Texas Orthopaedic News Feed

  • John W. Hinchey, MD, Installed as TOA’s President
    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…
  • Texas Goes Live With the Interstate Medical Licensure Compact
    The Texas Medical Board (TMB) announced that Texas’ involvement in the interstate medical licensure compact will go live on March 1, 2022. Click here for details. HB 1616, authored by Rep. Greg Bonnen, MD, passed out of the 2021 Texas Legislature and allows Texas to recognize the medical licenses from 32 other participating states.
  • TDI-DWC Is Seeking Shoulder Experts
    The Texas Department of Insurance – Division of Workers’ Compensation is seeking shoulder experts for its Medical Quality Review Panel. Click here to learn more:
  • HIPAA Investigations by the Office of Civil Rights: January 25 Webinar
    TMLT will hold a January 25 webinar on violations related to HIPAA investigations by the Office of Civil Rights: Understand what the OCR is focusing on in its investigations. Explain how to prevent the most common violations cited by the OCR in 2021. Discuss the importance of cooperating with the OCR and responding to their…
  • TOA Supports TMA’s Lawsuit Challenging the Median In-Network Rate
    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…
  • U.S. House Addresses Medicare Cuts
    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…
  • Orthopaedics in Texas
    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…
  • The Prior Authorization Burden
  • TOA Supports Prescription Monitoring Program Efforts in the Texas Legislature
  • CMS Extends Hip-and-Knee Replacement Demonstration for Three Years
    The Centers for Medicare and Medicaid Services (CMS) finalized an extension of the Comprehensive Care for Joint Replacement (CJR) demonstration on April 29, and the extension will add an additional three years through 2024. The extension will only apply to hospitals in the mandatory portions of the demonstration. Click here to read CMS’s final rule.…
  • Anti-discrimination Statement (ACA)
    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…
  • Texas Orthopaedic Association Bylaws
    TEXAS ORTHOPAEDIC ASSOCIATION, INC. BYLAWS ARTICLE IThe name of this organization shall be the TEXAS ORTHOPAEDIC ASSOCIATION, INC. (hereinafter called the “Association”). ARTICLE IIPurposeSection 1. The purpose of this organization is to: Foster cooperation among the orthopaedic surgeons in the State of Texas. Encourage scientific, educational, and charitable endeavors which will promote and advance the…
  • San Antonio – Monday, April 5
    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…
  • TOA Submits Comments on Workers’ Comp Legislation – HB 2247
    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…
  • TOA Offers Testimony on SB 207
    The Texas Orthopaedic Association (TOA) offered testimony today on SB 207 in the Texas Senate Committee on State Affairs earlier today. Click here to view TOA’s proposed language.
  • Physicians Encourage Prescription Monitoring Program Funding
    The Texas Orthopaedic Association and other physician groups encouraged appropriators in the Texas Legislature to once again fund the software to integrate the state’s Prescription Monitoring Program (PMP) into EHRs.  The 2019 Texas Legislature funded physician’s licenses for the software. Click here to learn more.
  • Texas Supreme Court Rules in Favor of Physicians in Workers’ Comp Case
    The Texas Supreme Court ruled in favor of physicians in the case Patients Medical Center v. Facility Insurance Corporation, which questioned whether physicians had to assume the burden of proof throughout any medical fee dispute case that goes to SOAH, regardless of if the provider prevailed at the administrative level with the Division of Workers’ Compensation (TDI-DWC).    The…
  • TOA’s Musculoskeletal Primer for the 2021 Texas Legislature
  • Opioid Recommendations for the 2021 Texas Legislature
  • Congress’ End-of-Year Legislation
    Congress passed end-of-year legislation on December 21, 2020, that updated Medicare’s E/M cuts for orthopaedics, created a ban on surprise billing for emergency services, and added a new round of PPP. Updated Physician Fee Schedule Click here to view the E/M calculator:2021 Ortho codes only revised pro fee compare 2021 to 2020 Click here for…
  • TOA Supports Congressman Burgess’ Bid for E&C Leader
    The Texas Orthopaedic Association offered its support for Congressman Michael Burgess’ bid to serve as the Republican leader of the U.S. House Energy & Commerce Committee. Click here to view TOA’s support letter: Congressman Burgess Support Letter – Texas Orthopaedic Association
  • TOA Supports Congressman Burgess’ Bid for E&C Leader
    The Texas Orthopaedic Association offered its support for Congressman Michael Burgess’ bid to serve as the Republican leader of the U.S. House Energy & Commerce Committee. Click here to view TOA’s support letter.
