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Monday, December 15, 2008

TMA'S PRESCRIPTION FOR A HEALTHY TEXAS

TMA leaders have devised plans to pursue an ambitious agenda when the Texas Legislature convenes next month. We’ve spelled out our proposals in Doctor’s Orders, a new publication we’ve just posted on the TMA Web site. We will have the booklet in the hands of every Texas lawmaker before the holidays. A tight budget, narrow partisan margins in the Texas House and Senate, and anticipated all-out assaults on scope of practice and physicians’ ownership rights promise to make the 2009 legislative session particularly challenging for organized medicine. From health insurance accountability to protecting our liability reforms to tackling the obesity epidemic, TMA has written an extensive “2009 prescription for a healthy Texas.” Want to help? Here are five simple things you can do for your practice right from your office.

VOTE FOR HUFFMAN IN SD 17 SPECIAL ELECTION

Tomorrow is election day in the Senate District 17 special election to replace former Sen. Kyle Janek, MD (R-Houston). Republican Joan Huffman is TEXPAC’s pick in the Houston-Beaumont-Galveston-area race. If you live in the district, please vote.

ON THE ROAD WITH THE PRESIDENT

TMA President Josie Williams, MD, installed new officers at the Nueces County Medical Society and shared our legislative agenda at a joint meeting of the Midland and Ector county societies. Write to president@texmed.org to invite Dr. Williams to your county.

DEWHURST CONFERS WITH TMA LEADERS

TMA trustees Lyle Thorstenson, MD, and Bruce Malone, MD, and senior staff met with Lt. Gov. David Dewhurst to discuss the 2009 Texas Legislature. Lieutenant Governor Dewhurst asked for recommendations on health system reform and improvement.

TEXAN TO LEAD AMPAC

Congratulations to Sheldon Gross, MD. The pediatric neurologist from San Antonio is the new chair of the American Medical Association Political Action Committee Board of Directors. Dr. Gross’ election will mean good things for physicians and patients throughout the country.

NEW PRESIDENT FOR TMB

Gov. Rick Perry appointed Irvin E. Zeitler Jr., DO, a family physician from San Angelo, as the new president of the Texas Medical Board. He replaces Roberta Kalafut, DO, of Abilene, who helped lead the board through some turbulent times. "I applaud Dr. Kalafut's dedication to the mission of the board and steadfast leadership during her tenure as president, and I am pleased that she will continue to help protect the public as a member of the district review committee," Gov. Perry said. "I am equally pleased that Dr. Zeitler will be taking the reins as president, and know that he shares my strong belief that Texas must have a strong and fair medical board."

YOUR CHANCE TO LOBBY ON CAPITOL HILL

Online registration is open for the AMA’s 2009 National Advocacy Conference, March 10-11, 2009, at the Grand Hyatt Washington.

Monday, December 8, 2008

TMA TEAMS WORK ON HEALTH SYSTEM REFORM

Two TMA committees met at TMA headquarters to plan legislative solutions for both state and national health system issues. The select committees on National Health System Reform and on Medicaid, CHIP, and the Uninsured met jointly and in separate work sessions to tackle health system reform legislation that the incoming U.S. Congress and the 2009 Texas Legislature likely will address. The groups discussed national system reform proposals emerging from the U.S. Senate and President-Elect Barack Obama, and Texas Medicaid, Children’s Health Insurance Program (CHIP), and uninsured state budget issues. Joe Annis, MD, of Austin, a member of the American Medical Association Board of Trustees, addressed a joint session of the two committees as they worked on issues of importance to both groups. Chairs of the two select committees, respectively, are Doug Curran, MD, of Athens, and John Holcomb, MD, of San Antonio. Both select committees will have initial recommendations ready to go for the TMA Board of Trustees and the Council on Legislation before the legislature and Congress begin their 2009 sessions.

UTMB ALUMNI COME THROUGH

Graduates of The University of Texas Medical Branch at Galveston (UTMB) have fond memories of their days studying on the island and lots of compassion for today’s students. An e-mail request the TMA Foundation sent to all UTMB alumni raised more than $10,000 in just two days to help students who lost books, supplies, clothing, and much more due to Hurricane Ike. That is about the same amount the foundation raised in various other appeals over the previous six weeks. You can donate online for the students or for TMA’s Hurricane Ike Disaster Relief Fund. We are still accepting applications for relief fund grants for practices that incurred uninsured or nonreimbursable property damage and do not have adequate funding to cover the damage.

TEXPAC BACKS HUFFMAN IN SD 17 SPECIAL ELECTION

Republican Joan Huffman earned TEXPAC’s endorsement in the special election for State Senate District 17 to replace former Sen. Kyle Janek, MD (R-Houston), who resigned. Early voting begins today in the Houston-Beaumont-Galveston-area race. Election day is Dec. 16.

TMAIT: COVERAGE YOU CAN COUNT ON

Whether you’re a medical student or a physician about to retire, if you’re a TMA member, you know where to turn for the insurance and financial services you need. The TMA Insurance Trust (TMAIT) offers medical, life, income protection, group overhead, and ancillary insurance to TMA members and their group managers. For insurance and services tailored to the current stage of your medical career, check out TMAIT’s Coverage to Meet Your Changing Needs online, interactive toolkit.

Monday, December 1, 2008

HAPPY THANKSGIVING

I hope the entire TMA family enjoyed the holiday in some special way. Despite hurricanes, tough economic times, and significant stresses on the practice of medicine, we all have so much for which we can be thankful. I know I do, especially the opportunity to serve as your executive vice president and chief executive officer. Doing good, and doing it well, is quite fulfilling.

WHAT DOES WASHINGTON HAVE IN STORE FOR US?

President-Elect Barack Obama, his team, and Democratic leaders in Congress are making plans to move on one of the 2008 campaign's biggest issues: health care reform. What do Mr. Obama, Secretary of Health and Human Services-designate Tom Daschle, Senate Finance Committee Chair Max Baucus (D-Mont.) and others have planned? What would it all mean to patients and their physicians? And what do TMA and organized medicine plan to do to influence the outcome of the debate? To help you stay up to date, we’ve compiled a list of national health care reform resources on the TMA Web site. You can find links to:

  • The Obama plan, including the president-elect’s call for your ideas and suggestions;
  • The Daschle book: Critical: What We Can Do About the Health-Care Crisis;
  • The Baucus Call to Action white paper; and
  • TMA's Texas Medicare Manifesto II.

SAVE THOSE DATES

Grab your 2009 calendar and a big red pen, and be sure to circle these important dates. We need you to be a big part of our fight for patients and physicians in the new year:

  • 2009 TMA Winter Conference: Jan. 30-31, Hyatt Regency Austin
  • First Tuesdays at the Capitol: Feb. 3, March 3, April 7, and May 5. Be a lobbyist for a day and join the “white coat invasion” in Austin.
  • TexMed 2009: May 1-2, Hilton Austin and Austin Convention Center
  • 2009 TMA Fall Conference: Sept. 4-5, Hyatt Regency Austin

PRIMARY CARE ON THE ROPES?

In last week’s EVPGram, I reported on survey results released by the Physicians’ Foundation that depict widespread frustration and concern among primary care physicians nationwide. The December issue of Texas Medicine should land on your desk today or tomorrow with more details on the survey results, the stress on medical practices, and how TMA is working to help physicians of all specialties maintain the viability of their practices. The latest edition of Podcast TMA also explores these themes. Listen in as Texas Medicine associate editor Crystal Conde interviews retired Georgia pediatrician Walker Ray, MD, vice president of the Physicians' Foundation, and Juan Jose Ferreris, MD, a San Antonio pediatrician in a four-person practice.

Monday, November 24, 2008

SURVEY REVEALS PESSIMISM, HARD TIMES

Survey results released by the Physicians’ Foundation depict widespread frustration and concern among primary care physicians nationwide, which could lead to a dramatic decrease in practicing doctors in the near future. Nearly half of those surveyed say that over the next three years they plan to reduce the number of patients they see or stop practicing entirely. The reported reasons for the widespread frustration include increased time dealing with nonclinical paperwork, difficulty receiving reimbursement, and burdensome government regulations. Nearly 12,000 physicians across the country responded to the survey. The Physicians’ Foundation was formed as part of the settlement of state medical societies’ national class-action lawsuit against some of the country’s largest health plans. As foundation president, I hope to use these results to develop policies and programs that can help save private practice and keep physicians in practice.

BOARD ADOPTS 2009 TMA BUDGET

The TMA Board of Trustees approved a $22 million plan and budget for the association. The budget will allow TMA to staunchly represent physicians and patients in 2009, but it holds the line on most new spending. In a quick one-day session, the trustees also:
  • Reviewed TMA’s agenda for the 2009 Texas Legislature;
  • Discussed the health care system reform plans floating from President-Elect Barack Obama and the Democratic majority in Congress; and
  • Received an update on our Hurricane Ike Disaster Relief Fund.

TMA, HOSPITALS SEARCH FOR COMMON GROUND

TMA President Josie Williams, MD, and other TMA leaders met with their counterparts from the Texas Hospital Association. The agenda covered common issues for the upcoming legislative session, including funding for Medicaid and graduate medical education, and defending our 2003 health care liability reforms. Also participating from the TMA board were Drs. Lyle Thorstenson, Bruce Malone, Michael Speer, Austin King, and Joe Cunningham.

AETNA CONTRIBUTES TO RELIEF PROGRAM

Many thanks to Aetna for donating $15,000 for our Hurricane Ike Disaster Relief Fund. We are moving closer to our $1 million goal and have begun approving grants for practices that incurred uninsured or nonreimbursable damage. Physicians may apply for the grants online. We are still accepting donations for the relief fund.

BLUE CROSS BILLING DISPUTE HELP AVAILABLE

As part of the settlement in physicians’ national class action lawsuit against numerous Blue Cross and Blue Shield plans, physicians may submit billing disputes to a new external review board. The board can help resolve billing conflicts after you have exhausted all of the Blue Cross plan’s internal review and appeal processes. Details and all the forms you may need are available from the Physicians Advocacy Institute.

