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Monday, December 20, 2010

PRESIDENT SIGNS BILL AVERTING MEDICARE CUTS

President Barack Obama signed the bill that eliminates the planned 25-percent cut in physicians’ Medicare fees for 2011, a move that will save Texas physicians about $1.5 billion over 13 months — $30,000 per physician — the American Medical Association says. Once again, we are back in the usual starting gates. Once again, last-minute legislation put off a cut. Once again, we have bought some time to devise a permanent replacement for the sustainable growth rate (SGR) formula that drives the cuts every year — which is a top TMA priority. Once again, Washington politicians are promising not to squander the window of opportunity. “It’s time for a permanent solution that seniors and their doctors can depend on, and I look forward to working with Congress to address this matter once and for all in the coming year,” the president said as he signed the bill. We’ll see.

BLUE CROSS SETS ONLY EDUCATION SESSION ON NEW PHYSICIAN EVALUATION PLAN FOR WEDNESDAY

Blue Cross and Blue Shield of Texas (BCBSTX) is rolling out a new product called BlueOptions. This product takes the physicians who have been evaluated under BlueCompare and adds a PCA (Physician Cost Assessment) review. TMA has been urging BCBSTX to provide Texas physicians an educational webinar on both PCA and BlueOptions. We learned late last week that the company has scheduled one such educational session for this Wednesday, Dec. 22, from 1 to 2:30 pm, Central Time. We have asked BCBSTX to record the webinar or offer additional sessions. In the meantime, please share this information with your colleagues:

WHAT'S YOUR STORY?

The patient-physician relationship is medicine’s secret weapon. We need to make it not so secret. Every physician has a story. What’s yours? On the TMA website, we’ve posted a very short video from Fort Worth pediatrician Gary Floyd, MD. He tells a story only a physician can tell: what it means to be someone’s doctor, the trusting relationship between physician and patient. Every Texas physician has a story like this. We want to share these stories ... with lawmakers and the public. The power in these stories will help them understand the problems in medicine today and how we hope to solve them. So, what’s your story? Why did you go to medical school in the first place? Do you remember that patient encounter that brought it all home to you? The patient you think of when times are tough? Tell your story to a video camera. We don’t care if it’s your cell phone, or a flip camera, or a full-featured video recorder. Just “get it down on film” and send it our way. TMA has set up a special YouTube channel where you can upload your story. Just follow the simple directions at www.texmed.org/yourstory.aspx.

TMA, AMA CALL FOR FEDS TO TAKE ACTION ON MEDICARE BACK PAY, E-PRESCRIBING

TMA has joined with AMA and state and specialty societies across the country in a letter asking Health and Human Services Secretary Kathleen Sebelius to pay physicians overdue Medicare fees. We’re calling on the Centers for Medicare & Medicaid Services to use the $200 million Congress allocated to provide physicians long-overdue Medicare payments they should have received earlier this year. “After weathering a year filled with uncertainties from continuous threats of cuts to Medicare payments, many physicians are not in a position to rely on IOUs from the government,” said AMA President Cecil Wilson, MD. We joined in a second letter asking Secretary Sebelius to revise Medicare’s e-prescribing penalties. That policy, which would penalize physicians in 2012 if they don’t e-prescribe in the first six months of 2011, will hurt efforts to implement widespread health information technology adoption among physician practices and cause them to take on needless financial and administrative burdens. 

FIRST TMA LEADERSHIP SERIES WEBINAR NOW ONLINE

The first webinar in the TMA Leadership Series — “How TMA Makes Policy,” featuring an introduction by House of Delegates Speaker Steve Brotherton, MD — is now available for you to watch free on the TMA website. This webinar series, sponsored by Pfizer, was originally conceived as part of the TMA Leadership College course requirement, but we have opened it for any Texas physician to watch. Coming over the next few weeks will be two more free leadership webinars:
  • “Rules, Rights, and Powers: A Look at County Medical Society Bylaws,” with Holly Alt, JD, presenting; and
  • “How to Run an Effective Meeting,” with Robert Strauss, MD, presenting.
We will seek another grant from Pfizer to create three additional webinars next year. Which topics would you would like to see in 2011? Let me know.

HAPPY HOLIDAYS FROM EVPGRAM; SEE YOU NEXT YEAR

It’s a bit late in December, but EVPGram will take its annual holiday holiday over the next two weeks. We’ll be back in your inboxes on Monday, Jan. 10 — the day before the 2011 Texas Legislature convenes. I wish everyone a happy holiday season and a healthy new year.

Monday, December 13, 2010

ANOTHER MEDICAID CUT COMING FEB. 1

Responding to orders from top leaders trying to stanch the impact of the pending $25-billion-plus state budget shortfall, the Texas Health and Human Services Commission (HHSC) will chop Medicaid fees to physicians, hospitals, and providers by 1 percent effective Feb. 1. HHSC will cut payments to nursing homes and home health providers by 2 percent. Gov. Rick Perry, Lt. Gov. David Dewhurst, and House Speaker Joe Straus asked all state agencies to identify budget savings of 2.5 percent for the rest of fiscal 2011. A previous budget-cutting directive led HHSC to cut Medicaid fees by 1 percent on Sept. 1. “Identifying these savings builds on our ongoing call to keep government spending in check so that we can balance our state budget without raising taxes,” Governor Perry said.The new federal health law will make 1.5 to 2 million more Texans eligible for Medicaid beginning in 2014. Here’s how the report characterizes Texas’ ongoing predicament: “Without significant reform at the federal level, states are left facing a no-win dilemma. Opting out of Medicaid means giving up federal tax dollars paid by the state’s residents to provide health care for our most vulnerable residents. Staying in the program forces states to pay for a federally-mandated expansion of Medicaid with little control over the program’s ever-rising costs, exacerbating an already unsound financial situation.”

MEDICARE MELTDOWN DELAYED A FULL YEAR; WILL CONGRESS FIX IT BY THEN

In almost unanimous votes, the U.S. Senate and House of Representatives sent President Barack Obama a bill stopping the 25-percent cut in physicians’ Medicare payments that was scheduled for Jan. 1. Thanks to all physicians, medical students, and alliance members who took the time to write or call their senators and representatives, urging them to stop the Medicare Meltdown. I also encourage you to thank your Medicare patients, especially those who are members of AARP, for lobbying Congress to stop the cut. Unfortunately, lawmakers did what they have done for the past decade — postpone a scheduled cut, this time for a year — instead of fixing the payment system permanently. “More than 3.3 million Texas seniors, people with disabilities, and military families deserve a sustainable health care program — one they can depend on," said TMA President Sue Bailey, MD, in calling on Congress to get to work now on a payment formula that works

TMA WINS INSURANCE CONSUMER PROTECTIONS

The Texas commissioner of insurance adopted three rules proposed by the Office of Public Insurance Counsel prohibiting discretionary clauses in insurance policies. Such clauses, already outlawed in 22 states, give insurers free rein to interpret policy terms and evaluate a patient's claim for benefits any way they choose. Public Insurance Counsel Deeia Beck praised TMA for being “instrumental in getting the new rules adopted.” In a letter supporting the rules, then-TMA President Bill Fleming, MD, wrote that discretionary clauses create a "fox guarding the henhouse situation that serves to provide the insurer with the authority to consistently deny benefits that a reasonable insured person would believe falls within the terms of the policy."

CONGRESS EXEMPTS DOCTORS FROM RED FLAGS RULE

Physicians aren’t their patients’ creditors and so don’t have to comply with the Federal Trade Commission’s onerous “red flags rules” to protect against identity theft. That’s what TMA, the American Medical Association, and other medical societies have argued for years. Last week, Congress agreed, sending the president a bill that exempts physicians from the rules.

MALONE HONORED AS TRAVIS PHYSICIAN OF THE YEAR

Congratulations to TMA President-Elect Bruce Malone, MD. His colleagues awarded the Austin orthopedic surgeon with the Travis County Medical Society’s Gold-Headed Cane. I was proud to join Dr. Malone, his wife Libby, and his many friends at the ceremony.

NEW TMA LOBBYIST IS A FAMILIAR FACE

TMA physicians and members of the Texas Legislature should feel right at home with TMA’s newest lobbyist. And he should feel right at home in our offices. Troy Alexander returns to TMA today to join our public affairs team again. He was director of TEXPAC from 1999 to 2003 before leaving to work as a top policy analyst for the speaker of the house. Welcome back, Troy.

Don’t Miss Dec. 31 Deadline to Nab 2010 PQRI, eRx Bonuses; TMA Can Help

Are you leaving a 4-percent Medicare bonus on the table this year? TMA-endorsed vendor DocSite offers members a free and simple way to satisfy the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Initiative requirements and qualify for incentive payments. Contact the TMA HIT Helpline at (800) 880-5720 by Dec. 31 for a coupon to have your fees waived.


DON'T MISS DEC. 31 DEADLINE TO NAB 2010 PQRI, eRx BONUSES; TMA CAN HELP

Are you leaving a 4-percent Medicare bonus on the table this year? TMA-endorsed vendor DocSite offers members a free and simple way to satisfy the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Initiative requirements and qualify for incentive payments. Contact the TMA HIT Helpline at (800) 880-5720 by Dec. 31 for a coupon to have your fees waived.

TENERY LAUNCHES HEALTH CARE BLOG

Never shy in sharing his opinions about health care, former TMA President Rob Tenery Jr., MD, has a new outlet for his thoughts: a blog called Echos for the Future: Reflections on the State of Healthcare. Do you blog? Join Dr. Tenery and the TMA-member bloggers featured on our website.

