Earlier this week, the Texas Medical Association’s Board of Trustees approved the task force report on balance billing for its recommendations regarding network adequacy and out-of-network billing. It will now be sent to the TMA House of Delegates for consideration. Click here to read more.
On February 24, the Blue Cross Blue Shield Association released a study promoting the use of outpatient surgery for certain services, including lumbar spine surgeries. Click here to read the Association’s release regarding the study, “How Consumers Are Saving with the Shift to Outpatient Care.” KEY FINDINGS: Patients who utilized outpatient procedures saved money in 2014: $320…
Last Spring, Congress passed the Medicare Payment and CHIP Reauthorization Act (MACRA), which replaced the Medicare physician payment SGR formula with two new avenues for Medicare physician payment: MIPS (Merit-based Incentive Payment System) – This path allows physicians to receive bonuses based on quality reporting. APM (Alternative Payment Model) – This path allows physicians to…
On March 10, 2016, the Texas Supreme Court will hear oral arguments in the case of Doctors Hospital at Renaissance, Ltd. and RGV Med, LLC v. Jesus Jaime Andrade and Jessica Andrade, which relates to whether a limited partnership made up of physicians (a physician-owned hospital) could be liable for one of the physician’s alleged negligence.…
One of the top health care issues in Congress remains the new new site neutral Medicare payment policy for new off-campus, hospital outpatient department (HOPD) deals that were signed on and after November 2, 2015. As a reminder, the November 2015 budget ceiling deal included site neutral payments as a payment offset. Under this scenario,…
The Centers for Medicare and Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP), which represents most commercial health insurance plans, released seven sets of clinical quality measures that cover areas such as accountable care organizations, patient-centered medical homes, cardiology, gastroenterology, and orthopaedics. The goal is to reduce inefficiencies by putting the health plans and…
Electronic health record companies and policymakers have been telling orthopaedic surgeons to contact their state societies for assistance regarding their participation in registries in order to meet meaningful use stage 2 requirements. At the moment, AAOS has not endorsed a registry. Based on TOA’s research, it appears that only a handful of registries are currently…
Over the past six weeks, TOA has updated you on its new relationship with AOPOC, which has created a low-cost patient outcomes measurement tool for orthopaedic surgeons. If you would like to participate in TOA’s effort with AOPOC, please notify TOA (Bobby@toa.org). TOA is negotiating a special rate for TOA members to participate. While we…
The Texas Medical Disclosure Panel is seeking an orthopaedic surgeon to serve on the panel. Please contact TOA (Bobby@toa.org) if you would like to serve. Also, the panel has proposed several new disclosures involving total joint arthroplasty to be disclosed to patients. Click here to read the proposal.
TOA’s Board of Directors met with Ken Bine, the president and CEO of AOPOC US Inc., on January 23 to discuss details regarding how TOA can offer the platform at a discounted rate for TOA members. Recognizing the high cost of existing patient reported outcomes platforms, AOPOC Inc., which is funded by the AO Foundation…