Monday, November 17, 2008

TEXANS’ LIABILITY PLAN ADOPTED

The Texas proposal to ensure that liability protection (PDF) for physicians is equal to what may be offered to drug or medical device manufacturers won unanimous approval from the American Medical Association House of Delegates. “The purpose of the resolution is to make sure that AMA policy is to stand strong for physicians,” said Beaumont orthopedic surgeon David Teuscher, MD, who helped write the resolution in response to two recent U.S. Supreme Court cases. “All we’re asking for is fair and equal treatment, and we’re standing up for the physicians of Texas and the physicians of America.” Meeting in Orlando, the AMA house moved through nearly 130 reports and resolutions in record time, closing its deliberations a day early.

ARENS HONORED BY AMA

A lifetime’s work as a teacher and patient safety advocate earned retired Houston anesthesiologist Jim Arens, MD, the AMA’s Distinguished Service Award. AMA cited his work to “dramatically reduce anesthesia-related mortality” and for his legacy as an educator. Hundreds of Texas anesthesiologists studied at his side. “Mentoring is one of the most important and satisfying rewards in life,” Dr. Arens told the AMA House of Delegates. He served 42 years as a professor and chair of anesthesiology at five premier medical schools, including The University of Texas (UT) Medical Branch at Galveston, the UT M.D. Anderson Cancer Center, and the UT-Houston College of Medicine.

IKE RELIEF FUNDS AVAILABLE

Do you know any physicians who can’t reopen their practice after damage from Hurricane Ike? Point them towards TMA’s Hurricane Ike Disaster Relief Fund. “Grants are available if your practice incurred uninsured or nonreimbursable property damage and you do not have adequate funding to cover the damage,” said Steve Brotherton, MD, speaker of the TMA House of Delegates and chair of the relief fund. The TMA Foundation continues to accept online donations.

HOW DO 12,000 PHYSICIANS SEE THE FUTURE?

How do physicians across the country see the medical practice environment? How do you feel about the state of your profession, and that of the industry at large? What plans do you have for the future of your practice? Do you believe there are enough of you to handle an influx of more patients? The Physicians’ Foundations surveyed 12,000 physicians across the country to answer these and other vital questions. We have a national news conference scheduled for Tuesday to release the findings. Stay tuned.

HARD HATS RECOGNIZED

TMA’s Hard Hats for Little Heads program won the Fan Favorite/Best Campaign Award from the Austin Chapter of the Public Relations Society of America. Since TMA started the program in 1994, physicians and their families have given away 50,000 helmets to Texas children. See the TMA Web site to find out how you can help protect little heads in your community.

DON’T MISS TMA’S 2009 MEDICARE CODING UPDATE

Register online for this first-rate seminar.

Monday, November 10, 2008

TEXPAC PUTS ANOTHER DOCTOR IN THE HOUSE

As part of a bundle of state and federal wins on Election Day, TEXPAC worked hard to turn out the physician and alliance vote for Fort Worth pediatrician Mark Shelton, MD. Dr. Shelton defeated an incumbent Democratic trial lawyer (YouTube video) to win Texas House of Representatives District 97. That makes him and Rep. John Zerwas, MD (R-Richmond), the only two physicians – and TMA members – in the House. The only TMA member in Congress, U.S. Rep. Michael Burgess, MD (R-Lewisville), announced he is running to become chair of the House Republican Policy Committee. All four of TEXPAC’s endorsed statewide candidates (PDF) (U.S. Sen. John Cornyn and three Texas Supreme Court justices) won, as did all but one of the congressional candidates we backed and most of those we supported for the Texas House and Senate. We already have begun personal outreach from physicians to the candidates we did not support so medicine can build strong relationships with these new lawmakers.

TEXANS STANDING UP FOR TEXANS AT AMA

More than 100 Texas physicians, residents, and medical students are representing patients and physicians at the 2008 American Medical Association Interim House of Delegates meeting in Orlando. Hot topics include health care system reform, physician supervision of allied health practitioners, insurance company practices, Medicare payments, physician ownership of health care facilities, tobacco control, and medical homes. Our medical liability resolution has received a strong and positive response so far. We’re going to experiment with live coverage of house debate at 3 pm Central Time today and 8 am Tuesday on Blogged Arteries. Tune in.

HINCHEY PUSHES FOR HEALTH PLAN TRANSPARENCY

In testimony before the Texas Senate State Affairs Committee, TMA Immediate Past President Bill Hinchey, MD, said health plans’ own actions and business tactics are forcing patients to incur greater out-of-pocket costs. Dr. Hinchey urged the committee to hold the plans more accountable for the accuracy of the information they report about their physician networks and to require more transparency in how they calculate “usual and customary charges” for out-of-network services. Health insurance reform – especially business practices that are easier to understand for physicians, patients, and employers – will be a centerpiece of our 2009 agenda at the Texas Legislature.

TMA TO CMS: REFORM THE GPCIS

TMA’s Council on Socioeconomics urged the Centers for Medicare & Medicaid Services (CMS) to adopt more fair and rational methods (PDF) for setting the Geographic Practice Cost Index (GPCI) modifiers to the Medicare physician payment system.

MEDICINE LOSES A LEADER

We mourn the death of AMA Immediate Past President Ron Davis, MD, at age 52, after a valiant battle with pancreatic cancer. He was an incredible antitobacco crusader.

Monday, November 3, 2008

VOTE TOMORROW

If you missed the chance to vote early, I sincerely hope you’ll brave the lines and cast your ballot on Election Day. If you’re in the profession of medicine, you’re in the business of politics. TEXPAC has endorsed promedicine candidates (PDF) for the U.S. Congress, Texas Legislature, and the judiciary. Please encourage your friends, family, colleagues, staff, and patients to vote the party of medicine as well. And Tuesday is your last chance to vote in TMA’s health care presidential straw poll.

TMA’S IKE RELIEF FUND TAKING APPLICATIONS

Did Hurricane Ike do more damage to your practice than you or your insurance can cover? TMA is now accepting applications for our Hurricane Ike Disaster Relief Fund. “The program’s purpose is to reestablish the delivery of medical care to the hardest-hit areas of Texas,” said TMA House Speaker Steve Brotherton, MD, chair of the relief fund.

TEXANS BRING LIABILITY RESOLUTION TO AMA

Courts, Congress, and state legislatures shouldn’t grant pharmaceutical and medical device manufacturers immunity from liability simply because their products were used according to Federal Drug Administration (FDA) guidelines, and TMA says the American Medical Association (AMA) needs to get involved. “Physicians may become not simply the ‘deep pocket,’ but quite likely the ‘only pocket’ against whom patients who are injured by said drugs or devices may seek redress,” says a resolution the Texas Delegation is bringing to the AMA House of Delegates meeting next week in Orlando. The resolution also calls on AMA to support liability protections for “physicians who use FDA-approved devices and pharmaceuticals in a reasonable and prudent manner.” As usual, we will report from the AMA meeting on Blogged Arteries and Twitter.

PERRY NAMES GASTROENTEROLOGIST TO TMB

George Willeford III, MD, of Austin, is the newest member of the Texas Medical Board. Gov. Rick Perry appointed him for a term to end in 2011.

IT’S OFFICIAL; MEDICARE PAYMENTS TO GO UP 1.1 PERCENT NEXT YEAR

Medicare posted the notice of new payment rates for 2009. As part of the big congressional battle we won this summer, payments will rise 1.1 percent – rather than drop the scheduled 5.4 percent. Physicians also can earn bonuses of 2 percent each for using electronic prescribing and for participating in the Physician Quality Reporting Initiative (PQRI). TMA has tools to help you integrate both e-prescribing and PQRI into your practice. But we also have our work cut out for us. If Congress doesn’t rewrite the Medicare financing schema this year, payments rates will plummet by more than 20 percent in 2010. Our updated Texas Medicare Manifesto explains TMA’s principles for fixing this ever-worsening dilemma.

FIRST HCNN SAFETY ALERT SENT

Did you hear about the FDA’s safety alert on fluoroquinolones? You already have received an e-mail if you have signed up for the free Health Care Notification Network through TMA. It will probably take a month or so if you’re waiting for the paper alert to arrive in the mail.

Monday, October 27, 2008

KEEP ON VOTING EARLY

Huge numbers of Texans showed up for early voting last week, just one more sign that the lines will be real long on Election Day. Early voting for the general election runs through Friday. Why not stop at the polls on your way home tonight and cast your ballot for the party of medicine? TEXPAC has endorsed promedicine candidates (PDF) for the U.S. Congress, Texas Legislature, and the judiciary. Please encourage your friends, family, colleagues, staff, and patients to vote the party of medicine as well. Find out where you can vote early in your county.

TEXPAC PUSHING HARD FOR DR. SHELTON

If you live in House District 97, or anywhere else in Tarrant County, you’ve been receiving the cards, e-mails, and letters urging you to support Mark Shelton, MD, in his rematch run for the Texas House. More than 700 physicians and TMA Alliance members live in the already-Republican-leaning district, and their vote can put Dr. Shelton over the top in his race against a doctor-suing trial lawyer. Watch our video on the TEXPAC Web site or YouTube.

EVERY PENNY HELPS

Thanks to the Williamson County Medical Alliance for its $500 contribution to TMA’s Hurricane Ike Relief Fund. Our steering committee, chaired by House Speaker Steve Brotherton, MD, meets this week to finalize the details of our program to help physicians in the declared Hurricane Ike disaster area get their practices back open and begin seeing patients again. If you or your organization wants to help, please contact me, or see the TMA Foundation Web page.

IT’S 51-42, McCAIN

Almost 700 TMA and TMA Alliance members have responded to the TMA health care presidential poll. Please vote in our straw poll AFTER you cast the ballot that counts.