  • 2022 Circle of Champions
    Several industry partners choose to support TOA throughout the year in 2022 by serving as TOA’s Circle of Champions. TOA’s Circle of Champions & Sponsorship Opportunities Click here to learn more about TOA’s sponsorship opportunities in 2022. TOA’s Title Sponsor
  • MPOWERHealth’s Clinically Integrated Network
    MPOWERHealth is an Addison, Texas-based entity that created a clinically integrated network for musculoskeletal care, which consists of a number of orthopaedic surgeons in the Texas market. Click here to learn more. TOA recently sat down with Adam Bruggeman, MD – MPOWERHealth’s chief medical officer – to learn more about the network. TOA: What was…
  • Action Alert: Congress Congress to Stop Medicare’s Surgical Cuts
      Medicare proposed musculoskeletal cuts of at least 5 percent in its 2021 Physician Fee Schedule proposed rule earlier this summer. All surgeons are encouraged to contact their members of Congress to co-sponsor HR 8702 to prevent the cuts by the end of the year. Click here to send an e-mail to ask your member…
  • CARES Act Provider Payments
      Click here to learn more. Click here to view the list of Texas recipients: HHS_Provider_Relief_Fund
  • May 2020 – TOA Presidential Line Analysis
    June 18, 2020, Presidential Line Agenda: 6.18.20 – TOA Leadership Council 2021 Meeting Plan PowerPoint (Created on 6.16.20): 2021 Annual Conference & Beyond PowerPoint: 6.18.20 – TOA Leadership Council 2020 Budget Adjusted (05.04.20): TOA 2020 Budget – 05.04.20 2019 P&L (05.04.20): 05.02.20 – 2019 TOA Budge vs. Actual Link to those owing 2020 dues –…
  • Revenue Generation and Elective Surgeries; April 29 Zoom
      By John Early, MD Medical Director, MedHab, LLC Just a few weeks ago we were all wondering how our practices were going to survive the pandemic relative the rulings regarding elective surgeries. Now that states are beginning to open the door for elective surgeries, we can rest assured that we get back to business…
  • TOA’s Position on AAOS’s Proposed Bylaws: 1, 2 & 3
    April 22, 2020 Dear TOA Member: TOA’s Board of Directors reviewed AAOS’s proposed bylaws changes, and TOA’s Board is encouraging a “no” vote on AAOS’s proposed bylaws changes related to groups 1 and 2. A number of orthopaedic societies and past AAOS Board of Councilors have issued recommendations in opposition to AAOS’s proposed bylaws changes…
  • Texas Senate Letter – 04.15.20
    04.15.20 – Senate Letter
  • Practice Preservation & Remote Patient Monitoring; Upcoming Webinars
    By John Early, MD Medical Director, MedHab, LLC It wasn’t very long ago when the typical orthopedic practice was full of activity. Patients were calling and appearing in person to be examined for a myriad of conditions. Surgeries were being performed. Therapy was being prescribed and patients were being helped to recover function. Little thought…
  • Updated Chronic Pain and Telemedicine Regulations – Texas Medical Board
    Note: This has been provided for informational purposes only and does not serve as legal advice. Consult your attorney. This has been created by Weaver Johnston & Nelson. Governor Abbott Extends TMB Waiver for Chronic Pain Patients; TMB Telemedicine FAQ Updated April 14, 2020 Extension of TMB Waiver for Telephonic Prescriptions for Chronic Pain Patients To…
  • PAs & APRNs – State of Texas Regulations
    Note: The following has been provided for informational purposes only and does not serve as legal advice. Consult your attorney. From Weaver, Johnston & Nelson: April 8, 2020 On April 5, 2020, Texas Governor Greg Abbott temporarily waived certain regulations to allow more flexibility between physicians and the physician assistants (“PAs”) and advanced practice registered…
  • TOA Highlights Measures for Business Partners to Help Medical Practices
    For more information: Contact: Bobby Hillert | 214.728.7672 m | Bobby@toa.org TOA Highlights Measures for Business Partners to Help Medical Practices April 8, 2020 – According to Modern Healthcare: “The healthcare industry’s 42,500 jobs lost in March amid the COVID-19 pandemic were almost entirely on the outpatient side. Hospitals added 200 jobs.” All types of…
