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Monday, January 12, 2015

TEXAS LEGISLATURE CONVENES TOMORROW; HERE'S OUR HEALTHY VISION


The 84th Texas Legislature begins its 140-day regular session in Austin tomorrow with a new lieutenant governor (Dan Patrick) and a new governor (Greg Abbott) waiting to be inaugurated next week, and a host of new senators and representatives. From the opening gavel at noon on Tuesday through sine die on June 1, TMA will be your very active voice at the Texas Capitol. The second edition of TMA’s Healthy Vision 2020 lays out our agenda for the session. As TMA President Austin King, MD, says, “Our government must make it easier — not more difficult — for us to care for our patients.” Here are our top 10 recommendations:
  1. Increase funding for graduate medical education.
  2. Improve physicians’ Medicaid and Children’s Health Insurance Program payments to more appropriately reflect the services they provide to patients.
  3. Hold health insurance companies accountable for creating and promoting adequate physician networks.
  4. Devise and enact a system for providing health care to low-income Texans that improves efficiencies by reducing bureaucracy and paperwork.
  5. Stop any efforts to expand scope of practice beyond that safely permitted by nonphysician practitioners’ education, training, and skills.
  6. Promote government efficiency and accountability by reducing Medicaid red tape.
  7. Protect physicians’ ability to charge for their services.
  8. Improve the state’s public health defense to better respond in a crisis.
  9. Preserve Texas’ landmark medical liability reforms.
  10. Protect the patient-physician relationship from corporate intrusions. 

TMA, ALLIANCE MEMBERS GAIN LEGISLATIVE CLOUT WITH SENIORITY


When the 2015 legislative session convenes here tomorrow, five physicians and one TMA Alliance member will be among the 181 senators and representatives taking the oath of office. Five of the six are returning legislators, gaining power with seniority and experience. Sen. Charles Schwertner, MD (R-Georgetown), has been serving as chair of the Senate Committee on Health and Human Services. The other TMA member in the upper chamber is Sen. Donna Campbell, MD (R-New Braunfels). On the House side, Reps. John Zerwas, MD (R-Simonton), and Susan King (R-Abilene) are both beginning their fifth term in office and can expect to play key roles in drafting the state budget. Reps. Greg Bonnen, MD (R-Friendswood), and J.D. Sheffield, DO (R-Gatesville), are coming back for their second term. A newcomer, Stuart Spitzer, MD (R-Kaufman), is a surgeon.

TMA CALLS FOR TOUGHER HMO NETWORK ADEQUACY RULES


TMA and 11 state specialty societies filed a 34-page letter with the Texas Department of Insurance  (TDI), commenting on the network adequacy and out-of-network payment provisions of TDI’s informal working draft rule proposal on HMOs. The letter says the draft proposal would reduce the value of HMO products available to consumers and increase consumer out-of-pocket expenses. “If health plans are not inclined to prioritize network adequacy requirements, as is implied by plan failure to comply with the most basic network adequacy reporting requirement, then it becomes much more important for the Department to make the health plans prioritize network adequacy through strong regulatory and enforcement actions,” TMA President Austin King, MD, and the presidents of the 11 other societies wrote. It is important to note that the working draft proposal is subject to further revision before publication of a final rule proposal. TMA and the specialty societies will continue to monitor the rule’s development and will provide additional comments when TDI proposes the rule formally, which is not expected until after the legislative session.

TMLT PUTS ANOTHER $15 MILLION INTO POLICYHOLDER LOYALTY PROGRAM


The Texas Medical Liability Trust (TMLT) has set aside $15 million for the Trust Rewards Program for 2015. TMLT uses these funds to reward policyholders for their loyalty. This year’s additional allocation brings the Trust Rewards total to $165 million. Funds are distributed to policyholders at the time of retirement or other qualifying event. “No other carrier offers this much to Texas physicians,” said TMLT President and Chief Executive Officer Robert Donohoe. TMLT is the only medical professional liability insurance provider created and exclusively endorsed by TMA.

DR. LAKEY STEPPING DOWN AS TEXAS HEALTH COMMISSIONER


David Lakey, MD, commissioner of the Department of State Health Services (DSHS) for the past eight years, is leaving his post Jan. 30 to join the Office of Health Affairs at The University of Texas System and the leadership team at The University of Texas Health Science Center at Tyler. “The goal of both positions is to improve population health, especially in East Texas and the areas of most need in our state,” Dr. Lakey said in an email to DSHS employees.

DR. MOY NAMED NEW BEHAVIORAL HEALTH MEDICAL DIRECTOR FOR TMF


Cliff Moy, MD, the speaker of the TMA House of Delegates, is the new medical director for behavioral health at TMF Health Quality Institute. Dr. Moy will support TMF’s medical directors on the Texas Medicaid Healthcare Partnership project and help TMF develop and implement behavioral health quality improvement opportunities.

REP. MICHAEL BURGESS, MD, WINS NATHAN DAVIS AWARD


Among the pile of letters waiting on my desk last week was one real thrill. American Medical Association CEO James Madara, MD, wrote to tell me that our nominee for the 2015 Dr. Nathan Davis Awards, Rep. Michael Burgess, MD (R-Lewisville), was selected by AMA’s panel of judges as the winner for Outstanding United States Representative. The Davis awards recognize career and elected government officials “for outstanding public service in the advancement of public health.” Dr. Burgess, the only TMA member in Congress and a steadfast champion of physicians and patients, certainly fits that description. “Given the many nominations submitted this year, it is a high testimony to the caliber of your presentation and the superb level of public service of your nominee,” Dr. Madara wrote. Dr. Burgess will receive the award next month in Washington, D.C.