AUSTIN PHYSICIAN AT TMB NO. 2 SPOT

The Texas Medical Board (TMB) named Alan Moore, MD, an Austin pathologist, as interim medical director of the agency. The board also appointed Mari Robinson, JD, interim TMB executive director following the retirement of Donald Patrick, MD, JD. Without a physician in the No. 1 spot at the board, state law requires TMB to hire a medical director.

TMA PUSHES UNITED FOR SYNAGIS COVERAGE CHANGE

Responding to a request from TMA and the Texas Pediatric Society (TPS), United Healthcare changed its policy for covering administration of Synagis to patients at increased risk of complications of respiratory syncytial virus (RSV). United began covering up to five doses, spaced a month apart, in mid-October. Previously, United paid for the drug from the beginning of the national RSV season starting Nov. 1. However, TPS data show the season starts earlier in Texas, primarily because of the state's warmer climate and its size.

EARLY VOTING STARTS TODAY

More Texans than ever have registered to vote this fall, and that means long lines on Election Day. Early voting for the general election begins today. Why not stop at the polls on your way home tonight and cast your ballot for the party of medicine? The Texas Secretary of State’s county elections office list can help you find out where you can vote early in your county. TEXPAC has endorsed promedicine candidates (PDF) for the U.S. Congress, Texas Legislature, and the judiciary. Please encourage your friends, family, colleagues, staff, and patients to vote the party of medicine as well. You can order our little, red judicial slate cards (PDF) from the TEXPAC Web site.

TMA E-RX SUMMIT SECURES JOINT COMMITMENT FOR CHANGE

More than 75 physicians, pharmacists, government officials, and technology vendors gathered at the TMA building for our first E-Prescribing Stakeholder Summit. Led by Joseph Schneider, MD, chair of TMA’s Health Information Technology Committee, the group examined what it will take to move e-prescribing forward in Texas, including needed changes in state and federal laws and regulations. Rules governing prescriptions for controlled substances and the requirement for a handwritten “brand medically necessary” notation on prescriptions are two areas ripe for consideration. Key leaders from all the sectors involved called the inaugural meeting a big success and vowed to bring the group together again.

PROP 12 BRINGS ANOTHER RATE CUT

Medical Protective announced a 6.2-percent rate reduction effective Jan. 1, 2009. It is Med Pro’s sixth rate cut in the past four years and the 25th rate cut by a Texas physician liability carrier since the passage of the 2003 lawsuit reforms. Texas physicians have seen their liability premiums reduced, on average, 27 percent.

TMA MEDICARE SEMINARS BEGIN NEXT MONTH

Medicare is rolling out its usual slew of new regulations next year, and TMA’s annual update seminar series is back to help you keep up with the changes. Our one-day programs, offered statewide, cover new coding and billing rules, the latest enrollment hassles, how to earn your Physician Quality Reporting Initiative (PQRI) bonus in 2009, and the new Medicare recovery audits. While TMA continues to fight for Medicare improvements on Capitol Hill, we are committed to giving you the tools you need to participate in the program effectively.

TMA MEMBER INDUCTED IN TEXAS HALL OF FAME

Gov. and Mrs. Rick Perry inducted Huda Zoghbi, MD, a professor in multiple disciplines at Baylor College of Medicine, into the Texas Women’s Hall of Fame. Dr. Zoghbi was selected for her pioneering research into brain disorders. Congratulations.

J-1 VISAS EXTENDED

President Bush signed a bill extending through March 6, 2009, the Conrad J-1 program, which allows states to request up to 30 visa waivers a year for foreign physicians to work in medically underserved areas.

Monday, October 6, 2008

TEXPAC UNVEILS 2008 SLATE

The TEXPAC Board of Directors has finished compiling our all-star list of endorsements. I wanted to give you, as a leader of Texas medicine, the first chance to download the complete file and our 2008 Election Primer from the TEXPAC Web site (PDF). The roster includes patient - and physician-friendly candidates for the Texas Legislature, U.S. Congress, and the judiciary.

IKE DISASTER FUND GROWS

Thanks to very generous donations of $500,000 from the Physicians' Foundation for Health Systems Excellence and $50,000 from the Texas Medical Liability Trust, we are closer to our $1 million goal for TMA’s Hurricane Ike Disaster Relief Program. We want to help physicians rebuild their practices and begin treating patients again as quickly as possible. If you or your organization wants to help, please contact me, or see the TMA Foundation Web page. We also are working with county societies, alliance chapters, and the TMA Medical Student Section to find housing for relocated residents and students from The University of Texas Medical Branch in Galveston.

PODCAST EXPLORES PRESIDENTIAL HEALTH CARE POLITICS

The cover story in October’s Texas Medicine takes a look at the health system reform proposals of both Democratic nominee Barack Obama and Republican nominee John McCain. In our latest Podcast TMA segment, American Medical Association President-Elect Jim Rohack, MD, and Roland Goertz, MD, a member of the American Academy of Family Physicians Board of Trustees, discuss how the candidates’ health platforms contrast and the prospects for major reform in the next congressional sessions. While you’re listening, cast your vote in the TMA 2008 Presidential Poll, where McCain is now leading Obama 55-38.

MORE ACEP HEROES

Last week’s EVPGram inadvertently omitted listing several other Texans named a Hero of Emergency Medicine by the American College of Emergency Physicians. They include Drs. Diana Fite of Houston, Juan Fitz of Lubbock, Raymond Fowler of Dallas, Robert Levine of Houston, Paul Pepe of Dallas, Ed Racht of Austin, Arlo Weltge of Houston, and James Williams of San Antonio. Their achievements were chronicled as part of the college’s 40th anniversary celebration.

MENTAL HEALTH PARITY NOW LAW

A provision requiring employers and health insurance companies that offer mental health benefits to provide them on par with medical benefits was included in the $700 billion financial rescue package President Bush signed last week. TMA and the AMA have been fighting congressional gridlock over mental health parity for 10 years.

REGISTER TO VOTE TODAY

In case you haven’t done it yet, today is the last day to register to vote for the Nov. 4 election. Here's an easy way to find out if you are still registered, and here’s a list of county election officials. Early voting begins just two weeks from today.

Monday, September 29, 2008

LARGE GROUP LEADERS SHARE LEGISLATIVE PRIORITIES

About 30 physicians and staff from Dallas-area large group practices joined TMA and Dallas County Medical Society staff for TMA’s first Large Group Forum. Led by TMA President Josie Williams, MD, and Council on Legislation member Les Secrest, MD, the meeting was the first of three scheduled across the state to discuss with the groups issues facing medicine next year in both the Texas Legislature and the U.S. Congress. Topping their list are payment issues (Medicare and commercial), protecting our liability caps, and scope of practice concerns. The remaining forums are in San Antonio this week and Houston next week.

MILLION-DOLLAR DISASTER RELIEF FUND LAUNCHED

Thanks to UnitedHealthcare’s generous $100,000 donation, TMA’s Hurricane Ike Disaster Relief Program is underway. As we did following Hurricane Rita in 2005, TMA is putting together a disaster relief program to help physicians rebuild their practices and begin treating patients as quickly as possible. Our goal is to raise $1 million. The TMA Foundation is working to raise funds along with physician and county society donors. If you or your organization want to help out, please contact me, or go to the TMA Foundation’s Web page. The relief program will begin formal outreach to physicians in storm-damaged areas in the next few weeks.

CANCER SOCIETY HONORS SENATOR NELSON

Congratulations to a long-time friend of medicine. Texas State Sen. Jane Nelson (R-Flower Mound) received the National Distinguished Advocacy Award from the American Cancer Society Cancer Action Network (ACS CAN). That’s ACS CAN’s highest honor. It recognizes her “consistent leadership in legislation to reduce the burden of cancer,” including the bill that created the Cancer Prevention and Research Institute of Texas and the constitutional amendment that authorized a $3 billion investment to fund it. Senator Nelson also is receiving the ACS’s highest state advocacy recognition, the True Grit Award, for her work on the institute.

TEXAS SENATORS STAND UP FOR PHYSICIANS

Many thanks to U.S. Sens. Kay Bailey Hutchison and John Cornyn for leading the fight once again to stop Congress from paying for a new program with fictional savings from restrictions on physician ownership in hospitals and other health care facilities. Their actions helped keep such limitations off of the bill that requires mental health coverage parity.

SPECIALTY SOCIETIES RECOGNIZE TEXAS PHYSICIAN LEADERS

Congratulations to a pair of fine TMA-member physicians for these excellent accomplishments:
  • Ronald B. Kuppersmith, MD, MBA, of College Station, has been elected 2008-09 president-elect of the American Academy of Otolaryngology–Head and Neck Surgery; and
  • The American College of Emergency Physicians named Angela Siler Fisher, MD, of Conroe, a “Hero of Emergency Medicine” for her work on involving emergency physicians in organized medicine.

Monday, September 22, 2008

TMA RAISING FUNDS TO HELP IKE-DAMAGED PRACTICES REBUILD, RECONNECT

We continue to survey the damage Hurricane Ike wrought on physician practices in Houston, Galveston, and East Texas. As we did following Hurricane Rita in 2005, TMA is putting together a disaster relief program to help physicians rebuild their practices and begin treating patients as quickly as possible. Along with the Harris and Montgomery county medical societies, we have several assessment surveys in the field. But we know that communication is still spotty in the storm-damaged areas. Please send any information about hurricane-damaged practices, and what help or services they need to reopen, to CJ Bradford in TMA’s Public Health Department. We hope to announce details of the relief program soon. Meanwhile, for insight into what our physicians have seen and done on the ground, please read the “Voices of Ike” feature on the TMA blog. If you have more stories to add, please send them our way.