  • “Stark Law Blanket Waivers Issued In Response to COVID-19”
    Note: This has been printed for informational purposes only. TOA does not offer legal advice. Please consult your attorney. April 8, 2020, update from Weaver, Johnston & Nelson: Following the drafting of our recent Office of Inspector General (“OIG”) COVID-19 guidance email, which can be found here, the OIG issued a Policy Statement in response to COVID-19 and…
  • AudxMD’s Summary of COVID-19 Supplemental Packages
    Phase One: [enacted March 6th, 2020] – The package appropriates $8.3 billion in emergency funding to give the federal government the initial tools to respond to the coronavirus outbreak. The law provides fiscal year 2020 supplemental funding for the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health,…
  • CMS: Hospitals & ASCs
    The Centers for Medicare and Medicaid Services (CMS) announced temporary regulatory waivers and new rules for hospitals and ASCs to respond to COVID-19. Physician-Owned Hospitals “Physician-owned hospitals can temporarily increase the number of their licensed beds, operating rooms, and procedure rooms. For example, a physician-owned hospital may temporarily convert observation beds to inpatient beds to…
  • ASC Regulatory Changes in Texas: COVID-19
    Click here to learn more.
  • Elective Surgeries During the COVID-19 Pandemic
    Note: Weaver Johnston Nelson sent this e-mail on March 22, 2020. TOA has published it for informational purposes only; it does not constitute legal advice. Elective Procedures and Surgeries March 25, 2020 On March 22, 2020, Governor Abbott signed Executive Order GA-09, which directs facilities and licensed healthcare professionals to postpone through April 21, 2020…
  • Summary of the CARES Act
    What Health Organizations Need to Know About the CARES Act’s Tax and Loan Provisions By Mel Gunawardena, Managing Partner, SYNERGEN Health As the pandemic continues to develop and negatively impact the U.S. and global economy, health practices in Texas and across the nation are being forced to plan for financial challenges. As different state, county…
  • COVID-19
      Click here to learn more about Congress’ end-of-year legislation in 2020. Texas DSHS Dashboard – June 2020 Click here for DSHS’s dashboard, including hospitalizations by trauma service area. Financial Relief Refer to TOA’s e-mail updates for members for extensive details related to federal relief. Texas Medical Board Click here to view the TMB’s guidance.…
  • CMS: Special Open Door Forum re: Prior Authorization Process
    Prior Authorization Process for Certain Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) Items: Inclusion of Lower Limb Prosthetics (LLPs) in Prior Authorization Wednesday, March 11th, 2020 2:00-3:00 PM Eastern Time Conference Call Only The CPI will host a Special Open Door Forum to invite suppliers, physicians, and other Medicare practitioners or interested parties to…
  • An Alternative to Private Equity and Hospital Absorption: Use of ESOPs for Medical Practices and Physician-Owned Hospitals in Texas
    TOA disclaimer: The following article has been provided for informational purposes only.  It does not constitute legal or accounting advice. You should consult your attorney and accountant. By Susan Scherbel, Bellview Associates It is hard to think of a profession that has faced more challenges than medicine. For the past decade, physicians have been hammered…
  • Are You Ready for the Trump Administration’s New Price Transparency Rules?
    Author: Mel Gunawardena, Managing Partner, SYNERGEN Health In November 2019, two new rules that require pricing information to be made public were finalized by executive order and announced by the Trump administration. The rules – Calendar Year 2020 Outpatient Prospective Payment System & Ambulatory Surgical Center Price Transparency Requirements for Hospitals to Make Standard Charges…
  • AAOS Announces Study of Stem Cells & Biologics
    Click here or on graphic to learn more!  
