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BPCI Extended Two Years

October 13, 2022

Per CMS: The Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model will be extended for two years, CMS announced today. The BPCI Advanced Model, which launched on October 1, 2018, was set to end on December 31, 2023, and will now conclude on December 31, 2025. BPCI Advanced is an Advanced Alternative Payment Model…

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Federal Government Asks for Stakeholder Comments on Good Faith Estimates

September 23, 2022

In a September 16, 2022, publication, the federal government asked stakeholders to provide feedback on the implementation of good faith estimates (GFEs), which were created by the No Surprises Act. Comments will close on November 15, 2022. In the request for information, federal regulators indicated that enforcement is pending related to GFEs for covered individuals.…

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John W. Hinchey, MD, Installed as TOA’s President

May 5, 2022

The Texas Orthopaedic Association (TOA) installed John W. Hinchey, MD, an orthopaedic surgeon with Ortho San Antonio, as the 2022-23 president. Dr. Hinchey replaced Luis H. Urrea II, MD, of El Paso, who served as the TOA president from 2021-22. Dr. Hinchey has served in a number of orthopaedic leadership roles, including chair of the…

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TOA Supports TMA’s Lawsuit Challenging the Median In-Network Rate

December 26, 2021

The Texas Orthopaedic Association submitted a supporting declaration in support of the Texas Medical Association’s lawsuit alleging that the rule created by the federal agencies responsible for implementing the No Surprises Act incorrectly directs arbitrators to determine appropriate out-of-network payments by relying primarily on the median in-network rate. The American Medical Association and American Hospital…

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U.S. House Addresses Medicare Cuts

December 9, 2021

The U.S. House passed a stand-alone Medicare package on December 7 that would address a significant portion of the 9.75% physician Medicare cuts that are scheduled to go into effect on January 1, 2022. In short, the 9.75% Medicare cut would become a .75% cut on January 1, 2022. The bill now moves to the Senate for…

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Orthopaedics in Texas

May 25, 2021

The Texas Legislature Passed the Nation’s Model Prior Authorization Law HB 3459, which passed in May 2021, will: Prohibit a PPO or HMO regulated by the state of Texas from requiring a prior authorization for a physician who meets certain thresholds. If during a prior six-month period a physician was approved for at least 90…

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Anti-discrimination Statement (ACA)

April 26, 2021

October 3, 2016 Dear TOA Member:   On May 18, 2016, the U.S. Department of Health and Human Services (HHS) issued a final rule regarding the Affordable Care Act’s non-discrimination policies in Section 1557.  Click here to read a very lengthy summary from the Kaiser Foundation.   The provision requires covered entities (physician practices) to post…

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San Antonio – Monday, April 5

April 5, 2021

Have you paid your TOA dues for 2021? If you aren’t sure, email edberg@toa.org. If you have an interest in contributing to the Texas Orthopaedic Association Political Action Committee (TOPAC), click here to contribute. Click here to send a message to your state lawmakers about opioids today. Click here to fill out the CME evaluation so…

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TOA Submits Comments on Workers’ Comp Legislation – HB 2247

March 30, 2021

TOA submitted comments to Rep. Hugh Shine related to HB 2247, which would give the State Office of Risk Management (SORM) the ability to determine whether a demonstration project for prior authorizations within Texas’ Workers’ Compensation program would result in greater efficiency for the system. TOA opposed 2017 legislation due to the fact that it…

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