’s September 1, 2019 mandate for physicians to check the state’s prescription monitoring program (PMP) before prescribing certain drugs. The committee, which is co-chaired by Senator Charles Schwertner, MD (R-Georgetown) and Representative JD Sheffield, […]

TOA Comments on Medicare’s Back and Knee Brace Proposal

18 Dec, 2018

The Texas Orthopaedic Association (TOA) submitted feedback on December 17, 2018 that expresses concern regarding the Centers for Medicare and Medicaid Services (CMS) proposal to add back and knee braces to Medicare’s new round of competitive bidding. TOA expressed concern that this could limit the number of physicians who would be able to provide these […]

Texas House Select Committee Releases Opioid Findings

05 Dec, 2018

The Texas House Select Committee on Opioids and Substance Abuse released its report on December 3, 2018. The committee is chaired by Rep. Four Price of Amarillo. An additional select committee, which is co-chaired by Senator Charles Schwertner, MD and Rep. JD Sheffield, DO, is expected to release a report on the state’s prescription monitoring […]

Medicare Unveils Price Procedure Lookup Tool for ASCs and HOPDs

28 Nov, 2018

The Centers for Medicare and Medicaid Services (CMS) introduced the Price Procedure Lookup tool, which allows consumers to compare the prices of ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), on November 27. The tool was created in January 2017 by the 21st Century Cures Act. Click here to learn more from CMS.

TOA’s Getting to Know: John Hinchey, MD of San Antonio

14 Nov, 2018

John W. Hinchey, MD recently joined Ortho San Antonio and recently sat down with TOA to conduct a Q&A to discuss his thoughts on the future of orthopaedics in Texas. Dr. Hinchey received his undergraduate degree from Southern Methodist University. He later attended The University of Texas Health Science Center at San Antonio (UTHSCSA) for […]

Texas Medicaid Proposes New Opioid Limits

07 Nov, 2018

The Texas Medicaid Vendor Drug Program has proposed a policy that would apply morphine equivalent dose (MED) limits per day and seven-day limits on opioids opioids that are used to treat acute pain in the state’s Medicaid managed care organizations (MCOs). The Texas Health and Human Services Commission (HHSC) is accepting comments until November 14, […]

Texas HHSC Proposes New Medicaid ASC Rates

06 Nov, 2018

The Texas Health and Human Services Commission (HHSC) has proposed new Medicaid rates for ambulatory surgery centers (ASCs).  Click here to download the .zip file for the “Medicaid Biennial Calendar Fee Review” dated January 1, 2019. The proposal is a mixed bag for orthopaedic ASCs. TOA will join other stakeholders to provide comments. HHSC will hold […]

TOA Update: Medicare Finalizes 2019 Physician Fee Schedule & ASC/HOPD Rules

05 Nov, 2018

The Centers for Medicare and Medicaid Services (CMS) released the final calendar year (CY) 2019 Physician Fee Schedule (PFS) rule on November 1, and CMS modified the controversial E/M proposal. CMS also released the hospital outpatient department (OPPS) and ambulatory surgery center (ASC) final payment policy rule for CY 2019 on November 2. Click here […]

New Workers’ Compensation Neuromuscular Plan-Based Audit

15 Oct, 2018

The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) announced on October 12, 2018 that it will conduct a plan-based audit for neuromuscular testing. Click here to view details of the plan-based audit. The study will focus on the 10 providers who had the highest number of referrals for neuromuscular testing during the time period […]

How Artificial Intelligence and Robotic Process Automation Tools Significantly Improve Revenue Cycle Management

27 Sep, 2018

By Mel Gunawardena, SYNERGEN Health Ensuring successful revenue cycle management comes down to how proficient health care organizations are at optimizing processes, utilization of staff and the latest technology. More health organizations are turning to advanced technology that can be integrated into their current billing software and delivers an immediate return on investment. Specifically, artificial […]

Q&A with Henry B. Ellis, MD

25 Sep, 2018

Henry B. Ellis, MD is a pediatric orthopaedic surgeon at the Texas Scottish Rite Hospital for Children’s Center for Excellence in Sports Medicine. Dr. Ellis is an El Paso native who received his medical degree from the University of Texas Science Center San Antonio, conducted his residency at UT Southwestern Medical Center, and completed fellowships […]

Texas Legislature to Review the Texas Prescription Monitoring Program

25 Sep, 2018

A special committee of the Texas Legislature chaired by State Senator Charles Schwertner, MD and State Representative JD Sheffield, DO will meeting on October 3, 2018 to review the state’s prescription monitoring program (PMP). Click here to view TOA’s position paper.