TEXAS PHYSICIANS TESTIFY ON MEDICAID, CONTROLLED DRUG TRACKING

Because it meets in formal session for only 140 days every other year, the Texas Legislature accomplishes a lot of important work – especially with complex issues – through committee hearings and investigations between sessions. TMA stood strongly for physicians and patients at two such hearings last week:
  • San Antonio pulmonologist John Holcomb, MD, represented TMA at a joint hearing of the Senate Finance and Health and Human Services committees. Dr. Holcomb is chair of TMA’s Select Committee on Medicaid, CHIP, and the Uninsured, which has been doing extensive work of its own lately. He thanked lawmakers for the historic 25- and 10-percent increases they approved last year in physicians’ payments for children’s and adults’ services in the Medicaid program, respectively. But Dr. Holcomb told legislators that TMA continues to seek Medicare parity for Medicaid payments as well as parity among payments for children’s and adults’ services in Medicaid. At that hearing, Medicaid officials said the program is on track to go over budget by $1.2 billion this fiscal year (PDF).
  • Austin anesthesiologist Cathy Scholl, MD, and Fort Worth emergency medicine specialist Jim Cox, MD, testified for TMA at the House Public Health Subcommittee on Access to Controlled Substances. They outlined physicians’ concerns with the state’s new program to collect more information from prescriptions for Schedule II-V controlled substances.

SURVEY FINDS QUALITY-IMPROVEMENT PROGRAMS DO LITTLE FOR A FEW

How many Texas physicians use health plan and government quality-improvement programs, and do they actually improve patient care? Not many and not much, according to a baseline survey we recently completed for TMA President Josie Williams, MD. Of all the programs surveyed, Medicare’s Physician Quality Reporting Initiative showed the greatest participation, at just 30 percent of the 774 responding physicians. Programs physicians implemented as part of Maintenance of Certification requirements for certification renewal were the most effective; 54 percent reported they improved patient care.

Monday, September 15, 2008

TEXAS PHYSICIANS STEP UP TO IKE

I am extremely proud once again of how Texas physicians, TMA, and our county medical societies prepared for and responded to the terrible destruction caused by Hurricane Ike. We continue to monitor the situation in Galveston, Houston, and East Texas and pray that all of our friends there can get back on their feet as quickly as possible. For insight into what our physicians have seen and done on the ground, please see the “Voices of Ike” feature on the TMA blog. If you have more stories to add, please send them our way. Here are some other highlights:
  • TMA and county society staff participated in State Operations Center conference calls throughout the week leading up to Ike’s Saturday morning landfall in Galveston.
  • County societies around the state are helping to provide medical staff for evacuation shelters, which may remain open for another week or longer. Please contact your county society to volunteer, and add your name and information to TMA’s Physicians Rapid Response Team Sign-up Form.
  • TMA gathered and posted useful Ike-related information from state agencies, health plans, and others on our Web site’s Disaster Preparedness Resource Center. We will continue to add updates.
  • The American Medical Association provided access to ICERx, a private, secure online source of available medication history information for patients evacuated from their homes. AMA also dispatched Italo Subbarao, DO, director of AMA’s Public Health Readiness Office, to Austin.

TMA SURVEY FINDS LIABILITY REFORMS BRING MORE CARE, MORE DOCTORS TO TEXANS

Texans now have more physicians offering more care, thanks to the state’s landmark 2003 health care liability reforms, according to the results of a new TMA survey (PDF). Released to mark the fifth anniversary of the passage of Proposition 12, the survey found Texas physicians are providing more services and caring for more patients with complex or high-risk problems. The survey also documented that the improved liability climate is an extremely important factor behind the rush of new physicians to Texas. “It proves once again that the reforms have worked,” said TMA President Josie Williams, MD.

FOUR TEXAS MEDICAL SCHOOLS LAUDED

Four of the top 10 medical schools for Hispanic students are in Texas, says Hispanic Business magazine. The University of Texas Southwestern Medical Center at Dallas, No. 1 on the list, “emphasizes educating doctors who will practice in medically under-served areas of Texas.” The others are The University of Texas Health Science Center at San Antonio (No. 4), The University of Texas Health Science Center at Houston (No. 5), and The University of Texas Medical Branch in Galveston (No. 7). Congratulations, and keep up the good work.

TEXAS CHILDHOOD IMMUNIZATION RATES HIT FIVE-YEAR HIGH

A national study says the Texas rate was 77.3 percent for 2007, up from 65 percent in 2002. We’re now ranked No. 22 in the country. If you want to help continue the momentum, please participate in TMA’s Be Wise – Immunize program.

Monday, September 8, 2008

TEXPAC VOTES TO RESTORE CORNYN ENDORSEMENT

U.S. Sen. John Cornyn got the message when TEXPAC pulled our endorsement for his reelection this summer after he did not vote to prevent the 10.6-percent cut in physicians’ Medicare payments. He subsequently voted for the bill, after hearing from many Texas physicians, and then voted to override President Bush’s veto. This gave medicine breathing room to work for a permanent Medicare payment fix before December 2009, and Senator Cornyn is campaigning on that issue. Our actions earned TMA and TEXPAC positive national publicity and helped to focus attention on the serious problems with the Medicare financing system. After a lengthy and passionate discussion, the TEXPAC Board of Directors voted overwhelmingly and in bipartisan fashion to reinstate our endorsement. Sometimes you fight hardest with those to whom you are closest. We look forward to working with Senator Cornyn to ensure Medicare’s long-term viability.

TMLT CUTS RATES AGAIN

Texas Medical Liability Trust (TMLT) will reduce insurance premiums an average 4.7 percent and provide a 22.5-percent dividend for renewing policyholders, effective Jan. 1. This is TMLT’s sixth straight rate cut since the passage of our 2003 liability reforms. The cumulative savings for Texas physicians from TMLT alone amount to about $380 million. That’s more than all the liability insurance written for physicians each year in the entire state of Pennsylvania. Here’s another sign of the success of Proposition 12: The Texas Medical Board licensed a record 3,621 new physicians this fiscal year; that’s 9 percent more than the previous record of 3,324, set just last year. Texas has licensed 14,499 new physicians since the 2003 liability reforms passed.

WHO’S BETTER ON HEALTH CARE – OBAMA OR MCCAIN?

If you missed the great debate at Fall Conference, you can still read our detailed analysis of the John McCain and Barack Obama health care platforms and how they compare to TMA policy. While you’re at it, take the TMA 2008 Presidential Poll.

BOARD ADOPTS TMA 2015 PLAN

How can TMA make sure we’re ready with the distinctive solutions you’ll need for the challenges you will face in caring for your patients in the next decade? That’s the big question the TMA Board of Trustees wrestled with at a planning session last month and again this past weekend. The board decided that the four broad goals of the TMA 2010 plan remain relevant and appropriate. They rearranged our priority strategies, though, and added some new ones to produce the TMA 2015 document. We will publish it online shortly and ask for your comments and suggestions.

GOODBYE TO A SPECIAL FRIEND

Anyone who knew Louis Gibson, MD, will feel the same sharp pains that struck me when I learned of his passing. He was a wonderful surgeon, the longtime head of the Corsicana Clinic, and an important behind-the-scenes player in Texas medicine when I came to TMA 20 years ago. Dr. Gibson and I made numerous trips to Washington, D.C., together to meet with Texans in Congress and his good friend Sen. Phil Gramm. My most sincere sympathies to his family.

Wednesday, September 3, 2008

TEXAS MEDICINE RALLIES WITH GUSTAV AID

Thank God the amount damage and casualties was much smaller than it could have been, but, like so many others, the family of Texas medicine was ready to do our part for the victims of Hurricane Gustav. I especially want to thank and congratulate the Smith, Bexar, and Travis county medical societies, who helped organize medical teams to care for special needs patients evacuated from Louisiana and the Texas gulf coast. Our partners in Dallas County also were geared up to handle mass evacuations. Many physicians stayed behind to provide emergency care after Jefferson, Orange, and Hardin counties were evacuated. And our TMA staff served as a vital link between the state emergency management operations, our county societies, and local relief efforts. We pray now that everyone returns home safely and begins, once again, to rebuild.

MCCAIN VS. OBAMA AT TMA FALL CONFERENCE

Which candidate’s health care platform will be the best for patients and physicians? The debate takes center stage Saturday at 2008 TMA Fall Conference. U.S. Rep. Michael Burgess, MD (R-Lewisville), a health advisor for the John McCain Campaign, and Erwin Tan, MD, from the Barack Obama Campaign, will face off at the 10 am General Session at the Hyatt Regency Austin. We also have an early morning tort reform session – both practical and political – and the “Damaged Care” musical satire revue at lunch. Take our straw poll.

CATCHING UP ON THE SUMMER NEWS

EVPGram was on vacation the past six weeks, but the leaders and staff of your medical society certainly weren’t. Some news you might have missed:

Monday, July 21, 2008

TMA BACK TO THE LONG-TERM MEDICARE GRIND

The drama of the past five weeks is over. Disaster was averted as Congress quickly and decisively overturned President Bush’s veto of the bill reversing the 10.6-percent cut in physicians’ Medicare payments. But all we’ve really done is bought ourselves 18 months to overhaul the Medicare funding formula. And we’re back to the basics of TMA’s Texas Medicare Manifesto, working with Congress to enact a rational physician payment system that automatically keeps up with the cost of running a practice and is backed by a stable funding source.

THANKING OUR FRIENDS

Angry physicians and worried patients made the difference on Capitol Hill. As TMA and the rest of organized medicine rallied physicians to contact senators and representatives against the president’s veto, AARP mobilized senior citizens to do the same. With that one-two punch, the Senate voted 70-26 and the House voted 383-41 to override the veto. Here’s how Texans voted:

  • U.S. Sens. John Cornyn and Kay Bailey Hutchison voted against the bill the first time it died in the Senate. They then voted for the bill, giving it a veto-proof majority, and voted to override the veto.