Monday, December 6, 2010

REPORT: TEXAS SHOULD CHANGE MEDICAID, NOT DROP IT

Texas shouldn’t — and can’t afford to — drop out of Medicaid, concludes a long-awaited report (PDF) from the Texas Health and Human Services Commission (HHSC) and the Texas Department of Insurance. If Texas were to leave Medicaid, the report concludes, up to 2.6 million Texans could lose health coverage, and physicians and providers in the state would lose $15 billion a year in federal aid. But current Medicaid spending patterns are unsustainable, and neither the report’s authors nor Gov. Rick Perry is satisfied with the status quo. “Texas, the states and the federal government would be much better served by increasing flexibility and innovation in Medicaid, even block granting funds to the states, so we can tailor Medicaid dollars to best serve the needs of Texas patients, families and taxpayers,” the governor said in a statement. “I have discussed these issues with other governors and policy experts, and will be working on ways to improve the utilization of Medicaid dollars in Texas.”

The new federal health law will make 1.5 to 2 million more Texans eligible for Medicaid beginning in 2014. Here’s how the report characterizes Texas’ ongoing predicament: “Without significant reform at the federal level, states are left facing a no-win dilemma. Opting out of Medicaid means giving up federal tax dollars paid by the state’s residents to provide health care for our most vulnerable residents. Staying in the program forces states to pay for a federally-mandated expansion of Medicaid with little control over the program’s ever-rising costs, exacerbating an already unsound financial situation.”

TMA will work with Governor Perry, legislative leaders, the Texas congressional delegation, and Health and Human Services Commissioner Tom Suehs to devise plans that trim Medicaid spending while providing cost-effective care to Medicaid recipients and adequate compensation to Texas physicians and providers in Texas.

ANOTHER MEDICARE MELTDOWN COMING JAN. 1

The one-month freeze on physicians’ Medicare rates that Congress passed and President Obama signed expires Dec. 31. Without further congressional action, Medicare payments will be cut 25 percent on Jan. 1. Several plans to freeze current rates for all of 2011 are circulating on Capitol Hill. Right now, the vehicle we’re watching most closely is the bill the lame duck Congress must pass to extend the Bush-era income tax rate cuts. The biggest roadblock is how Congress will pay the $15 billion cost of a one-year freeze. All of this uncertainty continues to frustrate Texas physicians and your patients. “Each time Congress plays this game of chicken, the cut to physicians grows deeper, and fear among our patients and physicians increases,” said TMA President Sue Bailey, MD. In Texas alone, more than 3 million patients’ health care could be put into jeopardy. Stay tuned.

TMA CME Program Wins High Honors, Six-Year Accreditation

I don’t brag often enough about our outstanding continuing medical education (CME) program. Not only does it ensure that TMA seminars, publications, and meetings provide you quality CME, but also it accredits the CME programs at 68 Texas hospitals, medical centers, and physician groups. The Accreditation Council for Continuing Medical Education (ACCME) completed its accreditation review of TMA’s CME program and gave us some great news. We passed all portions of the review with flying colors. “Yours is a learning organization and a change agent for the physicians you serve,” said ACCME Chief Executive Murray Kopelow, MD. “You have demonstrated an engagement with your environment in support of physician learning and change that is part of a system for quality improvement.” Our new accreditation is good for the maximum of six years.

ARE YOU GOING TO STAY IN MEDICARE IN 2011? WE CAN HELP YOU DECIDE

Physicians must decide their level of participation in the 2011 Medicare program by Dec. 31. The decision will be binding for the entire year, unless the Centers for Medicare & Medicaid Services reopens the enrollment period. We can’t tell you what to do, but we can offer you some help in making your decision. Check out our one-hour, recorded web seminar, “Evaluating Your Medicare Options,” on the TMA website. The webinar, featuring TMA’s in-house Medicare specialists, provides detailed information about participation options and the consequences of those choices. It also offers one hour of continuing medical education credit.

Tuesday, November 30, 2010

SENATE PASSES 30-DAY MEDICARE PATCH; HOUSE TAKES THANKSGIVING BREAK

With plenty of calls and e-mails from Texas physicians and patients, Congress took a tentative first step toward stopping the 23-percent Medicare physician payment cut set to take effect Dec. 1. The U.S. House of Representatives will have two days to stop the cut when Congress returns next week from its Thanksgiving recess. Before leaving Washington, the Senate approved a 31-day reprieve. TMA and the Texas AARP joined physician and patient groups from around the country in publicly calling for Congress to stop what TMA President Sue Bailey, MD, calls “this game of chicken.” In just three days, Texas physicians, students, alliance members, and patients sent more than 2,100 calls and e-mails to Capitol Hill. Watch the video from our Fort Worth news conference. Prospects for longer-term relief from the next Medicare Meltdown — a 25-percent cut scheduled for Jan. 1 — are still up in the air. We continue to push Congress to set stable rates for at least a full year.

BUDGET, PHYSICIAN EMPLOYMENT, SCOPE ISSUES TOP SPECIALTY ADVOCACY SUMMIT

More than 100 TMA Alliance members, medical students, and physicians of all specialties gathered to plan joint strategies for the 2011 Texas Legislature. The expected $20-billion-plus state budget deficit and how medicine should deal with it dominated many discussions. When representatives of state specialty societies laid out their legislative priorities, a few trends emerged:

  • Many specialties expect nonphysician practitioners to push for unsafe expansions of their scope of practice, and they called on all of medicine to work together to fight those battles.
  • There was strong support for TMA’s call to defend the ban on corporate practice of medicine.
  • Many physicians said patients benefit when offices can own their own labs, imaging equipment, and outpatient facilities.
We'll take all of that input, and more, into consideration as we draft TMA’s 2011 agenda over the next few weeks. By the way, have you registered for First Tuesdays at the Capitol yet?

FIVE FRESH FACES BRING HEALTH CARE PERSPECTIVE TO 2011 TEXAS LEGISLATURE

The Rookie Report is always one of the most interesting segments of the specialty advocacy summit. This year, five incoming House members shared war stories from the campaign trail. I was quite impressed with this year’s crop of featured freshman, all of whom bring some important health care connections to the 2011 legislature. They were:

  • Rep.-Elect Jose Aliseda (R-Beeville), whose father Jose is a retired anesthesiologist in McAllen.
  • Rep.–Elect Sarah Davis (R-Houston), a cancer survivor whose Houston Medical Center district has more physicians and TMA Alliance members than any other in the state.
  • Rep.-Elect J.M. Lozano (D-Kingsville), whose father, sister, and brother-in-law are all Texas physicians.
  • Rep.-Elect Dan Huberty (R-Kingwood), who defeated two TEXPAC-member physicians in the spring primaries and now has a great working relationship with TMA.
  • Rep.-Elect Charles Schwertner, MD (R-Georgetown), a surgeon who will become the fourth TMA member in the legislature next year.

TWO TMA LEADERS TO HELP SELECT DEPRESSION PERFORMANCE MEASURES

A pair of Texas psychiatrists — Cliff Moy, MD, of Austin, and Les Secrest, MD, of Dallas — will serve on the Physician Consortium for Performance Improvement® (Consortium) Adult Major Depressive Disorder Work Group. The intent of each Consortium workgroup is to develop measures that are useful to physicians at the point of care and in practice-wide analysis.

DR. MARCUS HONORED FOR ADVOCACY

Congratulations to physician Howard Marcus, MD, who was recognized by the Texas Chapter of the American College of Physicians (ACP) as Advocate of the Year. Dr. Marcus, an Austin internist with Austin Regional Clinic, is a statewide leader in medical liability reform from his post as chair of the Texas Alliance for Patient Access. “Dr. Marcus has demonstrated outstanding leadership in the areas of legislative advocacy and grassroots activism,” ACP said. “He has worked tirelessly with our elected representatives on behalf of Texas physicians and their patients; he has effectively communicated health care issues on behalf of the Texas Chapter of the ACP to elected officials.” The Texas chapter added that Dr. Marcus “represents the best in advocacy and serves as a role model for all of us to be involved in legislative activities in the service of our patients. He is a true leader of Texas medicine in general and the Texas Chapter of the American College of Physicians.”

HAPPY THANKSGIVING; EVPGRAM TAKES A SHORT HOLIDAY BREAK

Despite all the negative news of late, I hope all of you take the time this week to count and be thankful for all of our blessings. I hope you have a chance to spend some Thanksgiving time with family and friends. EVPGram will take a Turkey Day break and return to your inbox on Dec. 6.

Monday, November 15, 2010

IS A 25-PERCENT MEDICARE CUT OK WITH YOU

Congress returns to Washington today for a lame duck session, and lawmakers need to hear from you and your patients. If they leave town without taking action, physicians’ Medicare payments will drop by 23 percent on Dec. 1 and more than 25 percent on Jan. 1. We need to light up the phones on Capitol Hill and ask for stable rates through the end of next year. On Wednesday, TMA President Sue Bailey, MD, will join representatives of AARP at a news conference in Fort Worth to encourage Medicare patients to call their U.S senators and representative to stop the cuts. Look for a TMA Action Alert Wednesday morning with details on where you should call. This seemingly never-ending crisis affects more than 3 million Texas seniors, people with disabilities, and military families. Get your patients engaged in the Medicare Meltdown Countdown. Post this poster in your waiting and exam rooms. Or, play TMA’s new video explaining the Medicare Meltdown to your patients. In case you’re wondering if they care, 94 percent of Americans say they are concerned about a looming Medicare cut to doctors, according to a new American Medical Association poll.

AMA HOUSE OF DELEGATES ADOPTS TEXANS' PROPOSALS

Texans in the AMA House of Delegates pushed the house to force AMA leadership to articulate the major flaws in the Affordable Care Act and devise a plan to correct those flaws. We argued successfully that AMA needs a very specific action plan to take to the new Congress. In what appeared to be a major sea change at the house’s interim meeting in San Diego, delegates voted to overturn AMA policy that supports an individual mandate to buy health insurance. Minutes later, however, the house decided to send that item — and several others relating to the new health reform law — to the AMA Board of Trustees for further study. Several other items brought by the Texas delegation found favor with the house:

  • The house sent the AMA board a resolution asking AMA to take a closer look at turning itself into an organization of organizations instead of an individual-membership association. AMA is losing membership at an unsustainable rate at a time of unprecedented change and upheaval in the American health care system. It’s a time when physicians and patients need the strength that comes from the ability of AMA to say it represents the majority of America’s physicians.
  • The delegates unanimously approved a Texas resolution to support pending federal legislation that would exclude from consumer credit reports, within 30 days, medical debt that has been fully paid or settled. This would motivate patients to pay off their medical debt quickly.
  • Finally, the house accepted a resolution brought by Edward Rensimer, MD, of Houston, stating that hospital medical staffs should be able to choose their own officers without interference from hospital leaders. AMA will take this strong new policy to The Joint Commission.