Medicare Proposes Favorable New Rules for ASCs

20 Sep, 2018

The Centers for Medicare and Medicaid Services (CMS) released proposed changes to the Conditions of Participation for ambulatory surgery centers (ASCs), hospitals, and other segments of the health care industry on Monday. CMS indicated that it has gathered feedback from stakeholders, and this proposal would address 55 percent of the issues. As a result, CMS […]

Q&A with David Brigati, MD

29 Aug, 2018

David Brigati, MD is a fellow in adult reconstructive surgery at the Dell Medical School at the University of Texas at Austin. Upon completion of his fellowship, Dr. Brigati hopes to go into practice in the Fort Worth area. Dr. Brigati, a Texas native, performed his orthopaedic residency at the Cleveland Clinic. He performed his […]

Texas Begins Re-Write of Trauma and Stroke Rules

29 Aug, 2018

The Texas Department of State Health Services (DSHS) will dedicate the rest of 2019 and 2020 to re-writing its trauma and stroke rules. TOA is joining the Texas Medical Association and other stakeholders to make recommendations. DSHS has announced the following stakeholder meetings for the rest of 2019:

Orthopaedic Residents Go to Capitol Hill

14 Aug, 2018

Three members of TOA’s Residency Council – Max Danilevch, MD (UTMB), Jacob Murphree, MD (Texas Tech) and Joey Romero, MD (UT Southwestern) joined the Texas Orthopaedic Association for its annual trip to meet with the Texas Congressional Delegation on Capitol Hill in June 2018. The three orthopaedic surgeons … click here to view the entire article.

TOA’s 2019 Annual Conference

26 Jul, 2018

Click here for the latest info for our upcoming 2019 Annual Conference. Sponsorship details are coming soon!

Practice Perspective – Data-Based Management’s Effect on Staffing and Duty Allocation

20 Jul, 2018

By Joseph Mathews How much is just enough? This is an ongoing conversation for practices regarding staffing as we face lower profit margins, increasing overhead and patient populations that demand both quick processes and high levels of customer service. However, this conversation and the decisions that follow can become less tedious and stressful if practices […]

Medicare’s 2019 Physician Fee Schedule and Quality Payment Program Proposal Released

13 Jul, 2018

The Centers for Medicare and Medicaid Services (CMS) released the calendar year 2019 payment rule for the Medicare Physician Fee Schedule (PFS) and Quality Payment Program for MACRA on July 13, 2018. Comments are due on September 10, 2018. TOA’s members are invited to review TOA’s analysis of the proposal, which can be found in […]

Q&A with Karl Koenig, MD

09 Jul, 2018

Integrated Practice Units and the Perioperative Surgical Home: What’s on the Horizon? Q&A with Karl Koenig, MD Karl Koenig, MD, MS is the Medical Director for the Musculoskeletal Institute at UT Health Austin. He specializes in treatment of hip and knee arthritis including both primary and revision surgery. Dr. Koenig has a special interest in […]

Pre-Authorization for Compound Drugs in Workers’ Comp Program Begins on July 1, 2018

26 Jun, 2018

The Texas Department of Insurance – Division of Workers’ Compensation adopted a rule on March 29, 2018 that will require compounded drugs to be preauthorized beginning on July 1, 2018. Click here to learn more.

Practice Perspective: Data-Based Management of the Patient Experience; Starting with Scheduling

26 Jun, 2018

By Joseph Mathews While the patient experience should begin with a seemingly uncomplicated call to schedule an appointment, the patient journey is often marred by hard-to-understand greetings and instructions, abandoned calls, being sent to voicemail, or sitting on hold for long wait times while listening to a barrage of promotions about the organization. These are […]

Texas Medical Board Approves Protections for Team Physicians

15 Jun, 2018

The Texas Medical Board (TMB) approved a rule on June 15, 2018 that will recognize the out-of-state licenses for team physicians when they travel with their teams to Texas. Texas joins over 35 states that have passed similar measures. State Senators Charles Schwertner, MD and Don Huffines and State Representative Bobby Guerra worked with TOA […]

Protected: Thursday June 7, 2018 Capitol Hill Visits

06 Jun, 2018

There is no excerpt because this is a protected post.

