Medicare Announces New Bundled Payments | Texas Orthopaedic Association

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 […]

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 […]

TOA’s 2018 Annual Meeting

25 Sep, 2017

Click here for the latest info for our upcoming 2018 Annual Conference. Sponsorship details can be found in our 2018 Sponsor Prospectus.

CMS Proposes “Slow Ramp-up” of MACRA Policy

22 Jun, 2017

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule on Tuesday for implementing Medicare’s new physician payment program.  Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which creates two avenues for physicians to be paid under the Medicare program – MIPS (Merit-based Incentive Payment System) and APMs (Alternative […]

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 […]

Texas Governor Abbott Signs Enhanced Scoliosis Screening Bill

01 Jun, 2017

Texas Governor Greg Abbott signed HB 1076, which will update the state’s scoliosis screening standards to reflect the latest science. The measure was sponsored by Representative Tom Oliverson, MD (R-Spring) and Senator Don Huffines (R-Dallas). A groundbreaking 2013 study published in the New England Journal of Medicine affirmed that a back brace can slow the […]

What is the BOC and What Do They Do?

21 Oct, 2016

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 […]

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’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 […]

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.

Avoiding (and Winning) Lawsuits, Board Matters, and Peer Review

17 Oct, 2017

Fall2017Seminar_flyer

Texas Workers’ Comp Proposes New Telemedicine Regulations

25 Sep, 2017

The Division of Workers’ Compensation is accepting comments on an informal working draft of new 28 Texas Administrative Code §133.30 relating to Telemedicine Services.  This change would allow health care providers to bill and be reimbursed for telemedicine services regardless of where the injured employees are when they receive telemedicine services. Click here to read the […]

CMS Announces New Direction for CMMI

20 Sep, 2017

CMS announced a request for information regarding the future direction of the CMS Innovation Center. The Texas Orthopaedic Association will be providing comments regarding solutions for enhancing muculoskeletal in the Medicare program. Per CMS: In partnership with clinicians, patients, entrepreneurs, state officials, and others, the Centers for Medicare & Medicaid Services (CMS) plays a leading […]

State and Federal Regulatory Bodies Address Hurricane Harvey

30 Aug, 2017

State and federal regulatory bodies have relaxed some rules to help physicians and facilities respond to patients during Hurricane Harvey relief efforts. The following is an overview of some of the measures.  This is provided for informational purposes only and does not serve as legal advice. Texas Department of Insurance The Texas Department of Insurance […]

AAOS Comments on Medicare’s 2018 Quality Payment Rule

23 Aug, 2017

The American Association of Orthopaedic Surgeons (AAOS) submitted stakeholder comments to the Centers for Medicare and Medicaid Services (CMS) on its CY 2018 Updates to the Quality Payment Program for physician payments. Click here to view the letter. The comments focus on the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) payment mechanisms […]

Texas Workers’ Comp Proposes Changes to Designated Doctor Program

22 Aug, 2017

The Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) released an informal work draft on Friday to amend a rule related to the Designated Doctor program.  Comments are due on September 1, 2017. An open records request found that the Designated Doctor program has experienced a 67-percent decrease in the number of physicians participating […]

Texas Cities Remain in Medicare’s CJR; Effect of Tuesday’s Announcement

16 Aug, 2017

Tuesday’s proposal by the Centers for Medicare and Medicaid Services (CMS) would scale back the Comprehensive Center for Joint Replacement (CJR) mandatory bundles for lower extremity joint replacement and would eliminate the mandatory episode payment models (EPMs) for surgical hip/femur fracture episodes of care (SHFFT). CMS stated: Many providers are currently engaged in voluntary initiatives […]

Ten Percent Cuts to CR X-rays Looming

04 Aug, 2017

Congress passed an omnibus appropriations bill in 2015 that led to cuts for computed radiography (CR) x-rays by 7 percent in 2018 and 10 percent in 2023. This was supposed to serve as an incentive for practices to upgrade to digital radiography (DR).  However, CR is still digital, which makes it capable of interfacing with […]

TOA’s Getting to Know … Richie Edeen, MD

04 Aug, 2017

Richie Edeen, MD is the fifth generation of his family to grow up in the area of Vail, Colorado.  After high school, he attended the University of Colorado, where he worked as a student athletic trainer. From there, he moved to Austin, TX, where he worked as an athletic trainer for the University of Texas […]