  • A Look at Medicare’s Competitive Bidding Program for DME
    TOA recently sat down with Ross DeRogatis of Matrix Orthopedics to look at Medicare’s Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding program, which will affect back and knee braces. Ross is the President/Owner of Matrix Orthopedics, an exclusive Donjoy distributor.  He has been in the DME space for over 10 years and…
  • The Medical Expert Witness Industry: Q&A with J. Clark Race, MD
    Clark Race, MD is board certified in Orthopedic Surgery by the American Board of Orthopaedic Surgery and has been in private practice in the Austin area since 1983. Dr. Race recently created Expert Witness Doctors to provide medicolegal services, which include depositions, trial testimony, medical record reviews, IMEs, peer reviews, disability evaluations, designated doctor exams,…
  • 2020 Physician Fee Schedule Summary
    The Centers for Medicare and Medicaid Services (CMS) released its final payment rule for the calendar year (CY) 2020 Physician Fee Schedule (PFS) payment policy on Friday, November 1. CMS finalized most of the orthopaedic-related proposals that were published in this summer’s proposed rule. Therefore, this summary will simply touch on a few of the…
  • 2020 OPPS/ASC TOA Summary
    The Centers for Medicare and Medicaid Services (CMS) released its final payment rule for the calendar year (CY) 2020 hospital outpatient (OPPS)/ASC payment policy on Friday, November 1. CMS finalized most of the orthopaedic-related proposals that were published in this summer’s proposed rule. Click here to review TOA’s summary of the proposed rule. Click here…
  • A Look at the Evolution of Football Injuries
    TOA recently sat down with Field Scovell, MD of the Carrell Clinic in Frisco and Shane Miller, MD of Texas Scottish Rite Hospital for Children in Frisco to take a look at the evolution of football injuries and their treatment. The following is TOA’s conversation. TOA: Have you and your colleagues changed the way that…
  • Medicare Is Considering a Renewal of the CJR Program
    The White House Office of Management and Budget (OMB) is reviewing a three-year extension of the Comprehensive Center for Joint Replacement (CJR) model. CJR, which focuses on hip and knee replacement bundles, debuted in 2016. It is scheduled to end in 2020. Sixty-seven geographic areas, including five Texas regions, were included in the initial mandate.…
  • Texas Medical Board Offers Guidance Related to the State’s New Opioid Law
    The Texas Medical Board (TMB) issued preliminary guidance related to Texas’ new limit on opioid prescriptions that will go into effect on September 1, 2019. The 10-day limit on opioid prescriptions was created by HB 2174 in the 2019 Texas Legislature. Click here to view the initial guidance: HB 2174 Initial Guidance – TMB
  • TOA Encourages the Texas Medical Board to Seek Legislative Intent on Opioid CME Bills
    The Texas Orthopaedic Association (TOA) supported legislative efforts in the 2019 Texas Legislature to require continuing medical education (CME) for prescribing opioids. TOA was pleased that lawmakers worked with TOA on the issue. Instead of passing an omnibus bill related to opioids, the 2019 Texas Legislature took a “shotgun approach” to opioids by passing a…
  • A Look at Youth Baseball Injuries with Henry Ellis, MD & Christian Balldin, MD
    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
    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
    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
    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…
  • Patient Perception of Surgeon Reimbursement
    Click here or on graphic to enlarge! Click here or on graphic to enlarge!
  • There Is a Correct Way to Address Surprise Billing
    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
    TOA takes three orthopaedic residents to Washington, DC every June to visit with lawmakers about musculoskeletal issues that affect Texas patients. TOA’s goal is to introduce advocacy issues to residents at an early age. Jordan Handcox, MD of San Antonio, Dylan Homen, MD of Lubbock and Max Danilevich, MD of Galveston were the three residents…
  • Prescription Monitoring Program
    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 Strongly Supports the Prior Authorization and Utilization Review Provisions Passed by the Texas Legislature
    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 
    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
    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
    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
    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
    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
    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
    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
    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
    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
    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
    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
    Click here to view the Prescription Monitoring Program
  • TOA’s 2020 Annual Conference
    Click here for the latest info for our upcoming 2020 Annual Conference. Sponsorship details are coming soon!