CONCHO VALLEY GOES SMOKE-FREE

Congratulations to the people of San Angelo. They voted in the Nov. 2 election to become smoke-free. That makes 34 cities in Texas that now prohibit indoor smoking.

ADVOCACY RETREAT SET FOR THIS WEEKEND

Are you registered for the TMA/Specialty Society 2010 State Advocacy Retreat, Nov. 19-20 in Austin? It’s your chance to start building the health care system that awaits you tomorrow. All state specialty societies are welcome. For details and to register, please e-mail Lisa Jackson or call her at (800) 880-1300, ext. 1520, or (512) 370-1520.

CORPORATE PRACTICE OF MEDICINE BAD FOR PATIENTS AND PHYSICIANS

As we move closer to the start of the 2011 Texas Legislature, I want to remind you of TMA’s positions on key issues. I’ll start today with corporate employment of physicians. TMA’s long-standing policy in opposition to the corporate practice of medicine remains unchanged. At the heart of the issue is protecting the patient-physician relationship. The direct employment of physicians by hospitals and other corporations — outside the jurisdiction of the Texas Medical Board (TMB) — threatens patient care and physicians’ clinical decision making.

In 2011, we will continue to oppose efforts to allow hospitals and corporate entities to directly employ physicians. We will support efforts to strengthen TMB oversight of existing employment exceptions. At the same time, we recognize that many rural hospitals see direct employment as a solution to recruiting physicians to their communities. TMA believes the state should identify and correct barriers to physicians locating in medically underserved areas, such as payment formulas and incentives.

Physicians should work for the patient not the insurance company, hospital, or anyone else not directly responsible for the care of the patient. Tools currently exist for corporate entities and counties to recruit new physicians to their communities without eliminating the private practice of medicine.

TMB has the ultimate authority to regulate the practice of medicine in Texas on behalf of all our patients. The state should look to TMB not only to maintain high standards of ethical practice but also to establish mechanisms and processes that protect physicians’ responsibility to make clinical decisions in the best interest of their patients.

Monday, November 8, 2010

GOP ELECTION DOMINATION TO HAVE BIG EFFECT ON MEDICINE

Regardless of your partisan leanings, you had to be surprised by the strength of the state and federal Republican landslide in last week’s elections. (In case you somehow missed it, the GOP swept all the Texas statewide contests, won control of the U.S. House of Representatives, narrowed its minority margin in the U.S. Senate, took a nearly 2-1 advantage in the Texas House, and kept its 19-12 superiority in the Texas Senate. Gov. Rick Perry’s reelection effort led the Republican tide in Texas. The GOP won 21 new seats in the Texas House and three Democratic seats in the Texas delegation to Congress.) The victors’ campaign messages consistently featured tough anti-Washington rhetoric and fiscal conservatism. What do the election results portend for medicine when the Congress and Texas Legislature convene for new sessions in January?

In Washington, the new Republican House majority probably can’t overcome the Democratic leadership in the Senate and President Obama’s veto pen to actually repeal and replace the health system reform law. Expect them to hold a largely ceremonial vote on such a plan but then use the power of the purse to starve implementation of many of the new law’s programs.

We’re still pushing for the lame duck congressional session to vote for a 13-month reprieve of the pending 30-percent Medicare payment cuts for physicians. With the Democratic leadership reeling, there’s no telling what will happen in the lame duck. And if they slap on another patch — or worse, do nothing — will the 2011 House leadership support Medicare payment reform?

The Texas Legislature will convene next year facing a record $20-billion-plus shortfall. With that big a hole, look for health, human services, and education programs to be on the chopping block. Some GOP leaders are even floating the idea of Texas opting out of Medicaid.

TEXAS PUSH AMA TO SET HEALTH "RE-REFORM" PRIORITIES

Although the American Medical Association supported the president’s health reform bill, AMA didn’t get all that it wanted and frequently calls the law a “work in progress.” Just to make sure AMA knows what to keep and what to fix, Texas physicians attending the 2010 Interim Meeting of the AMA House of Delegates are pushing to set priority items for reforming the law. Among the issues our delegation is pushing to top the agenda:

  • Medical liability reform;
  • Repeal the Independent Payment Advisory Board;
  • Repeal the fiscal noose placed on physician-owned hospitals; and
  • Make physicians responsible for defining quality care.
These recommendation and many others will come before the house Monday and Tuesday. Check out Blogged Arteries and our Twitter feed daily to stay abreast of all the action

AMA EVP TO STEP DOWN

Mike Maves, MD, the AMA’s executive vice president since 2001, will leave that post when his contract expires next June. “As we enter into a new era that is redefining the way health care is delivered, both Dr. Maves and the Board of Trustees share the belief that new top leadership is required to address these challenges and to ensure the rights of physicians and patients continue to be passionately and effectively protected,” said AMA Board Chair Ardis Hoven, MD.

YOUNG TEXANS WIN AMA LEADERSHIP POSTS

Congratulations to four Texas medical students and two fellows for winning AMA leadership roles:

  • Justin Bachman, MD, a cardiology fellow from The University of Texas (UT) Southwestern Medical School, Dallas, is chair-elect of the AMA Resident and Fellow Section Governing Council.
  • Erin Dunnigan, MD, a fellow in endocrinology at Parkland Hospital in Dallas, was reelected alternate delegate to the AMA House of Delegates from the Resident and Fellow Section.
  • Neil Prikh and Archit Gulati, both students at Baylor College of Medicine in Houston, were elected Region 3 delegates to the AMA Medical Student Section House. Jasmeet Kaur from The University of Texas Medical Branch at Galveston and David Savage, who is a student at the UT- Houston School of Medicine, were elected alternate delegates.

ANOTHER MEDICARE MELTDOWN FIGHT COMING

It’s official. The Centers for Medicare & Medicaid Services posted the final 2011 Physician Fee Schedule Rule. It’s a cut of almost 30 percent, counting the 23-percent cut in physicians’ Medicare payment set to take effect Dec. 1 and the additional 6.5-percent cut coming Jan. 1. Look for a TMA Action Alert next week as we push the lame duck congressional session to stop this madness.

WILL YOU PARTICIPATE IN MEDICARE NEXT YEAR?

You must decide your 2011 level of participation in Medicare by Dec. 31, even if Congress fails to stop the pending cuts. TMA cannot tell you what to do, but we are offering some help in making a decision through a recorded seminar, “Evaluating Your Medicare Options,” on the TMA website. The one-hour webinar, featuring TMA's in-house Medicare specialists, provides detailed information about participation options and the consequences of those choices.

Monday, November 1, 2010

VOTE

Tomorrow is Election Day. If you haven’t yet, please go to the polls and cast your ballot. TEXPAC has endorsed (PDF) Gov. Rick Perry, Lt. Gov. David Dewhurst, and a host of executive, judicial, legislative, and congressional candidates. Please vote for the Party of Medicine.

TEXAS BRINGING FOUR RESOLUTIONS TO AMA; WHAT DO YOU THINK?

The Texas Delegation to the American Medical Association House of Delegates has submitted four resolutions — including one that would reorganize AMA membership — for the house to consider at its interim meeting, which starts this weekend in San Diego. Before I outline our four resolutions, though, I have a question for you. What message should we carry to AMA for you? Regardless of whether you’re a member, what suggestions do you have to help make AMA a true national voice for physicians and patients? Send me an e-mail with your ideas. Now, for our resolutions:
  • First, we ask AMA to take another hard look into turning itself into an organization of organizations (PDF) instead of an individual-membership association. AMA is losing membership at an unsustainable rate at a time of unprecedented change and upheaval in the American health care system. It’s a time when physicians and patients need the support and strength that comes from the ability of AMA to say it represents the majority of America’s physicians.
  • Second, we ask AMA to sponsor an annual, state-by-state study of retention rates (PDF) for medical students and residents trained in each state. Such a study will help states, and state medical societies, plan how to invest in undergraduate and graduate medical education.
  • Third, we ask the house to support pending federal legislation (PDF) that would exclude from consumer credit reports, within 30 days, medical debt that has been fully paid or settled. This would motivate patients to pay off their medical debt as quickly as possible.
  • Finally, we ask AMA to restate its recent position on antitrust protections (PDF) for accountable care organizations (ACOs) to emphasize that those protections should apply only to physician-led ACOs. We need to give physicians — not hospitals or insurance companies — those protections.

NEED HELP GOING ELECTRONIC

TMA is working with Texas’ four health information technology regional extension centers (RECs) to bring you a good deal. For just $300 a year, you get a consultant to help you decide if your practice is ready for an electronic medical record (EMR). If so, your REC can teach you how to select an EMR appropriate to your practice, how to navigate the EMR installation process with minimal disruption to your practice, and how to make meaningful use of an EMR so it helps your patients and qualifies you for a Medicare or Medicaid bonus. If you already have an EMR, the REC consultants can help you determine how to qualify for federal bonuses using your existing system. For physicians who qualify, reaching meaningful use can mean up to $63,750 in incentives from Medicaid or $44,000 from Medicare. Medicare incentives are highest for early adopters who commit to EMRs in 2011-12. For more information, visit the TMA REC Resource Center.

FROM OUR HEALTH REFORM SCHOOL CLASSROOM

TMA President Sue Bailey, MD, the self-described “headmistress of TMA’s Health Reform School,” called class to order in Beaumont and Dallas last week. More are scheduled. We’re collecting the most frequently asked questions, and their answers, to publish in an upcoming issue of Texas Medicine. One that comes up, frustratingly, at almost every event is this: Why did TMA support the health system reform law? Answer: We didn’t. No way. Backed by a set of principles adopted by the TMA House of Delegates, we opposed the bill that became law. We continue to work to keep what’s good in the law and fix what’s broken. That’s a lengthy agenda.