TOA’s Getting to Know Orthopaedic Surgeons

04 Aug, 2017

 Alphabetical List  Article/Post Link  Alderete, Joseph  Learn about Joseph Alderete, MD  Budord, Don  Learn about Don Buford, MD  Edeen, Richie  Learn about Richie Edeen, MD  Haynes, David  Learn about David Haynes  Roach, Christoper  Learn about Christopher Roach, MD, FAAOS        

TOA Submits Comments for Updating Texas Scoliosis Standards

20 Jul, 2017

The Texas Orthopaedic Association submitted comments to the Texas Department of State Health Services’ call for stakeholder comments on updating the state’s scoliosis screenings standards in Texas schools.  TOA recommended that DSHS follow the 2015 recommendations made by the American Academy of Orthopaedic Surgeons and Scoliosis Research Society that call for females to be screened […]

AAOS Update on Latest Quality Efforts for Orthopaedics

06 Jul, 2017

Click to view AAOS’s July 2017 quality update.

Getting Americans Back to Work

22 Jun, 2017

Bone and joint disorders are the leading cause of disability in the U.S., disabling a significant part of the American workforce. Orthopaedic surgeons help millions of patients get back to work every year. With patient-centered practices, voluntary and streamlined payment models, physician led delivery and renewed patient-physician relationships, they can keep the promise of ensuring […]

White Paper Uses Claims Database to Examine Opioid Crisis

15 Jun, 2017

A new white paper published by FAIR Health relies on its claims database to examine the opioid crisis in select cities, including several Texas cities.  The study examines opioid-related diagnoses. Regarding Texas, the study found that 66 percent of the claim lines occurred in San Antonio, and an additional 23 percent occurred in Dallas.  Houston […]

FAIR Health Database Analyzes Concussion Claims

13 Jun, 2017

FAIR Health recently created an analysis of concussions based on over 20 billion privately-billed medical and dental claims.  (click on graphic for full screen)

Teuscher Oath of Office

Orthopaedic Surgeon Sworn in as HHS Official for Region 6

23 May, 2017

David Teuscher, MD, a past president of the Texas Orthopaedic Association and American Academy of Orthopaedic Surgeons, was sworn in as the Regional Administrator for Intergovernmental and External Affairs for the U.S. Department of Health and Human Services’ Region 6 on May 22. Region 6 covers Texas, Arkansas, Louisiana, Oklahoma, New Mexico, and 68 American […]

CMS Asks for Comments on Physician-owned Hospitals

18 Apr, 2017

The Centers for Medicare and Medicaid Services (CMS) asked for comments regarding POHs in the proposed rule for inpatient hospital payments for 2018. CMS’s comments stated: “We are seeking public comments on the appropriate role of physician-owned hospitals in the delivery system. We are also seeking public comments on how the current scope and restrictions […]

Thank You To Our WiFi Sponsor!

23 Mar, 2017

Jungle Disk, the #1 data security suite for small businesses, provides backup, network security and email archiving solutions to protect critical data, such as patient information and electronic medical records, from system failure, human error and cyberattacks. Headquartered in San Antonio, TX, the Jungle Disk team now serves over 25,000 customers across the globe. We […]

AAOS Congressional Ambassadors: Texas Action Alert

01 Mar, 2017

Texas Ambassadors, I’m writing to ask you to help support a fellow Texan, AAOS Ambassador, and orthopaedic surgeon, Dr. David Teuscher. Congressman Brian Babin (TX-36) is circulating the attached letter of support for Dr. Teuscher for a senior-level post at the Department of Health and Human Services (HHS). AAOS has also written a letter of […]

TOA Launches a Financial Benchmarking Survey; Results to Be Analyzed at TOA’s May 5-6, 2017 Annual Conference

27 Jan, 2017

TOA will dedicate the Saturday, May 6 portion of the 2017 Annual Conference in Dallas to “The Business of Orthopaedics.” One of the presentations will examine key financial benchmarks in Texas orthopaedic practices and highlight some of the financial strengths and weaknesses facing orthopaedic practices in Texas.  TOA is seeking volunteers to participate in this […]

