Threat Level High: Ransomware a Bigger Threat.

COVID-19 has made a booming illicit business - ransomware - boom even louder. And the more medical practices and organizations fall victim to ransomware cyberattacks, the more illustrative it becomes how important it is to prevent such an attack.

Federal Fairness? Congressional Measure Addresses Out-of-Network Payments.

Congress in December 2020 passed surprise-billing legislation as part of a wide-ranging coronavirus relief bill, tying a bow on federal lawmakers' primary health care focus just prior to COVID-19. Texas already had set up its own system for state-regulated plans in 2019 with Senate Bill 1264, which took effect last year.

Medicine Trains Its Sight on Scope Expansions.

A court decision siding with chiropractors is the latest of many scope tests in the legislature and the law.

Shelter in a Storm: Liability Legislation Would Protect Physicians in Disaster.

The Texas Alliance for Patient Access (TAPA) announced in early March that Sen. Kelly Hancock (R-North Richland Hills) and Rep. Jeff Leach (R-Plano) would soon file COVID-19 liability legislation that would enhance liability protections to shield more physicians from lawsuits for care delivered during pandemics, hurricanes, and other catastrophic events that inject chaos into their good-faith medical efforts.

Wrong Directive: Legal Shifts on End-of-Life Care Concern Physicians.

Challenges to Texas laws governing end-of-life care, whether through legislative rewrites or judicial override, are nothing new. The recent success of those challenges is. In particular, two recent erosions have physicians like Houston palliative care specialist Mark Casanova, MD, chagrined and concerned about the future of doctors' role in end-of-life treatment.

Outrageous Overreach Medicine Fights Broad Documentation Requests.

When Andrew Indresano, MD, got a subpoena in January 2019, he found it "a little shocking" and "really invasive." The Fort Worth orthopedic surgeon wasn't even part of the personal-injury lawsuit for which he was being asked to produce a backward-looking swath of documents.

Ten Years Later: TMA Advocacy Nets Investments in Women's Health.

A decade ago, the Texas Legislature made a funding decision that devasted low-income women's access to health care and the physicians and community clinics that care for them. After 10 years, with the help of TMA advocacy and the formation of the Texas Women's Healthcare Coalition, funding for family planning and overall women's health is in significantly better shape.

Preventable Pain: COVID Surge, Anti-Vax Sentiments Compound Physicians' Turmoil on the Job.

Pushback from patients on medical advice and course of treatment is nothing new. But physicians say the degree of it - a lack of trust in science, medicine, and expertise - has never been as pronounced as it is now, in the era of the highly contagious delta variant, widespread availability of COVID-19 vaccines, and millions of people who simply refuse to avail themselves of them. And it's piling onto the already-existing assaults on physician mental well-being - now increasingly framed as physician "moral injury."

Funding the Future: Texas Legislature Fully Commits to GME.

The Texas Legislature's investment in medical education includes a full commitment to GME.

Obstacles to Clear.

Barriers stand in the way of physicians playing a greater role in addressing the social determinants of health, but awareness of those factors is increasing, and progress is happening.

Going Local: Accountable Health Organizations Could Help Combat Social Disparities at the Local Level.

"We believe that standardizing those kind of processes will be easier for [those] providing care. Because one of the things we hear a lot is this lack of harmonization of processes and procedures, whether that's in care or measures or processes. That is a really important part of it."

Staying the Course: Medicine Enters an Unprecedented Session at the Texas Legislature.

The way the Texas Legislature conducts business during the 2021 session may look different due to the COVID-19 pandemic. But the Texas Medical Association's commitment to improving health care remains the same. Some of those goals are up against deep cuts to state agency budgets. At the same time, however, the pandemic has created opportunities for medicine to bend lawmakers' ear on some of its longstanding goals, including advancing access to care, vaccines, health coverage, and telemedicine.

The Customer Is Always Right? Patient-Reported Outcome Measures Have Fans and Detractors.

For too long, some doctors say measures of a physician's quality of care have been about process: the average length of a patient stay, for example, or a patient's readmission rate. The bottom line is results, and that's why a shift to patient-reported outcome (PRO) measures is necessary. However, even proponents of PRO measures note that collecting the information from patients for those metrics places burdens on physicians, and some remain skeptical of bonuses and penalties tied to a measure that derives from a subjective factor: what patients think.

Troubling Trend: Texas' 2018 QPP Data Contains More Bad Signs.

As the Centers for Medicare & Medicaid Services continues to churn out glowing data annually on its Quality Payment Program (QPP), a full picture of the program's impact eludes the agency's reporting. According to the Texas Medical Association's analysis of state-level data in the 2018 QPP Experience Report, it's clear that small practices continue to feel most of the program's punitive pressures.

A Different Kind of Patient: CME from TMA Helps Docs ID Human Trafficking Victims.

A newly revised Texas Medical Association CME teaches physicians how to recognize human trafficking victims who come into their office, and how to help these patients escape what's sometimes referred to as "modern-day slavery."

No Escape: COVID-19 Continues to Exacerbate Physician Burnout.

The malaise in physician practice long known as burnout - a term doctors increasingly balk at - has been exacerbated by the pandemic, as an extensive survey by the Physicians Foundation recently showed. It's created its own stressors and made existing ones worse.

Making Billing More Balanced: Congress Considers Surprise Billing Legislation.

The widespread call to severely curb or end "surprise" medical bills prompted competing federal legislation during the summer and fall of 2019. The negotiations, maneuvering, and bill markups have continued into this year. Similar to a new Texas law governing state-regulated plans, federal proposals would ban balance billing and remove patients from having any role in out-of-network payment disputes. But with insurer-friendly language lurking in many of those proposals, Dr. Fleeger warns the impact of such legislation could go well beyond out-of-network payment.

Taking Their Lumps? TMA Works to Reverse Decision on Future Medical Expenses.

Does a court have full discretion to decide how much of an award for future medical expenses is paid in periodic payments versus a lump sum? The 4th Court of Appeals said yes, allowing a patient to collect the majority of a $3 million award up front. Medicine is concerned the ruling goes against a tort reform protection requiring periodic payments to be based on evidence the jury used to determine the future-medical award. That ensures patients get the compensation they are due for their future medical expenses but only when they need it.

The PMP Requirement Begins.

With EHR integration in place, physicians must check the state prescription monitoring program (PMP) prior to prescribing an opioid starting March 1.

Back to the Heart.

Cancer survivor Lee Tomlinson will stress compassionate care at TexMed 2020.