  • Republican U.S. Reps. Michael Burgess, MD (R-Lewisville), Ralph Hall (R-Rockwall), Mike McCaul (R-Austin), Ted Poe (R-Humble), and Lamar Smith (R-San Antonio) voted for the bill initially and also voted to override the veto. Democrats taking the same stand were Reps. Henry Cuellar (D-Laredo), Lloyd Doggett (D-Austin), Chet Edwards (D-Waco), Charlie Gonzalez (D-San Antonio), Al Green (D-Houston), Gene Green (D-Houston), and Ruben Hinojosa (D-Mercedes). Also voting “yes” twice were Reps. Sheila Jackson-Lee (D-Houston), Eddie Bernice Johnson (D-Dallas), Nick Lampson (D-Stafford), Solomon Ortiz (D-Corpus Christi), and Ciro Rodriguez (D-San Antonio).

  • U.S. Reps. John Culberson (R-Houston), Kay Granger (R-Fort Worth), Pete Sessions (R-Dallas), and Mac Thornberry (R-Clarendon) all voted against the bill, but then voted to override the veto.

  • U.S. Reps. Louie Gohmert (R-Tyler) and Silvestre Reyes (D-El Paso) missed the first House vote on HR 6331 but didn’t miss the chance to vote to override the president’s veto.

TMB CLEARS UP LICENSE BACKLOG

TMA told the Texas Legislature last year the Texas Medical Board (TMB) needed more staff and technology to process a huge backlog of licenses from physicians who want to practice in Texas. Lawmakers agreed, and last week TMB ratified our faith in its ability. Only 33 applications awaited screening in June, TMB reported, and the oldest was only 14 days old.

CONGRATULATIONS AHEAD OF TIME TO CONNIE

The American Association of Medical Society Executives (AAMSE) gathers this week in Minneapolis for its annual conference. Our own Connie Minogue, TMA’s vice president for marketing, is unopposed to be AAMSE’s president-elect. Way to go!

EVPGram TAKES A SUMMER RECESS

We’ll be back in your inbox and fax tray late next month.

Monday, July 14, 2008

TMA READY FOR MEDICARE VETO PEN

The bill that reverses the 10.6-percent cut in physicians’ Medicare payments moved through the U.S. Senate dramatically. Now we’re waiting for President Bush’s expected veto, as the White House promised shortly after the bill passed. We are very pleased that Sens. John Cornyn and Kay Bailey Hutchison joined seven other GOP senators in switching votes to support the bill. “Texas physicians want to commend the courage and wisdom of both [of our senators], who voted for their constituents – our patients – today,” said TMA President Josie Williams, MD. “We cannot thank them enough.” Senators Hutchison and Cornyn both said they will vote to override a presidential veto when that comes, and we really appreciate that. U.S. Rep. John Culberson (R-Houston), who originally voted against the bill, also said he will vote to override. TMA will send members an alert to spur calls and e-mails to our congressional delegation as soon as the president vetoes the bill. We will not only ask that they vote to override a veto but also encourage them to begin work on a long-term solution to the Medicare payment problem. Despite the confusion, we urge physicians to continue to submit Medicare claims on time.

THANK YOU, THANK YOU, THANK YOU

Senators Cornyn and Hutchison definitely heard TMA’s message on the Medicare bill loud and clear. TMA worked with our county societies to arrange dozens of solid stories in Texas and national news media. More important, TMA members flooded the senators’ phone lines and e-mail boxes with personal messages. Thank you for explaining to them why you were so upset at the prospect of the payment cut. Over the past 30 days, each of the senators received more than 1,400 e-mails and more than 400 phone calls from Texas physicians through the TMA and American Medical Association Grassroots Action Centers. Thank you for taking the time to engage in this critical political process. This is an important part of what makes TMA so effective.

FAREWELL TO A TEXAS LION OF MEDICINE

We join physicians and patients from around the world in mourning the death of the great Houston cardiac surgeon, Michael DeBakey, MD. TMA and many other Houston physicians are paying tribute to the 99-year-old father of modern cardiovascular surgery at events today. We are very proud that he chose to be a TMA member for so many years.

DALLAS RADIOLOGIST EARNS POST

Congratulations to Cynthia Sherry, MD, chair of radiology at Presbyterian Hospital of Dallas and president of the Texas Radiological Society, who was elected president of the American College of Physician Executives (ACPE).

BECOME YOUR OWN PAYMENT ADVOCATE

Under pressure to make sure your practice revenues keep up with expenses? You’re not alone. Sign up for TMA’s latest practice management seminar series. Learn how to resolve prompt pay issues including denials and refund requests, and pick up strategies to assess, challenge, and improve health plan ratings of your practice.

Monday, July 7, 2008

CONGRESS IS BACK; WHERE’S THE MEDICARE FIX?

Our senators and representatives are back in Washington today after the July 4 recess. It’s time for them to put away the holiday picnic fixings and get to work immediately fixing the Medicare payment system for physicians. TMA leaders are arranging meetings with U.S. Sens. John Cornyn and Kay Bailey Hutchison, whose votes allowed the 10.6-percent cut in Medicare payments to become official on July 1. In the meantime, please use the TMA Grassroots Action Center to contact our senators and send this vital, two-part message:
  • Make it your No.1 priority to pass legislation that will reverse the cuts before they further limit access to physicians for elderly patients on Medicare and Texans with disabilities; and
  • Begin work right away on a bill that will permanently fix the Medicare payment system, such as Senator Cornyn's S 2729, so that it can obtain the bipartisan support it needs to pass.

This weekend’s Houston Chronicle published an excellent article explaining the pending access crisis in Texas, and The New York Times had a great editorial urging Congress to take quick action.

WHAT DOES THE CUT MEAN?

Federal officials say Medicare will hold all physicians’ claims for the first 10 business days of July to give Congress time to reverse the 10.6-percent cut in payments. (For details, see the question-and-answer document from the Centers for Medicare & Medicaid Services [CMS].) Because of the July 4 holiday, that hold will run through July 15. TMA calculates that for Texas physicians treating Medicare patients, the hold involves $20 million a day, or $5,000 per physician over the 10-day period. CMS tells us this will cover 125,000 to 150,000 claims. We have published the new Medicare payment schedules on the TMA Web site, and also have information on physicians’ Medicare participation options (PDF). If Congress doesn’t act to reverse this debacle, the American Medical Association says, it will cost Texas $860 million through the end of 2009, an average of $18,000 per physician. That will affect more than 3.5 million Texas Medicare patients and military dependants on TRICARE.

OBAMA VS. McCAIN – SAVE THE DATE

What will the presidential contest mean for health care in America? Come to the TMA 2008 Fall Conference for the answer, an in-depth look at protecting Texas health care liability reforms, and a musical comedy about “Damaged Care” in America. The meeting is Saturday, Sept. 6, at the Hyatt Regency Austin. TMA business meetings begin on Friday, Sept. 5. Online registration for the conference opens next week. Make plans to be there.

EVPGRAM HAS ITS OWN BLOG

Read EVPGram articles anytime on our blog. It’s one of many TMA ventures into new communications media, including Blogged Arteries, RSS feeds, Facebook pages for residents and young physicians, Podcast TMA, even Twitter. Check ’em out.

Monday, June 30, 2008

TMA REACTS STRONGLY TO STALLED MEDICARE PAYMENT BILL

Hundreds of angry Texas physicians clogged the phone lines and e-mail boxes in the offices of U.S. Sens. John Cornyn and Kay Bailey Hutchison to complain about the senators’ votes against a bill to forestall tomorrow’s 10.6-percent cut in physicians’ Medicare payments. The bill failed by one vote, and Congress promptly left Washington for the July 4 recess. “Texas physicians are deeply offended that [the senators] chose to protect insurance companies’ profits instead of protecting our patients’ health,” TMA President Josie Williams, MD, said. In a show of no confidence for Senator Cornyn, the TEXPAC Executive Committee voted unanimously to withdraw our endorsement for his reelection. “There is talk and then there is action,” said TEXPAC Board Chair Manny Acosta, MD. “We expect our elected officials to show leadership and do the right thing. Absent that, TEXPAC has rescinded our endorsement of your candidacy.” Our strong words and actions earned TMA and TEXPAC positive coverage in the New York Times and media outlets across Texas. They also brought a phone call from Senator Cornyn to Dr. Williams explaining his vote. The American Medical Association joined TMA and state and specialty medical societies around the nation in protesting the Senate’s lack of action."

THANKING OUR FRIENDS

Two days before the debacle in the Senate, the U.S. House voted overwhelmingly for the bill that would have averted the Medicare cuts. Republican U.S. Reps. Michael Burgess, MD (R-Lewisville), Ralph Hall (R-Rockwall), Mike McCaul (R-Austin), Ted Poe (R-Humble), and Lamar Smith (R-San Antonio) withstood party and White House pressure to stand instead with physicians and patients.

Democrats voting for the bill were Reps. Henry Cuellar (D-Laredo), Lloyd Doggett (D-Austin), Chet Edwards (D-Waco), Charlie Gonzalez (D-San Antonio), Al Green (D-Houston), Gene Green (D-Houston), and Ruben Hinojosa (D-Mercedes). Also voting “yes” were Reps. Sheila Jackson-Lee (D-Houston), Eddie Bernice Johnson (D-Dallas), Nick Lampson (D-Stafford), Solomon Ortiz (D-Corpus Christi), and Ciro Rodriguez (D-San Antonio). Please thank them."

WHAT’S NEXT?

Frankly, we’re not 100-percent sure. There’s a chance the dead Senate bill could come back up after the July 4 recess. We will join AMA and others in working with our entire delegation in Congress, including both of our senators, to seek a quick resolution. I encourage all Texas physicians to contact their senators and representative to urge them to fix the problem before it further affects patient care. We will, of course, continue to press for a long-term solution to the Medicare payment crisis, as outlined in TMA’s Texas Medicare Manifesto. For physicians, the outlook is also murky:
  • By law, claims are not paid for 14 days after receipt, so there is a short opportunity for carriers to hold up processing in the hope that Congress acts quickly to avert the cuts retroactive to July 1.
  • Physicians can opt out of Medicare for two full years (PDF); however, there is no opportunity at this point for physicians to switch their Medicare status to “nonparticipating.”"

