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Monday, June 29, 2015

Supreme Court Ruling in ACA Case Leaves TMA in Familiar Spot

For the second time in three years, the U.S. Supreme Court has upheld a key piece of the Affordable Care Act (ACA). This time, the decision leaves in place the government subsidies for people who buy ACA health plans in states — like Texas — that have not established state-run ACA exchanges. In the wake of that ruling, TMA remains committed to our “find it, fix it, keep it” ACA strategy: find what’s missing from the law, fix what’s broken, and keep what’s working. Congress took care of our top “find it” priorities earlier this year when it repealed Medicare’s Sustainable Growth Rate formula and guaranteed that the ACA won’t topple Texas tort reforms. We’re still pushing for antitrust protections for physicians as well as a law to give physicians and senior citizens the ability to directly contract for any Medicare services. We’re also seeing some progress in the “fix it” category, as the House last week passed a bill to repeal the Independent Payment Advisory Board. We continue to push to eliminate restrictions on physician ownership of hospitals and facilities, and to delete the multitudinous, onerous regulations that force physicians to spend time filling out forms instead of seeing patients.

Counties and TMA Search for Members, Value

Growing membership and enhancing value for members — which, in turn, builds membership — were the hot topics at the annual meeting of Texas’ county medical society executives at the TMA building. We reviewed the digital tools TMA has built to help us recruit new members and renew lapsed members, and shared best practices from around the state. Darren Whitehurst, TMA’s chief lobbyist, discussed the highs and lows from the 2015 session of the Texas Legislature. Dave Spalding, the chief operating officer for TMA PracticeEdge, shared the new company’s growth plans and how it helps physicians who want to maintain their independence. I discussed the Washington, D.C., lobbying we’re undertaking as part of the 10-state Coalition of State Medical Societies and our joint federal advocacy efforts with the three other largest state societies.

Four Largest States to Congress: Stop ICD-10 or Require a Grace Period

TMA joined with the medical societies from California, Florida, and New York in a letter asking the leaders of the U.S. Congress to stop the Oct. 1 implementation of the ICD-10 coding system or require the Centers for Medicare & Medicaid Services (CMS) to establish a two-year, penalty-free grace period for physicians. “We remain steadfast in our belief that the ICD-10 coding system offers no real advantages to physicians and our patients — and certainly no advantages to justify the time and expense the entire health care system has invested in this transition,” we wrote, pushing them to pass HR 2126, the Cutting Costly Codes Act of 2015, by U.S. Rep. Ted Poe (R-Houston). “If these requests are not achievable, we strongly encourage you to pass legislation such as HR 2652, the Protecting Patients and Physicians Against Coding Act, by Congressman Gary Palmer (R-Alabama) and others, or simply join our call for CMS to implement a two-year ICD-10 grace period.” That request of CMS, expressed in an earlier joint letter to Acting Administrator Andy Slavitt, appears to be gaining traction at the agency. CMS leaders last week arranged a conference call for physicians and staff from the four states to further explain what we want to happen. TMA President Tom Garcia, MD, and Asa Lockhart, MD, vice chair of the Texas Delegation to the American Medical Association House of Delegates, represented Texas on the call.

TMA Foundation Hits $5 Million Milestone

Since its inception in 1993, the TMA Foundation (TMAF) has awarded more than $5.1 million in health improvement grants to TMA, county medical societies and alliance chapters, medical student groups, and other organizations. A record-setting gala at TexMed 2015 is helping to refill the TMAF coffers. Under the leadership of co-chairs Drs. Michelle Berger, David Tobey, Susan Pike, and Harry Papaconstantinou, the May 1 event raised more than $386,000. You can help extend that record thanks to a new challenge grant from the John P. McGovern Foundation, which will match donations up to a total of $10,000. TMAF proceeds support such TMA programs as Hard Hats for Little Heads, the Minority Scholarship Program, and Walk With a Doc Texas.

EVPGram Takes July 4 Holiday

In honor of the 239th anniversary of the birth of our great nation, EVPGram won’t publish next week. We’ll be back in your inbox on July 13.

Tuesday, June 23, 2015

Governor Signs TMA “Home Runs” Into Law

Gov. Gregg Abbott completed his review of the 2015 Texas Legislature’s work, signing or allowing into law about 1,400 bills and resolutions, and issuing veto proclamations for 42 others. Over the past week, the governor put his signature on most of TMA’s major legislative successes, including:
  • Big increases in funding for new graduate medical education programs, mental health, and women’s health;
  • Significant reforms of how the state investigates and prosecutes suspected Medicaid fraud;
  • Elimination of the state Controlled Substances Registration program;
  • Elimination of the $200 annual occupation tax that all physicians pay;
  • ID card requirements for patients covered by Affordable Care Act (ACA) marketplace plans;
  • Retention of vaccination records in ImmTrac until age 26;
  • Tougher network accountability requirements for Medicaid HMOs; and
  • Enhanced liability protections for physicians using health information exchanges.

TMA Working Multiple Fronts on ICD-10

As the Oct. 1 deadline for transitioning to the ICD-10 coding system draws closer, TMA is working with other state medical societies to stop or delay the change or soften its blow. We continue to support HR 2126, the Cutting Costly Codes Act of 2015, by U.S. Rep. Ted Poe (R-Houston), to stop the implementation of ICD-10 outright. Last week, we joined with the California, Florida, and New York state medical associations in a letter asking the Centers for Medicare & Medicaid Services (CMS) to adopt a two-year, penalty-free, ICD-10 grace period. Writing on behalf of more than 120,000 physicians and medical students, we asked for:
  • A two-year period during which physicians will not be penalized for errors, mistakes, and/or malfunctions of the system;
  • A two-year period in which physicians will not be subject to special Medicare-payment audits due to ICD-10 coding mistakes;
  • A two-year period during which physician payments will not be reduced or withheld based on ICD-10 coding mistakes; and
  • Advance payments in the event that claims are delayed.
We are working with those same states and the larger Coalition of State Medical Societies on several other bills in Congress that would force CMS to mitigate the ICD-10 impact on physicians. We’re also putting the finishing touches on our August and September ICD-10 workshops for physicians and staff, and we offer several outstanding ICD-10 planning webinars, podcasts, and publications in the TMA Education Center.