TMA TO PUSH STATE FOR PATIENT, PHYSICIAN PROTECTIONS IN ACOs

A team of TMA experts, under the direction of Asa Lockhart, MD, will participate in an ACO stakeholder meeting with the Texas Department of Insurance and the Texas Health and Human Services Commission. The state agencies are starting to develop policy on how the state might want to regulate these new health care delivery systems. Here are the two priority points we will make:
  1. ACOs must be physician-led organizations to ensure that physicians’ clinical judgment is paramount in making patient care decisions.
  2. The driving force for how ACOs increase quality and hold down costs must be patients, not profits.

Monday, October 18, 2010

WHY SHOULD YOU CARE ABOUT TEXPAC JUDICIAL SLATE CARDS?

After last week’s EVPGram article on TEXPAC’s judicial election slate cards, several readers wrote asking me to remind TMA members why those little red cards are so important. Two big reasons:
  • First, the justices we elect to the Texas Supreme Court and our 11 courts of appeals make huge decisions that affect our legal system. Many cases that interpret our 2003 liability reforms are still making their way through the courts, and we need to make sure we don’t allow the trial lawyers to elect activist judges who will rewrite that law from the bench.
  • Second, we make a big difference in these elections. TEXPAC has been on the forefront of helping to elect fair, impartial, and qualified judicial candidates since the successful Clean Slate in ’88 program. By distributing the slate cards to your patients, friends, and colleagues, you are playing an active role in political education. Order yours today (PDF).

TMA LEADERSHIP COLLEGE CLASS SURVIVES "BOOT CAMP"

From negotiating skills to liability risks for nonprofit board members, from personality types to media interviews, the 23 members of the charter class in the TMA Leadership College soaked up the knowledge at their four-day “boot camp.” The college’s mission is to instill strong and sustainable leadership qualities and promote the role of physicians as trusted leaders in their communities. “We believe it is essential to help grow new leaders from within, to lead from the exam room to the board room,” TMA President Sue Bailey, MD, told the scholars. Homework assignments, attending at least one First Tuesdays at the Capitol next year, and a final two days at TexMed 2011 in Houston will complete the students’ course work.

SGR, HEALTH REFORM VOTES EARN TEXPAC ENDORSEMENT FOR TWO

U.S. Reps. Chet Edwards (D-Waco) and Michael McCaul (R-Austin) joined Michael Burgess, MD (R-Lewisville), as the only Texas congressional representatives to win TEXPAC’s endorsement for the Nov. 2 general election. Those three are the only Texans in Congress who voted both for repeal of Medicare’s sustainable growth rate (SGR) funding formula and against passage of the health system reform bill. “Because we have been so disappointed in what Congress has and hasn’t done over the past two years, we wanted to set the bar very high and focus on the Medicare and health reform votes, which were so vitally important to patients and physicians,” said TEXPAC Board Chair Susan Strate, MD. “To be sure, other members of the Texas delegation have been friends to patients and physicians, but Representatives Burgess, Edwards, and McCaul were the only ones to cast the right votes on those critical decisions.”

WEARY PHYSICIANS WARNED TO BE WARY

Speaker after speaker at TMA 2010 Fall Conference acknowledged physicians’ ongoing unease over the still-uncertain changes coming from Washington and the lack of any long-term solution to the Medicare SGR problem. But, they warned, the road is likely to become bumpier before it smooths out. “Our inability to enact a permanent fix for the SGR — especially with a brand new ‘Medicare cost containment program’ slated to start in just four years — is probably the most frustrating experience of my past 10 years in organized medicine,” said Dr. Bailey. Other speakers cautioned physicians to be careful — but not to stick their heads in the sand — as they examine offers to be part of an accountable care organization (ACO). One expert reminded audience members that they could identify the real winners on that issue if they rewrite the acronym to stand for “Attorneys’ and Consultants’ Opportunity.” On the state legislative front, panelists pointed out that redistricting and the state budget will overwhelm just about every other issue our lawmakers will face in the 2011 session. The projected $10 million-$20 billion budget shortfall will have enormous implications. “We do not have the money to sustain the programs that are in place now,” said State Rep. Susan King (R-Abilene), the only TMA Alliance member in the Texas House. “That means that we must cut, not only to the skin, to the muscle, to the bone, to the bone marrow.”

EARLY VOTING BEGINS TODAY; VOTE FOR THE PARTY OF MEDICINE

Today is the first day to vote early in the Nov. 2 general election. Early voting closes on Friday, Oct. 29. Please remember to vote, and encourage your staff, friends, family, and patients to cast their ballots as well. TEXPAC recommends these executive, legislative, and judicial candidates (PDF) for your strong consideration.

Monday, October 11, 2010

TMA AND ALLIANCE LEGISLATORS TO OUTLINE TEXAS ROAD TO REFORM THIS WEEKEND

I look forward to seeing you Friday and Saturday for TMA 2010 Fall Conference at the Hyatt Regency Austin. Our closing general session Saturday morning features three of our own who will be making key decisions in the 2011 Texas Legislature. Rep. Susan King (R-Abilene), a TMA Alliance member, will join Rep. Mark Shelton, MD (R-Fort Worth), and Rep.-to-be Charles Schwertner, MD (R-Georgetown), to discuss “Shaping Health System Reform in Texas.” Other general session speakers Saturday include Andrew Gurman, MD, vice speaker of the American Medical Association House of Delegates, who will discuss the next steps in health system reform; and William Darling, JD, who will talk about accountable care organizations and your options. Online registration for the conference is closed, but you still may register in person on Friday at the Hyatt or TMA building and on Saturday at the Hyatt. Please note that there will be several road closures on the route from the TMA building to the Hyatt. On Friday, part of Cesar Chavez and the First Street Bridge will be closed for Austin Start Heart Walk; Thursday through Sunday, part of Congress Avenue and 11th Street will be closed for the Texas Book Festival. View (PDF) a map of the road closures and recommended alternative routes.

GRANT TO FUND FIRST TMA LEADERSHIP COLLEGE

The Physicians Foundations has given TMA a $75,000 grant to support the inaugural class of our TMA Leadership College. The year-long program begins with a four-day boot camp this weekend. This college is designed to identify, train, and build young TMA member physicians into leaders at the state and local levels. It is aimed at active members in their first eight years of practice or younger than 40. The Physicians Foundations also gave TMA a $150,000 grant to develop a meaningful use achievement toolkit for physicians. It will give detailed instructions to physicians and their staff about exactly what they must do, specific to their electronic medical record (EMR) product, to meet any one of the 25 meaningful-use criteria the federal government has set. Eligible physicians may receive bonuses of up to $44,000 under Medicare or $63,750 under Medicaid for achieving meaningful use with their EMR.

AMA CALLS TEXAS A "MEDICARE ACCESS HOT SPOT" THAT COULD GET WORSE

Texas senior citizens, individuals with disabilities, and military families already are having a hard time finding physicians to care for them under Medicare and Tricare. That’s why AMA has designated our state a “Medicare Access Hot Spot.” (PDF) AMA says nearly one in eight Texans lives in a primary care shortage area, and 40 percent of the state’s Medicare beneficiaries live below 150 percent of the federal poverty level. That makes the 23-percent cut in physicians’ Medicare payment set to take effect Dec. 1 that much more critical for us to stop. And don’t forget the additional 6.5-percent cut coming Jan. 1. We’re asking physicians and patients to meet with our senators and representatives while they are home now campaigning. Here’s the message:
  • We need their personal commitment for a 13-month Medicare payment freeze starting Dec. 1.
  • Congress cannot delay action until some future date and think that a retroactive “fix” makes medical practices whole. It has and will significantly impact Medicare patient care and access.

JUDICIAL ELECTION SLATE CARDS READY FOR ORDER

Who are medicine’s picks for justices on the Texas Supreme Court and our 11 courts of appeals? These low-profile races rarely attract much attention, but the winners make some very important decisions for physicians and your patients. That’s why TEXPAC once again is offering our little red slate cards for you to share with your patients. Each election cycle, TEXPAC and the medical community distribute up to 1 million slate cards to help educate voters on the best judicial candidates. Please order your customized slate cards today (PDF).

CONSIDER THE PATIENTS

State leaders should consider how their decisions impact patients’ lives when they decide how to implement provisions of the new health system reform law (PDF) in Texas. That was the message Austin neurologist Sara Austin, MD, delivered on behalf of TMA to the House Select Committee on Legislation, chaired by Rep. John Zerwas, MD, last week. Dr. Austin’s testimony focused on three challenges to implementing the law:
  • Establishment of accountable care organization pilots in Medicaid, the Children’s Health Insurance Program, and employment retirement services, including the private market;
  • Establishment of a Consumer Assistance Office/Ombudsman Program; and
  • Establishment of a state insurance exchange.
She also noted that TMA has traveled the state, educating physicians about the new health law and what it means to their practice and what it means to their patients.

Monday, October 4, 2010

TMA HONORED FOR BUSINESS EXCELLENCE

An accurate membership list is the heart of any medical society. I’m proud to announce that we have a very healthy heart. It’s much more than a list. It’s a complex piece of business software known as iMIS that drives almost every TMA business function. We’re so good at using it that Advanced Solutions International (ASI), the software vendor, awarded us silver status in the iMIS Business Excellence Forum. ASI cited our development of an automated dues processing system and our focus on measuring results, and said we have “become an industry leader” by supporting Texas county medical societies and other state medical associations with their use of iMIS. “Rarely do we encounter a non-profit that is as focused on performance measurement, planning, and continuous improvement as TMA,” said Nathan Slovin, executive director of ASI’s Business Excellence Forum. Congratulations to TMA Chief Operating Officer John Dorman and his team.