Monday, June 23, 2008

CALL HOUSE TODAY ON MEDICARE PAYMENT BILL

With just one week left until the 10.6-percent cuts in physicians’ Medicare payments take effect, the U.S. House of Representatives is taking its shot at averting the cuts. Tomorrow, the House should consider H.R. 6331, which would continue current payment rates through the end of the year and add a 1.1-percent increase for 2009. The strategy requires a two-thirds vote of the House for the bill to pass. Please use the American Medical Association’s toll-free Grassroots Hotline at (800) 833-6354 to call your U.S. representative today and urge a “yes” vote on H.R. 6331. Negotiations continue among Senate Democrats, their Republican peers, and the White House on a bill that can pass and avoid a presidential veto. A Senate vote may come later this week, so be prepared for another call to action aimed at our U.S. senators.

BORDER PHYSICIANS HEAD NORTH TO WASHINGTON

Physicians from McAllen to El Paso join their colleagues from other border states on Capitol Hill today for a three-day lobby trip to engage Congress on border health issues. The well-timed visit gives the Border Health Caucus the opportunity to talk directly about the Medicare funding crisis. Tomorrow’s third annual Border Health Conference will cover adequate funding for Medicare and Medicaid, support for physician training, ensuring quality health care for border patients, and proper preparedness for disasters and infectious epidemics.

AMA HOUSE MOVES QUICKLY, ADOPTS TEXAS PROPOSALS

The 2008 annual meeting of the American Medical Association House of Delegates completed its business and closed up shop a day ahead of schedule, something even long-time delegates said they had never seen happen before. The house calmly considered and debated new AMA policies and elected a new slate of leaders. Highlights:

WHAT’S IMPORTANT TO YOU?

We are preparing materials now for the TMA Board of Trustees’ biennial strategic planning session. We need your input. Let me know what issues are critical for you and your practice and where you would like to see TMA focus during the 2009 Texas Legislature.

Monday, June 16, 2008

MEDICARE FIX STILL BREATHING

It was, and still is, our best bet to stop the 10.6-percent cut in physicians’ Medicare payment scheduled for July 1. But severe partisan politics in Washington prevented the U.S. Senate from moving forward with Senate Bill 3101. A vote to take up the measure failed (54 to 39), short of the three-fifths majority needed to stop debate and take action on it. “Watching Congress work its will is, more often than not, frustrating and mind-boggling when you are faced daily with the challenges of caring for your patients,” said TMA President Josie Williams, MD. The bill would have maintained current Medicare payment rates for the rest of the year, and add a 1.1-percent increase in 2009, a 2-percent bonus for e-prescribing in 2009 and 2010, and a 2-percent bonus for reporting Physician Quality Reporting Initiative measures in 2009 and 2010. The biggest stumbling block was that S 3101 would have cut Medicare Advantage plans to pay for increasing physicians’ payments. President Bush says he will veto any bill that takes money from the Medicare Advantage plans. Senate Democratic and Republican leadership have begun negotiating a bipartisan compromise that can pass muster with the White House. “We will continue to keep you apprised of progress as it occurs and will ask for your action only when it’s critical to moving the bill along,” Dr. Williams said.

TEXANS ON A WINNING STREAK AT AMA

What a great weekend in Chicago for TMA physicians. The big news is that Jim Rohack, MD, won an uncontested race to be president-elect of the American Medical Association. Dr. Rohack, a cardiologist from Temple, will be installed as the 164th AMA president next June. Under his leadership, Dr. Rohack pledged, AMA will be 'clear, focused, and forceful' in advocating on behalf of American physicians and their patients. In other AMA election news:

  • Fort Worth’s Sue Rudd Bailey, MD, won reelection to the AMA Council on Medical Education.
  • Dawn Buckingham, MD, of Austin, is chair-elect of the AMA Young Physicians Section.
  • Jayesh Shah, MD, of San Antonio, is vice chair of the AMA International Medical Graduate Section.
  • Reid Orth, a medical student from The University of Texas (UT) Health Science Center at San Antonio won reelection as vice chair of the AMA Medical Student Section (MSS).
  • Spencer Pruitt, a medical student from UT Health Science Center at Houston, is the new chair of AMA MSS Region 3.

Follow all the AMA action this week, including the fate of Texas’ three resolutions, in Blogged Arteries.

UT-HOUSTON MED STUDENTS HONORED

Congratulations to the medical students of The University of Texas-Houston in general and Spencer Pruitt in particular. The AMA MSS named UT-Houston the Chapter of the Year, and Spencer received the section’s 2008 Leadership and Excellence Award.

Monday, June 9, 2008

CONGRESS BUILDING A BIGGER MEDICARE BAND-AID?

As usual, it takes a deadline with a big cut in physicians’ Medicare payments for Congress to act. This time, it’s the 10.6-percent cut scheduled for July 1. TMA is very engaged in the debate, and we’re working with all of our allies in Washington to stop the cut and find a way to stop this annual circus. A TMA team of physicians and county society executives will be in Washington June 23 for our annual Border Health Conference. It’s a highly charged and partisan atmosphere, but there is some movement in our direction. And thanks to Texas physicians’ hard work, most of the Texas congressional delegation supports a bigger Band-Aid than we’ve seen in recent years, and they want a permanent Medicare fix. Here’s where we are so far:

  • The most recent plan we’ve seen from Senate Finance Committee Chair Max Baucus (D-Montana) would stop the cut and institute a 1.1-percent increase for the rest of this year and all of 2009.
  • That would give Congress 18 months to devise a long-term replacement for the sustainable growth rate (SGR) financing formula. It also sets up a very steep cliffhanger: The cost of the 18-month delay would require a cut in physician Medicare payments of 20 percent or more in 2010.
  • That cut is even more incentive to replace the SGR with a system that keeps up with the cost of running a practice. The best permanent fix bills have come from Texans: Sen. John Cornyn and Rep. Michael Burgess, MD (R-Lewisville).
  • Financing the 18-month stopgap also includes money set aside to increase payments to Medicare Advantage plans. President Bush has threatened to veto any bill that cuts on Medicare Advantage.

CARROTS AND STICKS FIND A HOME IN MEDICARE BILL

Most versions of the Medicare fix bills we’ve seen would increase the bonus for the Physician Quality Reporting Initiative (PQRI) from the current 1.5 percent up to 2 percent of your allowed charges. Most of the bills also would give physicians a 2-percent bonus for using electronic prescribing. But that carrot would turn into a 1-percent penalty by 2011 for physicians who don’t e-prescribe.

WE MADE A BAD TAX BETTER

June 15 is the deadline for paying the new state business tax, and I’m sure you’re hearing grumbling from physicians who’ve never had to pay this tax before. Remind your colleagues that TMA fought at the Texas Legislature to make sure physicians could exclude payments from Medicare, Medicaid, and other government health programs from their taxable revenue. You also can deduct the costs of uncompensated care. And we worked overtime with Comptroller Susan Combs’ office to make sure the tax rules preserved those important protections for physicians and patients.

PODCAST TMA: “RUN, JIM, RUN”

Check out our interview with Jim Rohack, MD, the former TMA president running for American Medical Association president-elect at the AMA House of Delegates meeting, June 14-18. We won’t have an EVPGram next week, but we’ll blog about all the action.

Monday, June 2, 2008

TMA TESTIFIES FOR PATIENTS AND PHYSICIANS

The Texas Legislature meets in regular session for only 140 days every odd-numbered year. But House and Senate committees get much work done between sessions, and TMA is there to provide health care guidance along the way. Just last month:

  • Charlotte Smith, MD, of Austin, told the Senate State Affairs Committee why TMA strongly opposes physician-ranking schemes that are based on faulty data.
  • Suzanne Madden of the Verden Group testified before the State Affairs Committee on behalf of TMA. She shared data (PDF) showing how health plans hide how they spend insurance premium dollars.
  • Former TMA President Ladon Homer, MD, told two Senate committees why state support for graduate medical education is critical for Texas to have enough physicians to care for our growing population.

NPI-ONLY RULE CREATING HAVOC ON CLAIMS

Since the May 23 deadline to submit Medicare and Medicaid claims with National Provider Identifiers (NPIs) only – no legacy numbers – state and federal officials are reporting a large number of physicians’ claims are being rejected. See this week’s Action newsletter for details. Having NPI-related claims problems? E-mail the TMA Knowledge Center, call (800) 880-7955 or (512) 370-1550 for assistance, or visit TMA's online NPI Resource Center.

THE TRIAL LAWYERS ARE COMING

See for yourself.

TEXAS SENDING TWO CANDIDATES, THREE RESOLUTIONS TO AMA

A pair of Texas physician leaders is running, so far unopposed, for office at this month’s meeting of the American Medical Association House of Delegates. Jim Rohack, MD, a former TMA president, is running for AMA president-elect, and Texas Delegation Chair Sue Rudd Bailey, MD, is seeking reelection to the AMA Council on Medical Education. The meeting is June 14-18 in Chicago. We’ll blog about all the action. We’re also taking three resolutions that the TMA House of Delegates passed in May. They would:
  • Ask AMA to help physicians move toward e-prescribing, such as by winning approval to remove the requirement that physicians handwrite “brand medically necessary” on Medicaid prescriptions.
  • Urge Congress to increase penalties for using health savings accounts for nonmedical purposes.
  • Have AMA hold all its meetings at completely smoke-free facilities, “within all reasonable means.”

AETNA TO CONTINUE SETTLMENT TERMS

Although the five-year term of its settlement with organized medicine expires today, Aetna has agreed to maintain most of the business practice changes it implemented because of the settlement. We urge you to file any problems with Aetna — or any other health plan — through our Hassle Factor Log.

Tuesday, May 27, 2008

HONORING OUR VETERANS

I hope you enjoyed a restful Memorial Day weekend. I’m sure many of you spent time in your offices, emergency rooms, and hospitals. Thanks for your dedication.