Orthopaedic Surgeon to Lead Texas Senate Health Committee

27 Jan, 2017

Texas Lieutenant Governor Dan Patrick named the Senate committees for the 85th Texas Legislature, and Charles Schwertner, MD (R-Georgetown) – an orthopaedic surgeon – will continue to lead the Senate Health and Human Services Committee. Two other physicians serve in the Texas Senate: Dawn Buckingham, MD (R-Austin) – an ophthalmologist – and Donna Campbell, MD […]

Senator Offers Amendment to Protect Team Physicians

11 Jan, 2017

State Senator Charles Schwertner, MD (R-Georgetown), the chair of the Senate Health and Human Services Committee, is expected to offer an amendment to the Texas Sunset Commission’s report on the Texas Medical Board that would direct the Board to license out-of-state team physicians when they travel with their teams to Texas. The Texas Orthopaedic Association […]

Measuring Outcomes through AOPOC

04 Nov, 2016

About AOPOC The AO patient outcome measurement initiative has been launched by AOPOC US Inc., and funded by the AO Foundation and AO North America. The project was initiated to create a software platform that a typical orthopedic surgeon could use to collect scientifically-validated patient reported outcome measures to help improve clinical care. The project […]

CY 2017 HOPD/ASC Rule Finalized – Further Guidance on Off campus, Provider based Departments

03 Nov, 2016

CMS issued the final rule for its calendar year 2017 payment policy for hospital outpatient departments (HOPD) and ASCs, and CMS backed off some of its proposals to limit higher payments for off-campus, provider-based departments. To review, President Obama signed a budget bill on November 2, 2015 that ended higher payments for off-campus, provider-based departments […]

2017 Final Rule – Medicare Physician Fee Schedule CMS Listens to Texas Orthopaedic Surgeons

03 Nov, 2016

CMS released the final rule for the calendar year 2017 Medicare Physician Fee Schedule on November 2, 2016, and CMS dedicated a large amount of the commentary to how it will collect data on global surgical packages. Thanks to the Texas orthopaedic surgeons who responded to the AAOS/TOA survey on August 12. As a result […]

Demystifying MIPS/MACRA Webinar held 10-31-2016

28 Oct, 2016

TOA members are encouraged to turn to TOA’s e-mail newsletters for more information regarding MACRA.  TOA will also cover MACRA at TOA’s May 6, 2017 annual conference in Dallas. Click here to view TOA’s October 31, 2016 webinar on MACRA implementation. Click here to claim CME for participating in the webinar. Cheat sheet for TOA […]

Section 1557 Anti-discrimination Deadlines

03 Oct, 2016

In May 2016, the U.S. Department of Health and Human Services (HHS) issued a final rule for Section 1557 of the Affordable Care Act. Covered entities are required to post a discrimination and patient rights notice in the top 15 languages found in the state by October 16, 2016. In addition, covered entities are required […]

Q&A with Dave Rothenberg, President of Privia Health

26 Sep, 2016

Virginia-based Privia Health recently launched in Texas and features a nationwide network of over 1,600 physicians.  The network’s goal is to keep physicians independent by building high-performance physician groups and clinically integrated provider networks.  In 2014, a Goldman Sachs-led group invested $400 million in Privia. Last month, the Centers for Medicare and Medicaid Services (CMS) […]

Q&A with Jacob Murphree, MD of Texas Tech

26 Sep, 2016

Jacob Murphree, MD is in his third year of orthopaedic residency at Texas Tech University Health Sciences Center.  Dr. Murphree serves on the TOA Residency Council. TOA recently sat down with Dr. Murphree to learn more about his thoughts on the future of orthopaedics in Texas. TOA: What do you plan to do when you […]

Medicare’s MACRA Expectations for 2017

14 Sep, 2016

Andy Slavitt, the Centers for Medicare and Medicaid Services (CMS) acting administrator, announced CMS’s expectations for MACRA quality reporting in 2017 on September 8th. The announcement provided four models for physicians to take in 2017 in order to not be penalized by Medicare in 2019: Participate in an APM. Virtually no orthopaedic surgeon will be […]

Public Health: Scoliosis Screening – 2017 Legislature

13 Sep, 2016

Major new research has found that bracing may deter the need for surgery when scoliosis is found at an early age. Unfortunately, Texas’ school screening standards are set by legislative statute, and the current ages may be too late for early detection to be made. Therefore, it is critical for the 2017 Texas Legislature to […]