TODAY IS THE LAST DAY TO REGISTER TO VOTE

Are you registered? Today is the last day to register to vote in the Nov. 2 election. It’s your last chance to make sure you can cast a ballot for governor, Congress, and most of the Texas Legislature. You can use TMA’s Grassroots Action Center to print out a voter registration card, which has to be postmarked before midnight tonight to count. Early voting begins Oct. 18.

SURVEY SAYS TEXAS TORT REFORMS HAVE STRONG BIPARTISAN SUPPORT

A survey released by Texans Against Lawsuit Abuse (PDF) found that the majority of Texas voters — from across the political spectrum — believe that lawsuit reforms have helped increase access to health care, injected fairness in our courts, and helped attract businesses and jobs to the state. Sixty-two percent of the respondents said our 2003 medical liability reforms have been a good thing because they have helped bring thousands of new physician specialists to Texas, allowed hospitals to provide expanded medical care, and reduced lawsuits so people with legitimate liability claims can have their cases heard. Supporters include 58 percent of Democrats, 61 percent of political independents, and 68 percent of Republicans. More than three-quarters of all respondents said the Texas Legislature should “protect reforms designed to reduce abusive lawsuits.”

TEXPAC CONTRIBUTIONS PASS $900,000 MARK

If you joined TEXPAC this year you have lots of company — not enough, of course, but lots of it. As we closed the books on our TEXPAC membership year, we blew away our totals from 2009. This is only the fourth time in TEXPAC’s 48-year-history that physicians and alliance members have contributed more than $900,000 in one year. The first three were in 1990, 2002, and 2003.

FALL CONFERENCE SPEAKER TO FOCUS ON "POST-REFORM FIXES"

If you thought the health system reform debate was tough, are you ready to do it again? And again? And again? Join your colleagues to discuss all that and more in Austin Oct. 15 and 16 for TMA 2010 Fall Conference. Our keynote speaker on Saturday morning is Nathan Kaufman of Kaufman Strategic Advisors, who will share his thoughts on “Preparing for Inevitable Post-Reform Fixes.” Tweeting at the conference? Remember to use the #TMAFALL hash tag.

NEW ACO WORKSHOP HELPS YOU UNDERSTAND YOUR CHOICES

I’m sure you’ve heard about accountable care organizations (ACOs). Maybe a hospital has asked — or pressured — your practice to sign up for one of these yet-to-be-defined delivery systems. The ACO questions seem to vastly outnumber the answers at this point. TMA’s new ACO seminars, starting next month, will focus on helping doctors examine their range of practice options: Should you stay put or look at alternative arrangements with groups or hospitals? What are the benefits and limitations or pros and cons of each? We urge you to take the time to learn about these systems. Understand their differences and what they can mean to your practice and your patients.

WACO PHYSICIAN TAKES LEAD AT AAFP

Congratulations to Roland Goertz, MD, of Waco on his installation as the new president of the American Academy of Family Physicians (AAFP). You can read and watch excerpts of Dr. Goertz’s remarks on the AAFP website.

Monday, September 27, 2010

TMA HELPS YOU FIND WHAT'S REALLY IN THE HEALTH REFORM BILL

Now that the first wave of the health system reform law (PDF) is in effect, you might be asking yourself: What else is really in that bill? How can I get beyond the talk-show hyperbole and read the facts? TMA’s crack policy, legal, and lobby teams have compiled two excellent, easy-to-read summaries. Our executive summary reviews what the bill does — and what it doesn’t do. For more depth, see our section-by-section summary (PDF). That document can help you decide which provision of the law may pertain to a particular question or issue. Use it to gain a basic understanding of what the law intends to accomplish before reviewing the actual statutory text. Find all of this and more on TMA’s Health System Reform Action Center.

TEXPAC ALLIANCE VOLUNTEERS SHINE IN CANDIDATE'S TV AD

This weekend’s TEXPAC Alliance Volunteer (PDF) activity was supposed to be a Saturday afternoon of block walking with State Rep. Donna Howard (D-Austin). But at the last minute, the Howard campaign staff decided they needed to film a health care TV commercial instead — and they needed extras. Our men and women in scrubs and white coats came through. Special thanks to Drs. Eric Tiblier, Paul Keinarth, Bradley Price, Maureen Margaret Swenson, and Frank Adams, and Travis County Alliance member Roberta Pazdral. Our next events are Oct. 9 and 11 in Corpus Christi. For details or to register, please contact TEXPAC’s Paula Frey or TMA Alliance’s Sandy SolĂ­s.

DR. BURGESS: DRIVE HOME THE MEDICARE MESSAGE DURING OCTOBER CONGRESSIONAL RECESS

U.S. Rep. Michael Burgess, MD (R-Lewisville), briefed TMA leaders on several possible scenarios for how Congress might address the looming Nov. 30 Medicare cut when the House and Senate return for a post-election “lame duck” session. Remember, a 23-percent cut in physicians’ Medicare fees takes effect on Dec. 1, and an additional 6.5-percent cut kicks in on Jan. 1, 2011. Dr. Burgess, the only TMA member in Congress, recommended that physicians and patients meet with our senators and representatives when they are home campaigning next month. Here’s the message:
  • We need their personal commitment for a 13-month Medicare payment freeze starting Dec. 1.
  • Congress cannot delay action until some future date and think that a retroactive “fix” makes medical practices whole. It has and will significantly impact Medicare patient care and access.

HEALTH REFORM SCHOOL COMES TO HOUSTON AND TYLER

TMA Trustee Doug Curran, MD, led the Health Reform School session we conducted with the Smith County Medical Society in Tyler, while lobbyist Dan Finch worked with the Harris County Medical Society Southwest Branch. Upcoming classes are scheduled for McAllen, Houston, San Antonio, and Beaumont. If you can’t make any of those events, you can earn an hour of continuing medical education credit by watching the video of the presentation from TexMed 2010.

GOT QUESTIONS? WE'VE GOT ANSWERS

All the planning for our presentations on health system reform can’t predict the great questions we receive from physicians in the audience. As part of TMA’s Health Reform School, we’re compiling the best questions — with answers — for December’s Texas Medicine. Here’s a sample:

Q: When will insurance coverage be better and more regulated? Right now physicians are heavily regulated but insurance companies are not. When will this change?

A: The health system reform law provides that the Internal Revenue Service (IRS) is charged with enforcing the insurance purchase mandate. Thus, if a person does not have health insurance coverage that conforms to the requirements of the law, a penalty is assessed by the IRS.

DID YOU DOWNLOAD TMA'S NEW MOBILE APP YET?

Let your iPhone do the work the next time you need a colleague’s contact information. The new TMA Mobile App offers 24/7 access with up-to-the-minute data on 45,000 of your Texas colleagues. Plus, the app gives you TMA news, events, alerts, and information to keep you informed. To download this free, members-only mobile application, go to www.texmed.org/iphone from your iPhone or iPad. You will need your TMA website user name and password to log in and use the app features. For a demonstration and some insight from the app’s developer, check out this video podcast that Dan McCoy, MD, chair of the TMA Council on Legislation, did with TMA Director of Business Intelligence Grant McInnes. If you can somehow wait, we’ll have a live demo of the new app — plus TMA Physician Oncology Education Program’s first iPhone app, CanSearch — at 2010 TMA Fall Conference. Although available only for the iPhone now, TMA is developing the same app for the Blackberry and the Android.

Monday, September 20, 2010

TMA'S HEALTH REFORM SCHOOL DELIVERS THE ANSWERS

What parts of the new health reform law take effect this week? How will the new quality rating and fraud and abuse provisions affect you and your practice? What do you need to know about accountable care organizations? If you had taken part in our telephone Health Reform School or the outstanding in-person event in Wichita Falls last week, you’d know the answers. TMA President Sue Bailey, MD, led the latest Health Reform School classes. Missed them? Listen to a recording of the telephone session — and pick up an hour of continuing medical education credit (PDF). Or you can attend one of our upcoming events in Houston, Tyler, McAllen, San Antonio, or Beaumont. Or you can read the excellent fact sheets and summaries posted on TMA’s Health System Reform Action Center. Don’t be late for school.

DIAGNOSIS: POLITICAL ANXIETY.RX

As you reflect on our challenges persuading lawmakers in Washington and Austin, think about how you can make an impact. The easiest and most cost-effective investment for increasing our legislative capital is your and your colleagues’ contributions to our political efforts. Your TMA dues help underwrite our hands-on lobbying efforts, but your TEXPAC contribution helps ensure that medicine-friendly candidates will serve as legislators. Need proof? Think about the difference between lobbying State Rep. Mark Shelton, MD (R-Fort Worth), and the man TEXPAC helped defeat: the author of the book Cheaper to Kill Than Maim: A Patient’s Guide to Medical Malpractice in Texas. You get the idea. The TMA Board of Trustees and the TEXPAC Board of Directors strongly encourage you and, in particular, all former TEXPAC physician members to rejoin TEXPAC and help attain our goal of 100-percent retention of last year’s members. We’re currently running at 70 percent, which is 10 percent better than our average going back to 2000. Go to www.texpac.org or call TEXPAC at (800) 880-1300, ext. 1361. Call today but certainly before the 2010 membership dues cycle ends on Sept. 30. I want to personally extend my thanks and appreciation to the 1,025 TEXPAC members who’ve contributed every year for the past decade as well as this year’s 609 “rookie” contributors. Keep your streak going in 2011.

POEP LAUNCHES CANSEARCH APP

TMA’s Physician Oncology Education Program released its first iPhone app, CanSearch. Created for primary care physicians, this free app quickly displays the current recommended screening guidelines for the top 25 cancers and includes their risk factors, nutrition and chemoprevention stats, and available imaging tests. To download, point your iPhone browser to www.texmed.org/iPOEP. And don’t forget the new TMA Mobile App, which offers 24/7 access with up-to-the-minute data on 45,000 of your Texas colleagues. Download at www.texmed.org/iPhone.

