Texas Orthopaedic Association Statement in Support of SB 1122 & HB 2535 The legislation would help ensure that injured employees with complex and severe injuries have access to the designated doctors with the highest level of training – physicians. The Texas Orthopaedic Association (TOA) strongly supports SB 1122/HB 2535, which would eliminate the state’s upcoming…
The Biden Administration proposed two prior authorization rules related to Medicare Advantage plans over the past 10 days. TOA members can turn to TOA’s e-mail updates to read more about the two proposals.
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…
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.…
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…
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…
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…
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…
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…