TOA in Washington DC

30 May, 2018

Every year, over a dozen Texas orthopaedics go to Washington, DC to participate in the American Academy of Orthopaedic Surgeons’ National Orthopaedic Leadership Council (NOLC) to educate the Texas Congressional Delegation about musculoskeletal issues that affect Texans. On June 7, 2018, Texas orthopaedic surgeons will discuss two Medicare issues that are specific to Texas – […]

TOA & AAOS Support Texas Medical Board’s Team Physician Proposal

20 Apr, 2018

Andrew Palafox, MD of the Texas Orthopaedic Association and David Halsey, MD of the American Association of Orthopaedic Surgeons submitted a letter to the Texas Medical Board in support of its proposed rule that would recognize the out-of-state licenses of team physicians when they travel with their teams to Texas for athletic competitions. The move […]

A Look at the Center for the Intrepid with Joseph F. Alderete, MD

18 Apr, 2018

Col. Christopher J. Roach, MD, FAAOS – the chair of the Department of Orthopaedics at the San Antonio Military Medical Center – presented on the Center for the Intrepid (CFI) at the Texas Orthopaedic Association’s 2018 Annual Conference. Click here to view Dr. Roach’s PowerPoint presentation from the conference. The following is a Q&A that […]

TMB Proposes Protection for Team Physicians

28 Mar, 2018

Rep. Bobby Guerra (D-McAllen) and Sen. Don Huffines (R-Dallas) pushed legislation in the 2017 Texas Legislature that would direct the Texas Medical Board (TMB) to recognize the out-of-state physician licenses for team physicians when they travel to Texas to provide support for their teams while in Texas. The legislation died due to un-related matters. TOA […]

Q&A with Don Buford, MD

27 Mar, 2018

Don Buford, MD, Director, Dallas PRP and Stem Cell Institute is a board-certified orthopaedic surgeon who has been practicing in the Dallas area for 18 years. He grew up in Los Angeles and attended Stanford University. While at Stanford, he was a member of the baseball team and had a double major in economics and pre-med. […]

Texas Senate Examines Opioid and Substance Abuse

22 Mar, 2018

San Antonio orthopaedic surgeon Adam Bruggeman, MD – the Texas Orthopaedic Association’s second vice president – testified before the Texas Senate Committee on Health and Human Services’ hearing on opioid and substance abuse. The Texas Legislature will continue examining the opioid issue in the months leading up to the 2019 Texas Legislature. TOA is educating […]

A Look at Muve Health’s Joint Replacement Strategy in Austin

16 Mar, 2018

Muve Healthcare opened a joint replacement-focused ambulatory surgery center (ASC) in Lakeway outside of Austin in 2017. TOA recently conducted a Q&A with Marshall Maran of Muve to learn more about the concept. TOA: Prior to your entrance into the Texas market, what has the ASC volume for lower extremity joint replacements been like in […]

Texas Updates Spinal Screenings to Meet Latest Science

15 Mar, 2018

The Texas Department of State Health Services (DSHS) announced on March 9, 2018 new spinal screening standards for the 2018-19 school year. The changes come as a result of HB 1076 in the Texas Legislature. Sponsored by Rep. Tom Oliverson, MD and Sen. Don Huffines, HB 1076 reflects the latest science regarding scoliosis treatment. Click […]

TOA Urges Lawmakers to Contact Congress on BPCI Advanced/CJR Conflict

14 Feb, 2018

BPCI Advanced – Medicare’s new physician-led bundled payment program that was announced in January 2018 – will not allow orthopaedic surgeons located in Texas’ five Comprehensive Center for Joint Replacement (CJR) to lead their own bundles for lower extremity joint replacements in the new BPCI Advanced program. Due to the upcoming March 12, 2018 application […]

IPAB and Physical Therapy Included in Congress’ Medicare Extender Package

09 Feb, 2018

The U.S. House and U.S. Senate approved a funding resolution on February 9 that includes several Medicare provisions that affect musculoskeletal care: Physician-owned Hospitals:  No Relief. An effort by Texas lawmakers to allow physician-owned hospitals located in areas affected by the recent hurricane to expand by 50 percent was not included in the bill. However, […]

Medicare Data Demonstrate Price Differences Among Texas Cities for Joint Replacements

05 Feb, 2018

The Centers for Medicare and Medicaid Services (CMS) proposed the latest physician-led bundled payment model – BPCI Advanced – in January 2018. March 12, 2018 is the deadline to apply. Click here to learn more from TOA. Publicly available data gathered by Archway Health on lower extremity joint replacement surgeries for 2015 Medicare payments demonstrate […]

Medicare Announces New Bundled Payments

05 Feb, 2018

The Centers for Medicare and Medicaid Services (CMS) announced on January 9, 2018 that it is creating the voluntary Bundled Payments for Care Improvement Advanced (BPCI Advanced) demonstration that requires participants to take on financial risk. In addition, the program, which includes outpatient and inpatient episodes of care, would count as an Advanced APM for […]

Medicare’s Removal from TKA from Inpatient-Only: Clarification

30 Jan, 2018

The Centers for Medicare and Medicaid Services (CMS) removed total knee arthroplasty from Medicare’s inpatient-only (IPO) list for the 2018 final rule. However, this does not mean that Medicare will pay for TKA in ambulatory surgery centers (ASCs). The American Association of Orthopaedic Surgeons (AAOS) produced the following FAQs to answer questions. Click here to […]