NATIONAL COORDINATOR TO DELIVER SPECIAL HIT SESSION AT TMA FALL CONFERENCE

I’m pleased to announce that David Blumenthal, MD, national coordinator for health information technology (HIT), U.S. Department of Health and Human Services, will conduct a special HIT town hall session at 2010 TMA Fall Conference on Friday, Oct. 15. The lecture hall holds just 100 people and already is sold out, but we are arranging live video feeds to an overflow room at the conference and online. You can catch the USTREAM feed at noon on Oct. 15.

TEXPAC ALLIANCE VOLUNTEERS WALK FOR MIKLOS

Dallas County Medical Society President Stephen Ozanne, MD, and his wife, Bev, led the contingent of TEXPAC Alliance Volunteers who laced up their sneakers to block walk for State Rep. Robert Miklos (D-Mesquite). Our group joined with the candidate and other volunteers to walk the district and turn out the vote for the Nov. 2 election. And they had a lot of fun to offset the blisters. Our next TEXPAC Alliance Volunteer events are a TV commercial shoot in Austin and a block walk and envelope stuffing extravaganza in Corpus Christi. Let TEXPAC know if you want to join the fun.

HOW MUCH CHARITY CARE DO YOU PROVIDE?

According to responses to TMA’s August survey, the average dollar value of the charity care delivered per physician in 2009 was $41,000, and the average amount of uncollectible debt was $70,500. Both have decreased since 2007. Does this reflect the charity care and bad debt expense in your practice? Let me know.

Monday, September 13, 2010

REFERRALS, NEWS JUST A TAP AWAY ON TMA'S NEW MOBILE APP

Let your iPhone do the work the next time you need a colleague’s contact information. The new TMA Mobile App offers 24/7 access with up-to-the-minute data on 45,000 of your Texas colleagues. Plus, the app gives you TMA news, events, alerts, and information to keep you informed. To download this free, members-only mobile application, go to www.texmed.org/iphone from your iPhone or iPad. You will need your TMA website user name and password to log in and use the app features. For a demonstration and some insight from the app’s developer, check out this video podcast that Dan McCoy, MD, chair of the TMA Council on Legislation, did with TMA Director of Business Intelligence Grant McInnes. Although available only for the iPhone now, TMA is developing the same app for the Blackberry and the Android.

TEXAS ENJOYS ANOTHER RECORD YEAR IN PHYSICIAN LICENSE REQUESTS

Our successful liability reforms continue to draw record numbers of new physicians. The Texas Medical Board (TMB) finished the fiscal year having received a record 4,128 new physician applications. Last year’s total of 4,094 was the previous record. This marks the fifth successive year that new physician applications have exceeded 4,000 and continues to dwarf the prereform numbers (pre-2003). TMB licensed 3,523 new doctors this year; that’s 12 percent more than last year and just 98 short of the state’s all-time record of 3,621.

TMA BACKS PHYSICIAN-OWNED HOSPITALS' SUIT

TMA filed an amicus curiae brief (PDF) in federal district court that supports a lawsuit seeking to overturn the new health system reform law’s restrictions on physician ownership of hospitals. We put our weight behind a federal lawsuit against Health and Human Services Secretary Kathleen Sebelius by Physician Hospitals of America and Texas Spine & Joint Hospital. “Physician hospitals have endured bullying by their non-physician-owned competitors for years,” the brief says. “Unfortunately, under pressure from non-physician-owned hospital giants, the government has impermissibly banned the future development of physician-owned hospitals. There is no justification for targeting the class of physicians in this way. No other class of professionals is discriminated against in this way.

DR. BAILEY TAKES HEALTH REFORM SCHOOL TO SOUTH TEXAS

Storms ravaging the DFW Airport slowed but could not stop TMA President Sue Bailey, MD, from filling her roll as chief instructor in TMA’s Health Reform School. Dr. Bailey made it to Corpus Christi in time to join senior TMA staff for a presentation to the Nueces County Medical Society. Later in the week, she traveled to San Antonio for the Baptist Health System Physician Hospital Organization’s annual physician conference. The latest version of Health Reform School covers:
  • Provisions of the new health system reform law effective in 2010, many of which start Sept. 23;
  • The current political climate on Capitol Hill;
    How the new quality rating and fraud and abuse provisions impact you and your practice; and
  • What you need to know about accountable care organizations.

Remember to wait by your home phone at 8 pm on Wednesday, Sept. 15, when Health Reform School comes directly to you. All you have to do is stay on the line and listen — or ask questions. You will earn 1 hour of continuing medical education credit for your time (as long as you stay on the line for the entire program). No reservation is necessary.

ARE YOU ON TOP OF NEW COMP RULES?

If you don’t keep up with workers’ compensation rules and regulations, your practice and your comp patients can run into trouble. TMA’s daylong “Workers’ Compensation 2010” seminar series begins this week. Register online. TMA and representatives from the Texas Department of Insurance Division of Workers’ Compensation will address the most frequently asked comp questions; offer practical advice on common billing, coding, and administrative errors; and preview proposed regulations that will affect how you care for injured workers in Texas.

Monday, June 28, 2010

MEDICARE PATCH APPLIED; PAYMENTS ON HOLD AGAIN

The 21-percent cut is, temporarily again, on hold. Unfortunately, so are Medicare and TRICARE payments to physicians as the Centers for Medicare & Medicaid Services hustles to implement the 2.2-percent increase that Congress included in its latest Band-Aid. Payments reflecting the new fee schedule, which will be in place through Nov. 30, should begin flowing by Thursday. It was last Thursday when the U.S. House of Representatives finally approved the patch. The increase automatically will be applied retroactively for claims for services on or after June 1. It’s one of several sad commentaries on Medicare financing that the 2.2-percent increase is the largest for physicians since 2001. Here are two more: If Congress does nothing between now and Nov. 30, Medicare payments will drop by 23.5 percent. And on Jan. 1, 2011, the cut will be an additional 6.1 percent. "I don’t want to be watching Congress wrestle with this turkey of an issue on Thanksgiving," TMA President Sue Bailey, MD, said in a news release after the House vote. If history is any guide, it will likely be a Thanksgiving turkey and a Christmas goose. Prospects for a long-term replacement for the Sustainable Growth Rate (SGR) formula remain awfully dim. I do want to send a shout out to the four House members from Texas who stood up during the debate to call for a permanent fix. They were Reps. Michael Burgess, MD (R-Lewisville), Charlie Gonzalez (D-San Antonio), Gene Green (D-Houston), and Sheila Jackson Lee (D-Houston). Dr. Bailey wants to take them up on it. “I am ready, right now, to roll up my sleeves and get to work,” she wrote in a letter to the Texas delegation in Congress. “But physicians can’t do it without Congress. And our patients, your constituents, need us to work together now and get this done.”

TMA CALLS FOR SCALPEL, NOT CLEAVER, ON STATE BUDGET

A 1-percent cut in physicians’ Medicaid payments could actually cost the beleaguered state budget more than it saves, TMA witnesses will explain at a Texas Health and Human Services Commission (HHSC) hearing tomorrow. As outlined in a letter (PDF) Dr. Bailey wrote to state leaders, the proposed cut in Medicaid and Children’s Health Insurance Program (CHIP) payments could backfire by further reducing physician participation in those programs. “Texas must make investments in primary and preventive health care that will reap much-needed savings down the road,” she wrote. “To that end, one of the soundest investments Texas can make to limit Medicaid and CHIP cost growth is to broaden physician participation in these programs.” Dr. Bailey also called on primary care physicians to share their concerns with their state senators and representatives and with HHSC Commissioner Tom Suehs. Use the TMA Grassroots Action Center to send your comments no later than 5 pm Tuesday.

POEP WINS $500,000 GRANT

The Cancer Prevention and Resource Institute of Texas approved a half-million-dollar grant to TMA’s Physician Oncology Education Program (POEP) for the next fiscal year. The grant, a big increase over POEP’s previous funding, will pay for seven physician education modules. TMA formed POEP in 1987. Its role is to educate primary care physicians about the state of the art and science in cancer prevention, screening, early detection, and control. Lewis Foxhall, MD, of Houston, the current chair of the POEP Steering Committee, did yeoman’s work along with our staff to secure the grant.

EVPGRAM TO TAKE SUMMER BREAK

With the latest Medicare crisis behind us for a few months, EVPGram begins our annual summer hiatus. We’ll be back to our regular schedule in August and, of course, bring you updates on fast-breaking issues as they occur. Happy Independence Day.

Monday, June 21, 2010

MEDICARE PAYMENT PROBLEMS HURTING TEXAS PATIENTS

Medicare payment checks to physicians are flowing again — but they’re 21.3 percent smaller than they were this time last week as Medicare officials could no longer wait for Congress to figure out how to apply the latest Band-Aid. A TMA flash survey that accompanied our news reports of the latest Medicare Meltdown finds that Texas physicians will take or are considering some very drastic action in response. The chart below shows the preliminary responses to the question, “Regardless of the outcome of the current Medicare payment cut, the ongoing cash flow problems and constant uncertainty over Medicare payments has led my practice to take, or consider, the following steps:”
  • Reduce my total Medicare caseload: 252 (68%)
  • Refuse all new Medicare patients: 210 (57%)
  • Lay off staff: 197 (53%)
  • Refer Medicare patients to the emergency room: 120 (33%)
  • Drop out of Medicare altogether: 117 (32%)
  • Stop seeing existing Medicare patients: 91 (25%)
  • It doesn't matter, I don't take Medicare anyway: 2 (1%)

We will keep the survey open for a few more days, so please share your opinion if you haven’t yet. The U.S. Senate on Friday approved a deal stopping the cuts and raising fees 2.2 percent until Nov. 30. But the House of Representatives had already gone home for the weekend and was not scheduled to resume voting until tomorrow. That led the Centers for Medicare & Medicaid Services, which had held Medicare payments since the first of the month, to direct Medicare contractors to begin processing claims dated June 1 and later under the new rates on a first-in, first-out basis. “Washington obviously doesn’t realize the damage they’re doing to our practices and our patients,” said TMA President Sue Bailey, MD.