Q&A with Amy McIntosh, MD of Texas Scottish Rite Hospital for Children in Dallas

09 Sep, 2016

Amy McIntosh, MD is an orthopaedic surgeon at Texas Scottish Rite Hospital for Children in Dallas (TSRHC). Prior to her current stint at TSRHC, Dr. McIntosh was an assistant professor of orthopaedics at the Mayo Clinic College of Medicine and a 2006-2007 orthopaedic fellow at TSRHC. The following is a Q&A that TOA recently conducted […]

The Notre Dame, UCLA & OU Team Physicians and Athletic Trainers Were Not Protected by Texas Law Last Weekend; TOA’s Plans for the 2017 Texas Legislature

09 Sep, 2016

With limited exceptions, team physicians and athletic trainers are only licensed in their home states.  Therefore, when team physicians and athletic trainers follow their teams across state lines, they are not licensed in the secondary state. An increasing number of states are passing laws to provide licensing exceptions to team physicians and athletic trainers for […]

Major Action on Rate Setting in California

09 Sep, 2016

California’s Assembly recently went one step further in the out-of-network balance billing debate and dictated rates for hospital-based providers for health plans that are not self insured.  (Federal ERISA laws prevent the states from regulating self-insured employer plans.)  The California Medical Association (CMA) was neutral. CMA viewed the bill as a “compromise” and a rate […]

Two-midnight Rule Update from AAOS

17 Aug, 2016

Click here to learn more.

AAOS Survey on Global Payment Data Collection Proposal

15 Aug, 2016

On July 15, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a unilateral decision to implement a new sweeping mandate to collect data about global surgery services. According to the proposal (pp. 46192-46200), beginning just five months from now on Jan. 1, 2017, surgeons providing 10- and 90-day global surgery services to Medicare […]

August 21 Deadline to Order Rx Pads from Texas TPS

15 Aug, 2016

August 21, 2016 is the deadline to order prescription pads from the Texas Department of Public Safety (DPS).  As a result of Senate Bill 195 from the 2015 Texas Legislature, authority to issue prescription drug pads is being transferred to the Texas State Board of Pharmacy on September 1, 2016. TOA provided details regarding this […]

Medicare’s Major Announcement on Bundled Payments and MACRA

29 Jul, 2016

On July 25, the Centers for Medicare and Medicaid Services (CMS) released a major proposal on the future of bundled payments and Medicare physician payments under MACRA. Click here for full details and a link to TOA’s 45-minute webinar on MACRA.

Medicare’s Major Announcement on Bundled Payments and MACRA

28 Jul, 2016

On July 25, the Centers for Medicare and Medicaid Services (CMS) released a major proposal on the future of bundled payments and Medicare physician payments under MACRA. Click here for full details and a link to TOA’s 45-minute webinar on MACRA.  

CMS Proposes Hip and Femur Fractures for CJR; New Cardiac Bundles for Most of Texas

26 Jul, 2016

On July 25, the Centers for Medicare and Medicaid Services (CMS) announced a proposal to add hip and femur fractures to the 67 existing Comprehensive Center for Joint Replacement (CJR) regions, effective January 1, 2017.  In addition, CMS announced a proposal to mandate bundled payments for cardiac care (heart attacks and bypass surgery) in 98 […]

Medicare’s MACRA Announcement on Monday, July 25, 2016

25 Jul, 2016

Medicare’s Announcement on Monday, July 25, 2016: New Hip/Femur Fracture Bundles New Voluntary BPCI-like Bundles Coming in 2018 Guidance on Which Bundles Count as APMs Under MACRA Hints at Outpatient and Physician-led Episodes of Care in the Future The health care media focused its attention on the proposal by the Centers for Medicare and Medicaid […]

Fifty-percent of Physicians Do Not Know What MACRA Is; TOA’s MACRA Webinar Is Now Available

22 Jul, 2016

A recent survey found that 50-percent of physicians do not know what MACRA is. Unless it is delayed, which CMS indicated is possible, the new Medicare physician payments for 2019 will be based on the reporting period that begins on January 1, 2017. If you missed last week’s TOA webinar presented by Lynn Scheps of […]