TMA EVPGram

You can probably feel the pre-meeting buzz in the TMA building. We’re packed and ready to move the operation to the Sheraton Dallas forTexMed 2012. Business meetings begin on Thursday before the show really blooms on Friday and Saturday. In addition to the great exhibit hall and 100-plus hours of continuing medical education (CME) classes, here’s what I’m looking forward to:

• The installation of Michael Speer, MD, and Linda Adkins as TMA and TMA Alliance presidents;
• TEXPAC’s 50th Anniversary Celebration Thursday night, and the TMA Foundation gala – Going Gold for Great Health – on Friday (you can still buy tickets to both);
• Some stimulating policy debates and intriguing elections in the House of Delegates (see below);
• Abilene’s Virginia Connally, MD, receiving the TMA Distinguished Service Award; and
• Saturday’s day-long CME session from the Council on Health Care Quality: “Quality: Building a Practice That Will Work for You in the Future.” Look for tools and instruction on how to improve the quality of care provided in your practice — while minimizing the costs of getting there.

After numerous delays, the 2012 party primary elections are here. Early voting for the May 29 election starts today and runs through Friday, May 25. In 2013, the U.S. Congress and Texas Legislature will have many opportunities to make things better — or worse — for you and your patients. Look for a customized email today listing the TEXPAC-endorsed candidates who will be on your ballot. Today I want to remind you of the nine TMA and TMA Alliance members running for Congress and the Texas Legislature: U.S. Rep. Michael Burgess, MD (R-Lewisville), the only TMA member in Congress, is running for reelection. So are State Sen. Bob Deuell, MD (R-Greenville) and State Reps. Susan King (R-Abilene) and John Zerwas, MD (R-Simonton). Looking to move up to the Texas Senate are State Reps. Charles Schwertner, MD (R-Georgetown) and Mark Shelton, MD (R-Fort Worth). Dennis Bonnen, MD (R-Friendswood); Sonal Bhuchar (R-Sugar Land); and Susan Todd (R-Fort Worth) are seeking their first elections to the Texas House. Good luck.

I have a feeling this year’s session of the House of Delegates will be one of the most interesting in recent memory. Saturday features contested elections for speaker and vice speaker of the house, the TMA Board of Trustees, and the Texas Delegation to the American Medical Association. The house agenda is packed with some of the hottest issues in medicine today. Among the 103 resolutions are those that would direct TMA to:

• Work to repeal the dual-eligible payment cuts;
• Make smoke-free Texas a top legislative priority for 2013;
• Work to make sure rules governing the Women's Health Program “do not interfere with physicians’ ethical and legal obligations to provide medically accurate, candid, and unbiased advice to obstetric patients”;
• Restore funding for state family planning services and the Women’s Health Program;
• Lobby to generate more residency slots and regain full funding for the Physician Education Loan Repayment Program;
• Advocate repeal of the Patient Protection and Affordable Care Act and Medicare’s Independent Payment Advisory Board (these are among several items the Texas delegation could take to the AMA meeting in Chicago next month);
• Support allowing physicians to balance bill Medicare and Medicaid patients; and
• Work with the Department of Public Safety to streamline processing of controlled substance permit applications.

The TMA Council on Health Care Quality isn’t even a year old yet, but the group led by Frank Villamaria, MD, has made serious progress. Some 48 member physicians in 17 practices across Texas took part in the council’s Diabetes Reporting Pilot Program. The pilot taught physicians how to decide if their practice could benefit from the work needed to participate in incentive programs like Medicare’s Physician Quality Reporting System (PQRS) and Blue Cross and Blue Shield’s Bridges to Excellence (BTE). PQRS rewards equal 1 percent of total 2012 Medicare Part B billing. BTE is a two-year program that rewards $100 per attributed diabetic or cardiac care patient each year. The council also received a $50,000, three-year grant from TMF Health Quality Institute to develop more than a dozen interactive calculators that will help practices figure out how they can bill for preventive services ranging from childhood vaccinations to screenings for substance misuse. For an example, check out TMA’s Tobacco Cessation Calculator.

 The TMA Division of Medical Economics has begun work on an initiative to shelter physician practices’ vaccine purchases from the state franchise tax, and to fix a technical error in the definition of health care provider. We will work to get those changes included in any legislative effort to revise the franchise tax. Look for the 2013 legislature to consider completely replacing the tax due to concerns about how much money it brings in, the impact on small business, and other reported inequities. TMA will evaluate every proposal to determine how it could affect physician practices, and we will continue to advocate against undue tax burden on physician practices.

Physicians have received more than $2 billion in benefits from national settlement agreements reached with Aetna, Cigna, Health Net, Humana, Anthem/WellPoint, and many Blue Cross and Blue Shield plans in class action lawsuits that 19 state and county medical associations and physician representatives brought against these insurers. TMA was an active plaintiff in many of these suits. The greatest benefit for most physicians came from the business changes the settlements required these insurers to implement. These included paying claims promptly, recognizing and paying for modifiers 25 and 59, notifying physicians 90 days before any material adverse contract changes, and limiting the time in which insurers could recover alleged overpayments. TMA actively monitors the insurers’ compliance with these requirements.

To recognize outstanding science educators and ensure their students have the learning tools they need, Dr. Ernest and Mrs. Sarah Butler of Austin donated $500,000 to the TMA Foundation’s Ernest and Sarah Butler Endowment for Excellence in Science Teaching. The Butlers established the endowment in 1998 to support the awards, which annually recognize an elementary, middle, and high school teacher for highly effective methods of engaging students in the sciences. This generous contribution brings their endowment to more than $1 million. You can do your part for the TMA Foundation at its 19th annual gala, Going Gold for Great Health, on Friday, May 18, at TexMed 2012 in Dallas. Tickets and table sponsorships are still available.