ANNIS WINS REELECTION TO AMA BOARD OF TRUSTEES

Our concerns over a potential anti-incumbent backlash at the American Medical Association House of Delegates didn’t materialize, as Austin anesthesiologist Joe Annis, MD, handily won reelection to the AMA Board of Trustees. Dr. Annis was one of eight candidates — and the only incumbent — seeking four seats on the board. “I’m so proud to be a member of a group of this caliber,” Dr. Annis told the Texas Delegation to the AMA. Other Texas candidates also did well in Chicago:
  • Elliot Richards, a first-year student at Baylor College of Medicine, was elected chair of the AMA Medical Student Section, Region 3. Andrew Harrell, another first-year student at Baylor, was elected secretary/treasurer.
  • Nakita Moore, MD, a third-year resident in child and adolescent psychiatry at Scott & White Memorial Hospital, was elected vice chair of the AMA Resident and Fellow Section, Region 3.

See photos and all of our coverage of the AMA meeting on Blogged Arteries.

PUBLIC HEALTH COALITION PRAISES SMOKING CESSATION PROGRAM

A smoking cessation pilot project under development for Texas Health and Human Services Commission (HHSC) state employees throughout Texas won the support of the Public Health Coalition. TMA is a charter member of the coalition. “For the 2009 session of the Texas Legislature, the coalition’s list of ‘legislative asks’ included funding for a comprehensive, statewide tobacco prevention and cessation program,” coalition Chair Herminia Palacio, MD, wrote to Commissioner Tom Suehs. “Thus we strongly support pilot initiatives such as the one HHSC is creating.”

STATE SENATE SPECIAL ELECTION TOMORROW; TEXPAC BACKS SIBLEY

Attention all physicians and alliance members in Texas Senate District 22 (in and around Waco). Former Sen. David Sibley (R-Waco) needs your help. The special election runoff to replace Sen. Kip Averitt (R-Waco) is tomorrow. Please cast your vote for him and spread the word. TEXPAC Board of Directors Chair Susan Strate, MD, said, “Without question, David Sibley is the most qualified candidate in the race when it comes to issues affecting patients and physicians.”

Tuesday, June 15, 2010

Congress Leads Physicians and Patients to Medicare Meltdown

The 21-percent cut in physicians’ Medicare and TRICARE payments kicks in this week with no relief in sight. After the Senate let the June 1 deadline come and go, the Centers for Medicare & Medicaid Services (CMS) ordered carriers to hold Medicare claims for 10 business days. Today is the 10th day. This morning, CMS ordered an additional three-day hold. Carriers will begin processing claims under the new lower rates on Friday unless Congress sends legislation to the president before then. Neither the House and Senate nor Republicans and Democrats can agree on how to pay for the Medicare payments or other programs that have expired. That’s what’s causing the delay. We will keep you informed if the situation changes. TMA, the American Medical Association, and all of organized medicine continue to push for both a quick end to this brinksmanship and a long-term replacement for Medicare’s physician payment formula. “Patients and physicians should not become collateral damage in a congressional stalemate on budgetary matters,” we said in a joint statement to Congress. “We expect our elected officials to resolve the budget issues without punishing physicians, seniors, and military families.” Yesterday, the AMA House of Delegates conducted a Write Coat Rally in one more attempt to get through to Congress.

Congratulations to Incoming AMA Alliance President Susan Todd

If organized medicine in Texas were a corporation, our most valuable assets would be our human resources. We are blessed with fantastic physician and alliance leaders who make us great. In the past decade, few have shined more brightly than former TMA Alliance President Susan Todd of Fort Worth. She also has led our TMA Foundation and is the driving force behind TMA’s First Tuesdays at the Capitol. Tomorrow, she takes her starring role to the national stage when she takes office as president of the AMA Alliance. To do something better, you must work an extra bit harder. For Susan Todd, that’s a constant state of mind, a disposition. Congratulations, Susan!

Deadline Tuesday for TMA Leadership College

Ready to take your leadership skills to the next level? Applications for the TMA Leadership College are due tomorrow, June 15. I invite all interested TMA members in their first eight years of practice or under the age of 40 to apply to this new leadership development program, designed to identify, train, and build young TMA member physicians into leaders at the state and local levels.

TEXAS MEDICAL STUDENTS WIN AMA LEADERSHIP POSTS

Elliot Richards, a first-year student at Baylor College of Medicine, was elected chair of AMA Medical Student Section Region 3. Andrew Harrell, another first-year student at Baylor, was elected secretary/treasurer. Congratulations, gentlemen. And Meredith Williams, another Baylor student who formerly served on the TMA Board of Trustees, takes her seat this week as the student member of the AMA Board of Trustees. She won that position in November.

State Senate Special Election Voting Begins Today

Attention all physicians and alliance members in Texas Senate District 22 (in and around Waco). Former Sen. David Sibley (R-Waco) needs your help. Early voting in the special election runoff to replace Sen. Kip Averitt (R-Waco) runs from today through Friday. Election day is Tuesday, June 22. TEXPAC Board of Directors Chair Susan Strate, MD, said Mr. Sibley earned medicine’s endorsement "because he has committed to supporting TMA's legislative agenda of protecting tort reform, patient rights, physician autonomy, insurance reform, and public health."

DO YOU KNOW ABOUT THE LINKS BETWEEN SMOKING AND MENTAL ILLNESS?

Thanks to the TMA Department of Public Health for collecting these interesting stats:

  • Rates of smoking are two to four times higher among people with psychiatric disorders and substance use disorders.
  • Nearly 41 percent of people who reported having a mental illness within the last month smoked.
  • 60 percent of current smokers report a past or current history of a mental health diagnosis sometime in their lifetime.
  • Quit rates among smokers with any history of mental health diagnoses are significantly lower than smokers with no history of mental illness.

Monday, June 7, 2010

AMA MEETING NEEDS DEBATE ON ORGANIZED MEDICINE'S FUTURE

With America’s physicians sharply divided over the American Medical Association’s strategy to support health system reform, the upcoming meeting of the AMA House of Delegates should be a lively one. Two important questions that should be asked:
  • Is AMA standing up for U.S. physicians so the physicians can stand up for their patients? Is it engaging grassroots physicians in the political and legislative process?
  • Is it providing physicians the tools they need to — as TMA President Sue Bailey, MD, says — “survive and thrive in the new health care landscape”?

These are some of the issues I hope delegates address, both on the floor and in the back room discussions, when the AMA house convenes Saturday in Chicago. The debates over AMA policy and the officer elections (PDF) — three candidates are running for AMA president, and eight physicians are seeking four spots on the Board of Trustees — will provide the forum for these discussions. Austin anesthesiologist Joe Annis, MD, an incumbent trustee, is running for reelection on the TMA platform: “Keep what’s good; fix what’s wrong.” Stay tuned. We’ll live blog all the key debates and report the outcomes here and in Texas Medicine. Add your opinions on TMA’s Twitter feed and Facebook page.

"STOP THE MEDICARE MELTDOWN" PETITION DRIVE HITS 100,000 SIGNATURES

As you’re reading this, members of Congress are returning from their Memorial Day recess, and TMA’s petition to “Stop the Medicare Meltdown” is collecting its 101,000th signature. The connection? Congress is back in Washington with a seven-day window to stop the 21-percent cut in physicians’ Medicare payments from taking effect. The cut kicked in June 1, but the Centers for Medicare & Medicaid Services (CMS) ordered carriers to hold Medicare claims for 10 business days. Our online petition campaign, plus nearly 20,000 paper signatures, calls on Congress to stop the Medicare madness. Physicians and patients are suffering from the constant uncertainty. If you haven’t yet, please sign the petition today and check out and share our latest mashup video.

TMB MEDICAL DIRECTOR TO STEP DOWN JULY 1

The Texas Medical Board’s (TMB’s) loss is TMA’s gain. Alan Moore, MD, the TMB’s first medical director, is leaving the agency July 1 to return to the private sector. I also am talking to the Austin pathologist about taking an active role in the TMA policymaking process. Dr. Moore has been a voice of reason at TMB, sharing our desire for a strong and fair board.

MEDICARE HSAs AND BILLING PRIVILEGES FOCUS OF TMA RESOLUTIONS IN AMA HOUSE

Following up on actions last month by the TMA House of Delegates, the Texas delegation is bringing a pair of resolutions to Saturday’s AMA house meeting. Resolution 115 calls on AMA to support legislation in Congress to allow Medicare beneficiaries to make tax-free contributions to health savings accounts. Resolution 116 would change AMA policy to prevent paperwork delays at CMS from penalizing physicians who provide care for Medicare patients. Check out Blogged Arteries and next week’s EVPGram for progress on these two items.

Tuesday, June 1, 2010

With Senate Inaction, Medicare and TRICARE Cuts Kick In — Again — Today

U.S. senators left Washington to ride in Memorial Day parades but left some work unfinished. For the third time this year, Congress went on vacation and allowed a 21-percent cut in physicians’ Medicare and TRICARE payments to take effect. For the third time this year, the Centers for Medicare & Medicaid Services ordered carriers to hold Medicare claims for 10 business days, this time until June 14, to allow time for Congress to return from vacation and vote to stop the cut. “As we prepare to honor those who have given their lives to our country this Memorial Day weekend, Congress turns its back on their families when they need health care,” TMA President Sue Bailey, MD, said. “It's time to stop playing politics with our patients’ lives and health.” What the Senate failed to vote on was a House-passed proposal that would provide a 2.2-percent Medicare physician payment increase for the rest of this year and a 1-percent update for 2011, and revert back to current law in 2012 — when an estimated cut of 30 to 32 percent would be called for under the Sustainable Growth Rate (SGR) formula.

Tell Congress What You Think About the Medicare Meltdown

Tired of constantly being the yo-yo on the congressional Medicare string? Here are two ways to tell Washington what you think of the latest on-again, off-again 21-percent cut in Medicare payments. TMA and our 50 state medical society partners continue to push for signatures on our petition asking Congress for a permanent revision to the Medicare payment formula. If you haven’t yet, please sign the petition today. It takes about 10 seconds of your time. After you sign it, ask your friends, family, and neighbors to sign it until you get 10 signatures or more. Also, the American Medical Association is encouraging physicians to contact Congress to explain how its mismanagement of the Medicare program is wreaking havoc on your practices. Use AMA’s grassroots hotline, (800) 833-6354, or send an e-mail.