BPCI Advanced Website Update:  “Conceptual Overview” physician focused webcast available now – REVISED “Application Process” Link

28 Jan, 2018

Greetings, Thank you for your interest in the newest CMS model – Bundled Payments for Care Improvement Advanced (BPCI Advanced).  We are excited about the enthusiastic response to our model announcement on January 9, 2018. We continue to receive a high volume of inquiries in the BPCI Advanced inbox and will address most of the […]

TDI-DWC Approves Lumbar Spine Audit Plan

26 Jan, 2018

Per the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC): On November 20, 2017, The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) solicited and received constructive input from workers’ compensation system participants on the proposed Lumbar Spine Magnetic Resonance Imaging (MRI)  Plan-Based Audit (Plan-Based Audit).  TDI-DWC appreciates the input provided by system […]

TDI-DWC Informal Language Examines Differences Between CARF-Accredited and Non-Accredited Programs

22 Jan, 2018

The Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) announced that it is accepting comments regarding potential changes to the rules related to Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited programs. The Workers’ Compensation Research and Evaluation Group recently published a report entitled “Outcome Comparisons of Return to Work Rehabilitation Programs by Accreditation […]

TMB Pain Clinic Rule Could Unintentionally Include Orthopaedists

06 Dec, 2017

The Texas Medical Board (TMB) released a proposed rule in November 2017 to identify physicians who have failed to properly register as a pain clinic.  Unfortunately, as written, the proposed rule could unintentionally include orthopaedic surgeons in the pain clinic registration, despite the fact that orthopaedic surgeons are not operating as pain clinics. TOA will […]

Proposed Medicaid Rates

16 Nov, 2017

Texas HHSC has proposed new Medicaid rates for musculoskeletal services (effective January 1, 2018). Click here to view the proposed rates. The Texas Orthopaedic Association and Texas Medical Association submitted a response to Texas HHSC.  Click here to view the response.  

Congress Introduces Legislation to Enhance Medicare Care Coordination

15 Nov, 2017

Congressman Kenny Marchant (R-Coppell) joined three other colleagues to introduce “The Medicare Care Coordination Improvement Act of 2017.” H.R. 4206 was introduced to address certain aspects of the Stark Law and physician self-referral laws that are preventing MACRA’s alternative payment models (APMs) from performing. The updates to the Stark Law are needed for Congress to […]

Medicare’s Quality Payment Program Rule for Year 2 (MIPS/MACRA)

03 Nov, 2017

The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Quality Payment Program’s second year on November 2, 2017. Click here for an extensive overview of the rule. Click here for an executive summary of the rule:   Among the highlights: From 90 Days to a Full Year Physicians will be […]

Medicare’s 2018 Physician Fee Schedule Final Rule

03 Nov, 2017

The Centers for Medicare and Medicaid Services (CMS) released the CY 2018 final payment rule for the Medicare Physician Fee Schedule on November 2, 2017. The following is a summary of the final rule.  TOA’s summary of the CY 2018 proposed rule, which was released this summer, can be found following this summary. Appropriate Use […]

Texas Medical Disclosure Panel Updating Its Nervous System Form

02 Nov, 2017

The Texas Medical Disclosure Panel (TMDP) announced earlier this fall that it will be updating its patient notification form of required risks and hazards related to the nervous system. The TMDP is asking for recommendations by December 1, 2017. Please provide your suggestions to TOA (Bobby@toa.org). Click here to view the current disclosure of risks and hazards […]

TKA/THA ASC Payment Rejected in 2018 Medicare Rule

02 Nov, 2017

The Centers for Medicare and Medicaid Services (CMS) released the CY 2018 final payment rule for hospital outpatient department (OPPS) and ambulatory surgery center (ASC) on November 1, 2017. TOA’s highlights of the CY 2018 proposed rule, which was released in the summer of 2017, can be found below this summary.  Many of the summer […]

Texas House & Senate Name Select Committees on Opioid Policy

24 Oct, 2017

Speaker Joe Straus of the Texas House of Representatives announced the Select Committee on Opioids and Substance Abuse, which will examine the use of opioids in Texas. The committee members include: Rep. Four Price, Chair Rep. Joe Moody, Vice Chair Rep. Carol Alvarado Rep. Garnet Coleman Rep. Jay Dean Rep. Ina Minjarez Rep. Andy Murr […]

Texas Workers’ Comp Proposes Telemedicine Initiative

19 Oct, 2017

The Texas Orthopaedic Association responded to the Texas Department of Insurance, Division of Workers’ Compensation’s request for comments on a proposal to expand telemedicine services throughout the Texas workers’ comp program. Click here to view the letter.