WILLIAMS HOSTS “ME & MY DOCTOR” LISTENING SESSION

Nearly 100 physicians and patients came together at a town hall meeting in Wichita Falls as part of our Me and My Doctor: We Know Best campaign. TMA President Josie Williams, MD, and Wichita County Medical Society President Gary Ozier, MD, served as hosts to a crowd concerned about preserving their access to the physicians of their choice. 'You need to help us help you,' Dr. Williams said. 'I honestly believe we can work together.' State Rep. David Farabee (D-Wichita Falls) and staffers for several other legislators also joined the event. The purpose of the multimedia campaign is to rally physicians and patients to wrest control of medical decision making away from outside interests.

TMA WINS THE BATTLE OF THE ANKLE, AGAIN

The Third Court of Appeals left the podiatrists with no leg to stand on in their ongoing battle to expand their scope of practice. Two months ago, the court ruled that the Texas State Board of Podiatric Medical Examiners was wrong when it adopted a rule that expanded the definition of the foot to include the bones in the ankle. At that time, it directed a lower court to rehear the case. The podiatry board and the Texas Podiatric Medical Association asked the appeals court to take a second look, and the court came back with an even stronger ruling. TMA and the Texas Orthopaedic Association will continue to fight for patient safety in this case, which likely will go next to the Supreme Court of Texas.

TMB OPENS WINDOW ON LICENSING

At TMA’s strong urging, the Texas Medical Board (TMB) activated an online system that allows physicians to monitor the progress of their medical license application. The License Inquiry System of Texas (LIST) not only gives physicians a quick look at their status but also should free TMB staff from answering those questions over the phone and let them focus on processing applications. TMB President Roberta Kalafut, MD, also announced a series of town hall meetings across the state this summer. “We want to encourage a more active dialogue with doctors and with the public,” she said. Look for more details in the June 1 issue of TMA’s Action newsletter.

TMA HELPS YOU COMPARE THE CANDIDATES

Where do Sens. Hillary Clinton, John McCain, and Barrack Obama stand on health care reform, Medicare and Medicaid, pay for performance, and other critical issues? Check out TMA’s side-by-side comparison of the candidates’ positions.

ARE YOU GETTING RIPPED OFF FROM THE INSIDE?

The newest Podcast TMA sheds some light on embezzlement: how to prevent it and how to treat it if it shows up in your practice. This and other practice operations problems are covered in our free e-book, TMA Practice E-Tips Greatest Hits, Vol. 1.

ARE YOU GETTING RIPPED OFF FROM THE INSIDE?

The newest Podcast TMA sheds some light on embezzlement: how to prevent it and how to treat it if it shows up in your practice. This and other practice operations problems are covered in our free e-book, TMA Practice E-Tips Greatest Hits, Vol. 1.

Monday, May 19, 2008

TORT REFORMS UNDER ATTACK; TIME TO RIDE TO THE RESCUE

Texas trial lawyers, their cronies at The University of Texas law school, and front groups like Texas Watch are firing broadsides at our 2003 medical liability reforms. They say the reforms weren’t needed, aren’t working, and are bad for Texans. TMA and our liability reform allies are gathering the data and building the political muscle to protect Proposition 12. (Don’t miss the excellent article in Saturday’s Wall Street Journal.) But we need your help. We need your success stories. Tell us about new physicians who’ve come to Texas because of the reforms and made a difference in your community. Tell us how your patients have benefited.

ANOTHER ATTACK ON PHYSICIAN OWNERSHIP SURFACES

This time Congress is thinking of attaching limits on physician ownership to a bill to fund the Iraq War. The Senate Finance Committee approved a supplemental appropriations bill that would starkly limit physicians’ ability to buy into hospitals and other facilities in the future. It would grandfather existing owners, but the details are not clear. The House passed a very different version of the bill, which likely will draw a presidential veto.

TMA PANEL FINDS BLUE CROSS COST RATINGS “DECEPTIVE AND INVALID”

TMA President Josie Williams, MD, called on Blue Cross and Blue Shield of Texas to stop using its risk-adjusted cost index (RACI) to evaluate physicians in its BlueChoice Solutions program. Dr. Williams’ letter is based on a strongly worded report from a TMA ad hoc committee that found RACI is so problem-ridden as to be “deceptive and invalid” for measuring how cost-efficient a network physician is. RACI is based on extremely flawed claims data, such as holding physicians responsible for patients they’ve never seen.

FOLLOW THE MONEY

Health insurance companies are not only putting it to your practices, but they’re also hitting the small employers that pay the way. Since many physicians’ practices are small businesses, they’ve got you coming and going. As employers pay more and more for health insurance, the health plans pay less and less for health care services. To improve relationships with small business, TMA has developed and promoted a tool to help them determine how much of their premium dollars actually go toward health care. It can help your practice, too.

RAND STUDY FINDS MORE RATINGS PROBLEMS

The Physicians Advocacy Institute sponsored a workshop that featured some soon-to-be published research into the failings of the health plans’ physician rating systems. Consistent with our research, the findings from the RAND Corp. study show significant problems with the ratings scales and the data they depend on. The lead researcher said the demand for accountability and consumer-directed care will only grow stronger. She challenged medicine to offer alternatives for measuring how physicians deliver high-quality, affordable health care.

Wednesday, May 14, 2008

Monday, May 12, 2008

DEWHURST STANDS STRONG FOR LIABILITY REFORMS

The annual Texas Alliance for Patient Access (TAPA) membership meeting focused on the challenges to our 2003 liability reforms that we expect to come in the 2009 Texas Legislature. Lt. Gov. David Dewhurst told TAPA members he remains a firm supporter. “We're in good shape in Texas because of your efforts,” he said. “When our only goal is putting Texas first and we work together, we can solve anything.”

OPPONENTS REVEAL PLANS TO WEAKEN CAPS

Texas trial lawyers laid out their antitort reform agenda to the Texas Senate State Affairs Committee. In addition to taking another shot at relaxing liability protections for emergency medical care, the plaintiffs bar told the committee that they want to:

  • Increase the $250,000 cap on noneconomic damages for physicians in a liability case,

  • Tie the level of the cap to inflation,

  • Have the cap apply to each defendant in a case, and

  • Require physicians to carry minimum levels of liability insurance coverage.


TMA, TAPA, and our allies are committed to holding the line on our 2003 reforms, which have boosted patients’ access to high-quality health care and drastically reduced physicians’ liability premiums.

TMA TO CONGRESS: STOP PRETENDING OWNERSHIP LIMITS SAVE MONEY

TMA President Josie Williams, MD, sent a sharply worded letter to key Texans in Washington. Dr. Williams asked them to, once again, prevent the hospital lobby from putting into law Stark limits on physician ownership of health care facilities under the guise of saving Medicare costs for the government. “We urge you not to allow this provision to become part of the Supplemental Appropriations Bill or any other legislation,” she wrote. “This is neither a Republican nor a Democratic issue; rather it is an issue of immense importance to Texas physicians and our patients. It is key to the future viability of our health care systems.”

QUALITY TEXAS CITES TMA FOR EXCELLENCE

TMA is making great progress in improving our operations. The Quality Texas Foundation says we have “well-deployed, effective, systematic approaches to organizational management, with good performance levels and trends evaluated against industry standards.” We are waiting for the foundation’s comprehensive report on how we can improve.

E-TIPS GREATEST HITS FOCUSES ON IMPROVING PRACTICE OPERATIONS

For more than eight years, TMA has offered practice management advice to physicians and office managers through our semimonthly TMA Practice E-Tips. Now we’re culling some of our best tips into a series of free “greatest hits” e-books. Our first, on practice operations issues such as personnel problems and how to deal with angry patients, is out on the Internet now (PDF). Watch for an accompanying Podcast TMA segment soon.

Monday, May 5, 2008

WILLIAMS INSTALLED AS 143RD TMA PRESIDENT

A nationally known expert on measuring and improving the quality of medical care is the new president of TMA. Josie Williams, MD, took the oath of office at TexMed 2008 in a room packed with family and friends. She pledged to lead TMA and Texas physicians in a movement to transform medicine. “There is no way to do it the way we’ve always done it,” Dr. Williams said. “We cannot attempt to deliver 2009 medicine in a 1950 chassis. It’s like trying to launch the space shuttle into orbit on the backs of the Kitty Hawk.” Dr. Williams is the fourth female president of TMA, and the first since Betty Stephenson, MD, of Houston, in 1994.

HOUSE PICKS FLEMING

The TMA House of Delegates rewarded its speaker with a promotion, unanimously selecting Houston neurologist Bill Fleming, MD, as president-elect of TMA. Dr. Fleming will take office at TexMed 2009 in Austin. In other elections:

  • The house promoted Vice Speaker Steve Brotherton, MD, to speaker of the house. The new vice speaker is Austin psychiatrist Clifford Moy, MD.

  • Delegates re-elected TMA Secretary-Treasurer Art Klawitter, MD, and Board of Trustees members Carolyn Evans, MD; Carlos Cardenas, MD; and Austin King, MD.

  • The Board of Trustees chose Nacogdoches ophthalmologist Lyle Thorstenson, MD, as its new chair. Michael Speer, MD, is the new vice chair; Dr. King remains as secretary; and Drs. Evans and Cardenas round out the members of the board’s executive committee.

HOUSE TACKLES MEDICINE’S PRIORITIES

The TMA House of Delegates efficiently dispatched an immense agenda at TexMed 2008 in San Antonio. Among its actions, the house:

  • Adopted private- and public-sector strategies for TMA to pursue to reduce the number of uninsured Texans;

  • Recommended that TMA work closely with the Texas Attorney General on issues such as health payment plan programs that rate physicians and the underpayment of noncontracted physicians;

  • Approved several recommendations to address emergency department overcrowding;

  • Adopted policy on evidence-based medicine;

  • Voted to support the addition of cystic fibrosis to the panel of tests for newborn screening;

  • Supported efforts to expand and promote state student loan repayment programs; and

  • Replaced TMA’s policy on gun control with one that focuses on responsible gun use.

