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 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.
The Texas Department of Insurance – Division of Workers’ Compensation is seeking shoulder experts for its Medical Quality Review Panel. Click here to learn more:
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…
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 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.…
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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…
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, 2017. SB 55 directs the two of the state’s…
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…
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…
