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Wednesday, July 15, 2015

Board Builds Stronger TMA

The TMA Board of Trustees met for a day-long look forward and back at the state of the association. The board focused on our three core functions: membership, member advocacy, and member education. Board Chair Doug Curran, MD, led board members and senior TMA staff through discussions of challenges and opportunities, and helped draft a work plan for the coming year. In the advocacy arena, for example, we see six areas where TMA will have to develop new strategies for success:
  • Medicaid,
  • Physician-directed delivery systems and the Medicaid 1115 waiver,
  • End-of-life issues,
  • Scope of practice,
  • Balance billing and fee transparency,
  • Protecting the prohibition on the corporate practice of medicine and stopping abuses by 5.01(a) organizations, and
  • Building stronger coalitions with county medical societies and state specialty societies.

Feds Heed Medicine's Call for ICD-10 Flexibility

It wasn’t all that we asked for. But it was a good bit more than I expected from a federal agency that hasn’t exactly embraced the idea that the ICD-10 coding system is a hugely expensive waste of time for physicians and patients. First off, the Centers for Medicare & Medicaid Services’ (CMS’) decision is not a delay. To get paid by Medicare — and other payers — physicians still must begin using ICD-10 on Oct. 1. Most importantly, the grace period essentially means that for one year Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes physicians provide, as long as you submit an ICD-10 code from an appropriate family of codes. TMA President Tom Garcia, MD, expressed some serious skepticism over whether this will be enough to prevent a coding disaster. “I'm worried that the software vendors, government, and other links in this complex chain will not be ready, and if so, physicians and their patients will suffer the consequences,” Dr. Garcia told the news media. “I hope CMS will extend the one-year penalty-free and audit-free grace period if we need more time.”

TMA, meanwhile, is ramping up our ICD-10 educational materials for physicians and your staff:

TMA PracticeEdge Working With a New Primary Care ACO

The TMA PracticeEdge team was in Kerrville this week visiting with members and recruits for the new Hill Country ACO, LLC. This primary care group plans to participate in the 2016 Medicare Shared Savings Program. Contact Kim Harmon, TMA PracticeEdge’s director of administration and membership, at kim@tmapracticeedge.com or (888) 900-0334 if you are interested in joining this group or would like more information about physician-led ACOs in your area.

EVPGram Takes Summer Break

This will be your last regular issue of the EVPGram for the summer. We’ll be back in your in-box after Labor Day. Of course, we’ll keep you up to date through our Action newsletter and through Texas Medicine, and I’ll send out special editions of the ’Gram when necessary.