HUTCHISON AND LEGISLATOR-DOCTORS IN THE HOUSE

U.S. Sen. Kay Bailey Hutchison, cosponsor of the Save Medicare Act of 2008, led an all-star cast of elected officials who addressed the TMA house. Senator Hutchison’s bill would stop the 10.6-percent cut in physicians’ Medicare payments scheduled for July 1 and provide a 1.8-percent hike for next year, buying time for Congress to enact a permanent fix to the flawed Medicare payment formula. “I really hope that we can do something that eases your pain and makes sure that none of you has to turn away any Medicare patients,” she said. U.S. Rep. Michael Burgess, MD (R-Lewisville), who is carrying a bill to peg Medicare payments to the cost of running a medical practice, also spoke to the House of Delegates, as did State Sens. Bob Deuell, MD (R-Greenville), and Kyle Janek, MD (R-Houston).

HEARN IS FIRST MALE PRESIDENT OF TMA ALLIANCE

Wichita Falls businessman Patrick Hearn is the 91st president of the TMA Alliance, succeeding the irrepressible Mia Price of Denton. “I’m honored to follow in the footsteps of some extraordinary women, who have set the bar high,” Mr. Hearn said. The alliance chose D’Anna Wick of Tyler as president-elect.

PAST, PRESENT, FUTURE LEADERS NAB AWARDS

As we reported in last week’s EVPGram, Houston family physician Max Butler, MD, the former TMA president, received the TMA Distinguished Service Award. His old friend Cliff Burross, MD, made the presentation. In other awards:

  • Bohn Allen, MD, won the Young Physician Section’s Young at Heart award. Brandy Landon, a prospective physician from Honey Grove, Texas, received the Michael O’Malley, MD, Memorial Scholarship. The award helps rural high school seniors pursue a degree in medicine.

  • The Resident and Fellow Section named El Paso obstetrician William Sullivan, MD, the winner of the J.T. Lamar” McNew, MD, Award for mentoring.

  • Dennis Dove, MD, of Amarillo, chair of the TMA Council on Medical Education, received the C. Frank Webber, MD, award from the Medical Student Section. The students also named the University of North Texas Health Science Center (UNTHSC) the Chapter of the Year and UNTHSC student Travis Bias the Student of the Year.

THREE TEACHERS WIN BUTLER PRIZE

Three outstanding Texas science teachers won the 2008 TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching. The awards honor teachers who share their energy and enthusiasm for science through creative and innovative methods. This year’s winners are Bradley Neu of Lubbock High School in Lubbock, Jill Bailer of Jane Long Middle School in Houston, and Michelle Yates, formerly of Bess Race Elementary School in Crowley.

TMA, FOUNDATION AWARD MINORITY SCHOLARSHIPS

Eight minority Texas college students entering medical school each received a $5,000 scholarship at TexMed 2008. Since 1999, TMA has awarded scholarships to encourage outstanding minority students to enter medicine and help meet the medical needs of Texas’ diverse population. To date, TMA has awarded 38 scholarships, totaling $190,000. Generous physicians, county medical societies, and corporate donors finance the scholarships through the TMA Foundation.

Monday, April 28, 2008

SEE YOU AT TEXMED 2008

TMA’s annual meeting starts Thursday in San Antonio and runs through Saturday. TexMed 2008 has much to offer: a Pulitzer-Prize-winning general session speaker; a record number of action items on the House of Delegates’ agenda; the TMA Foundation’s Gala: Night on the Mexican Riviera; more than 100 hours of free continuing medical education; a packed Expo Hall; the installation of new TMA President Josie Williams, MD, and TMA Alliance President Patrick Hearn; the unveiling of MedLink TV, the new, free, 40-inch, flat-screen member benefit from TMA; and much more. I hope to see you there. If you can’t make it, next week’s EVPGram will have all the highlights.

THE DISTINGUISHED DR. BUTLER

Congratulations to Max C. Butler, MD, who will receive the TMA Distinguished Service Award at TexMed 2008. A Houston family physician for almost 50 years, Dr. Butler has dedicated his career to serving his patients and furthering the work of organized medicine. His service to medicine has included the TMA presidency in 1989-90 and helping to establish the TMA Foundation, as chair of the state steering committee for the Legacy of Caring Campaign.

STATE OFFERS BUSINESS TAX EXTENSION

Comptroller Susan Combs announced that Texas businesses, including many physician practices, have an additional 30 days to pay the new state business tax. The deadline is now June 15. TMA fought hard to make sure that the new tax excludes payments from government health plans and allows physicians to take allowances for the cost of charity care. We also worked with Comptroller Combs’ office to make the tax as fair as possible to physicians.

SANCHEZ NEW BLUE CROSS MEDICAL DIRECTOR

Former Texas Commissioner of Health Eduardo Sanchez, MD, will be vice president and chief medical officer of Blue Cross and Blue Shield of Texas, effective May 30. TMA enjoyed an excellent working relationship with Dr. Sanchez when he led the Department of State Health Services, and we hope to continue that in his new position.

Monday, April 21, 2008

CORRECTION REGARDING TMB AND FINGERPRINTS

Today's EVPGram contained some misleading information regarding the Texas Medical Board (TMB) requirement for physician fingerprints as part of the licensing process. The TMB started taking fingerprints from applicants on Oct. 1, 2007. The board continues to require fingerprints of all physicians who had a new application pending on Oct. 1 or who have submitted a new application since that date. The TMB is not yet requiring fingerprints of current licensees. The board plans to start capturing that information in the not-too-distant future, but that requirement is estimated to be at least two months away.

MEDICINE BESTS HOSPITAL ASSOCIATION IN LATEST DC SHOWDOWN

One of the (many) reasons Austin is better than Washington, D.C., is a little rule in the Texas Legislature that requires amendments to bills to have at least something in common with the bill itself. Congress has no such requirement. That explains why the American Hospital Association (AHA) keeps trying to slap restrictions on physician ownership willy-nilly on every piece of legislation that looks like it actually might pass. The 2008 Farm Bill was the
latest vehicle for such chicanery, but TMA, the American Medical Association, and others mounted the political muscle to remove the amendment. We really appreciate the calls you made to Congress to turn that around.

Speaking of appreciation, TMA congratulates U.S. Reps. Sam Johnson (R-Plano) and Rubén
Hinojosa (D-Edinburg) for alerting their congressional colleagues to some AHA propaganda that misrepresents the quality of care provided by physician-owned hospitals. "Your joint letter to your colleagues proves that this is neither a Republican nor Democratic issue; rather it is an issue of immense importance to Texas physicians and our patients," TMA President Bill Hinchey, MD, wrote in a letter to the two congressmen.

TEXMED 2008 JUST AROUND THE CORNER

Today is the last day to register online for TMA's annual meeting, May 2-3 in San Antonio. Along with the House of Delegates meeting, more than 100 hours of free continuing medical education, and the chance to catch up with old friends, don't miss:
  • The special session to help you understand how health plans rate physicians, how to dispute a faulty rating, and how to adopt evidence-based tools that measure real quality and efficiency of care.
  • Reserving a spot to be fingerprinted to renew your medical license.
  • Previewing MedLink TV, the new, free, 40-inch, flat-screen member benefit from TMA.

PHYSICIANS ANSWER CALL FOR HELP

I want to express my personal appreciation to those San Angelo-area physicians who responded to TMA's request for doctors to screen the women and children taken from the religious compound in Eldorado. The Department of State Health Services turned to TMA for help in this different kind of disaster, and you delivered medical care where it was needed.

TMB HASTENING LICENSES

The flood of Texas-bound physicians continues, and the Texas Medical Board (TMB) issued 688 physician licenses at its latest meeting. TMB reports the average time to process a license is down to 55.5 days. That figure hit a high of more than 90 days before TMA helped the board win additional staff and funds from the 2007 Texas Legislature.

UT-HOUSTON LEADER PICKED

The new president of The University of Texas Health Science Center at Houston will be Larry Kaiser, MD, chair of surgery at the University of Pennsylvania School of Medicine. He succeeds James Willerson, MD, who will be president of the Texas Heart Institute.

Monday, April 14, 2008

EL PASO GIANT FALLS

We mourn the passing of William Gordon McGee, MD, the outspoken advocate for border health in his beloved, adopted hometown of El Paso. Dr. McGee, 74, was a past president of TMA, the El Paso County Medical Society, and the Texas Society of Pathologists. His death comes just weeks after the culmination of a dream when the Texas Tech University Health Sciences Center at El Paso won accreditation. We will miss his passion, compassion, and caring.

TMA TO CONGRESS: NO INCREASE FOR PLANS

As the federal government is starving physicians out of Medicare, the Centers for Medicare & Medicaid Services (CMS) announced another 3.6-percent payment increase for Medicare Advantage plans. TMA cried foul in a letter to Texans in Congress. “It is blatantly unfair for the federal government to unduly enrich the health plans simply for brokering or repackaging existing medical services,” wrote TMA President Bill Hinchey, MD. “Congress should not allow CMS to authorize any payment updates until a rational physician payment system is designed that reflects the actual costs for physicians of providing medically necessary health services to our patients.” Without congressional action, physicians’ Medicare payments will be cut 10.6 percent on July 1.

GOOD AND GETTING BETTER

For three days, examiners from Quality Texas roamed the halls of TMA, interviewing management and staff, seeing our best practices, and probing our strategic planning processes. The visit was part of our application for the Texas Award for Performance Excellence. Win or lose, we will receive back a comprehensive report on what we do well and where we can improve. The program is part of the Malcolm Baldrige National Quality Award.

PATRICK TO STEP DOWN

Donald Patrick, MD, JD, who has led the Texas Medical Board (TMB) through stormy waters, announced he will retire Aug. 28. Dr. Patrick is a highly principled man who faced the board’s challenges head-on. He revamped the TMB disciplinary process after the news media revealed lax treatment of physicians who sullied the profession. He won additional appropriations for the agency, and his final goal is whittling away at the huge backlog of license applications that have flooded TMB since our 2003 liability reforms made Texas such a great place to practice medicine.