TMA WINS BIG IN PHYSICIAN RATING RULES

It took the Texas Department of Insurance (TDI) nearly a year to write rules implementing a key piece of TMA’s health insurance reform package that the Texas Legislature approved in 2009. And TDI came through with flying colors by making sure that health insurance companies play as fairly as possible in their various schemes to rank physicians on cost and quality. As mandated by House Bill 1888 by Rep. John Davis (R-Houston) and Sen. Robert Duncan (R-Lubbock), the new rules require health plans to conform to nationally recognized standards and guidelines when ranking or tiering physicians. Additionally, it gives physicians extensive due process protections. One of the most important changes requires the health plans to inform physicians ahead of time when they are gathering data for performance rankings. TDI agreed with virtually all of the recommendations TMA made when it adopted the rules.

TEXPAC-ENDORSED JUDGE PLACED ON HIGH COURT

Gov. Rick Perry appointed TEXPAC-endorsed Judge Debra Lehrmann to a seat on the Supreme Court of Texas through the November general election. Judge Lehrmann is filling the seat vacated by Justice Harriet O’Neill, who stepped down. With TEXPAC’s help, Judge Lehrmann earlier this year secured the Republican nomination for a full term on the high court.

TECHNOLOGY BRINGS TMA HEALTH REFORM SCHOOL TO 4,200 PHYSICIANS AND MEDICAL STUDENTS

The phones rang all over the state, and you answered. Using the tele-town hall technology, more than 4,200 TMA-member physicians and medical students listened in to our Health Reform School session. “Just like our patients, our member physicians are uncertain about what’s in the new law and what it means to their practices,” said Dr. Bailey, who hosted the call. “It’s our responsibility to bring them the facts as we know them and the implications as we see them.” If you missed it, check TMA’s Health System Reform Action Center, where we’ll post the audio recording later this week. The online education center already includes two new TMA health system reform white papers: “Four Things Physicians Need to Know About Medicare Fees” and “Eight Things Physicians in Independent or Small-Group Practice Need to Know About Health System Reform.

“RED FLAGS RULE” DELAYED UNTIL YEAR'S END

The Federal Trade Commission (FTC) has delayed until Dec. 31 enforcement of the "red flags rule" (PDF) that was scheduled to take effect June 1. TMA has joined with AMA and other medical societies in fighting the rule, which says physicians who regularly bill their patients for services (including billing for copayments and coinsurance) are creditors and must develop and implement written identity theft prevention programs for their practices. The programs must identify and respond to patterns, practices, or specific activities known as "red flags" that could indicate identity theft. Visit TMA's Identity Theft Compliance resource page for more information, including how to sign up for the Red Flag Rules Recorded Webinar.

Monday, May 24, 2010

CONGRESS HAS THREE-YEAR SGR FIX IN THE WORKS

Democratic leaders in Congress are working up a three-year deal to address the looming 21-percent cut in physicians’ Medicare payment rates. The third Band-Aid of 2010 expires June 1. Under a deal crafted by House Ways and Means Committee Chair Sandy Levin (D-Mich.) and Senate Finance Committee Chair Max Baucus (D-Mont.), payments would increase by 1.3 percent for the remainder of 2010. In 2011, the proposal adds an additional 1 percent. The updates for 2012 and 2013 would be tied to the gross domestic product (GDP). For evaluation and management codes, the change would be GDP plus 2 percent; for all other services it would be GDP plus 1 percent. After 2013, the payment formula would revert to the current sustainable growth rate system, so physicians once again would face drastic cuts — probably in the 30- to 33- percent range — unless Congress acts again in the future. The bill is expected to be considered by the House early this week. As always, it seems they are running down to the wire to get this done before the Memorial Day recess. The House probably has until midweek to pass it, which it is expected to do. Senate action would follow late in the week. Presumably.

TMA'S "STOP THE MEDICARE MELTDOWN" PETITION DRIVE BRINGS PUBLIC AWARENESS TO SGR

Even if Congress enacts a three-year SGR fix this weekend, TMA and our 50 state medical society partners continue to push for signatures on our petition asking Congress for a permanent revision to the Medicare payment formula. As one prominent editorial stated last week, “Medicare is a lifeline for many Texas seniors. They have counted on it to be there for them in their time of need. But with physicians fleeing from the program, this security net is fraying badly. It must be fixed.” We have nearly 100,000 signatures on file already. If you haven’t yet, please sign the petition today. It takes about 10 seconds of your time. After you sign it, ask your friends, family, and neighbors to sign it until you get 10 signatures or more.

HEALTH REFORM SCHOOL: DON'T CALL US, WE'LL CALL YOU

We know it’s a new concept, so we’re not surprised that our tele-town hall meeting on health system reform is raising some questions. There’s no phone number for you to call. We will call you Thursday night. Expect your home phone to ring shortly before 8 pm Central Time. (Don’t worry, we’re protecting the privacy of your phone number.) Once we call you, you’ll have the choice to hang up or stay on the call. Stay on the line if you want to listen to TMA President Sue Bailey, MD, and physician and staff experts explain how your practice can “survive and thrive in the new health reform landscape.” We call it TMA’s Health Reform School. Join more than 20,000 of your colleagues in the broadcast. Ask questions. You also can use your computer to participate in the conference via a live web broadcast.

TMA TO HOST TWO-DAY LOOK AT THE FUTURE OF HEALTH CARE

The CEOs of 40 state medical societies gather at the TMA building today for a two-day conference on the future of health care and how organized medicine can best serve our members in this tumultuous environment. University of Virginia Associate Professor Jeff Goldsmith, a noted health care futurist, will deliver the keynote address. Topics on the agenda include organizational evolution, cultural changes within physician employment, staying sustainable, and creating value in membership. We’ll have a complete report in next week’s EVPGram.

WHAT DO YOU THINK BELONGS IN TMA'S FUTURE?

The TMA Board of Trustees will do some futures preparation of its own at our annual midsummer strategic planning session. We’ve invited Texas health care leaders from inside and outside of TMA to help us understand the forces that are shaping the new health care landscape. As always, our goal is to position TMA so we can best meet your needs today as well as five and 10 years down the line. Have some ideas on what the trustees need to cover? Send them my way.

AMA, OTHERS SUE TO STOP "RED FLAGS RULE"

Physician groups from around the country filed suit in federal court to prevent the Federal Trade Commission (FTC) from extending identity theft regulations to physicians. Led by the American Medical Association, the complaint (PDF) alleges that the FTC’s application of its “red flags rule” to physicians is “arbitrary, capricious and contrary to the law.” The rule says physicians who regularly bill their patients for services (including billing for copayments and coinsurance) are creditors and must develop and implement written identity theft prevention programs for their practices. The programs must identify and respond to patterns, practices, or specific activities — known as “red flags” — that could indicate identity theft. The Litigation Center of the AMA and State Medical Societies developed and approved the filing of this case. TMA is a founding member of the Litigation Center, and TMA General Counsel Rocky Wilcox is chair of the executive committee.

Monday, May 17, 2010

LISTEN FOR CALL FROM TMA'S HEALTH REFORM SCHOOL

Have questions about what the new health reform law means for your practice and your patients? Plan on being near the telephone at 8 pm (7 pm Mountain Time) on May 27. You’ll be hearing from us when we reach out to invite you to join TMA’s free Health Reform School. Moderated by TMA President Sue Bailey, MD, the hour-long tele-town hall meeting will feature physicians and TMA staff experts with information on how your practice can “survive and thrive in the new health reform landscape.” When the teleconference begins, you’ll get a telephone call. When you answer, you’ll hear a message from Dr. Bailey inviting you to remain on the phone to participate. If you have a question, just press 0 on the telephone keypad, and you’ll be entered in the queue to ask it. You also can use your computer to participate in the conference via a live web broadcast. Click on the link at 8 pm May 27, enter your information, and press OK.

MORE THAN 80,000 SIGN PETITION TO STOP THE MEDICARE MELTDOWN

TMA’s nationwide petition asking Congress to rewrite the Medicare payment formula flew past the 80,000-signature mark over the weekend. But we still have a long way to go. The next Medicare Meltdown date is June 1, when physicians’ payments once again will plummet by 21 percent. Congress thinks you don’t care. Congress thinks your patients don’t care. We need to prove Congress wrong. If you haven’t yet, please sign the petition today. It takes about 10 seconds of your time. After you sign it, ask your friends, family, and neighbors to sign it until you get 10 signatures or more. If you belong to civic groups, take the petition with you to meetings. We must get 1 million signatures by May 31. If you want hard copies of the petition, call Pam Udall at TMA at (800) 880-1300, ext. 1382, or download one from the TMA website (PDF). Note: Due to HIPAA regulations, we recommend that you not collect signatures directly from your patients nor use patient lists to disseminate this information without first having a HIPAA-compliant patient authorization to do so. You can post this flyer (PDF) in your waiting room.

LEGISLATIVE HEARINGS ZERO IN ON HEALTH REFORM IN TEXAS

The 2011 Texas Legislature won’t convene for eight more months, but your representatives and senators already are preparing for how the state will respond to the new federal health reform law. So is TMA. It’s our goal to make sure that Texans decide what health reform will look like in Texas. Council on Legislation Chair Dan McCoy, MD, led a host of TMA leaders who testified before legislative committees last week in hearings covering physician employment, scope of practice, Medicaid expansion, health information technology, the Texas Medical Board, patient privacy, and many more issues. Our witnesses included TMA House of Delegates Vice Speaker Cliff Moy, MD; John Holcomb, MD, chair of TMA’s Select Committee on Medicaid, CHIP, and the Uninsured; and Houston pediatric rheumatologist Robert Warren, MD.