About TMA Related Organizations TMA Calendar Site Map Contact Us

Tuesday, May 31, 2011

GOVERNOR PERRY PUTS MEDICAID COSTS ON AGENDA FOR SPECIAL SESSION

Texas lawmakers won’t even have a chance to head home for a change of clothes. The 2011 Texas Legislature regular session ended yesterday, and Gov. Rick Perry called them back for a special session that begins at 8 am today. The governor, who controls the agenda for a special session, has directed legislators to work on two items that failed to pass in the regular session:

  • A bill needed to balance the 2012-13 state budget, including a $4 billion cut in state spending on public schools; and
  • “Legislation relating to health care cost containment, access to services through managed care, and the creation of economic and structural incentives to improve the quality of Medicaid services.”
The Medicaid bill that died on the House calendar late Sunday night would have saved about $500 million for the state. A few ways it would achieve the savings are by expanding Medicaid managed care into the Rio Grande Valley, requiring Medicaid patients to use medicines on a state preferred drug list, and requiring Texans with disabilities to get home health services through Medicaid first.

TMA WINS KEY MEDICAL BOARD CHANGES

Physicians will face less bureaucratic hassle from the Texas Medical Board under a trio of TMA-backed bills that are waiting for Governor Perry’s signature. “These three bills provide much-needed due process protections for physicians without endangering the 2003 liability reforms that have meant so much to Texas,” TMA President Bruce Malone, MD, said in a letter (PDF) urging the governor to sign them. One of the most important things the bills would do is prohibit the filing of anonymous complaints. All three bills were headed for quick passage last week when special interests opposed to TMA sidelined the most important one, Senate Bill 190 by Sen. Jane Nelson (R-Flower Mound). Some quick thinking by Senator Nelson and Sen. Joan Huffman (R-Southside Place), however, resurrected that bill by tacking its contents onto another TMB-related measure sponsored by Rep. Charles Schwertner, MD (R-Georgetown). Read more details in a special issue of Action we emailed last week and in the July cover story of Texas Medicine magazine.

OTT TO LEAD TMLT

The Texas Medical Liability Trust (TMLT) Board named Charles R. (Chip) Ott Jr. as the new TMLT president and chief executive officer. He will assume office in late July, replacing Bob Fields, who is retiring after 25 years with the trust. Most recently, Mr. Ott was executive vice president of Guy Carpenter and Company, LLC, a global reinsurance broker. We welcome him to the TMA family.

LAWMAKERS ADOPT A PAIR OF NEW TMA HOUSE OF DELEGATES POLICIES

Less than a month after the TMA House of Delegates met, the Texas Legislature passed bills enacting two new house policies.
  • The House of Delegates “took a firm stand against the epidemic use” of cell phones and texting while driving because they often cause accidents. The legislature on Saturday sent Governor Perry House Bill 242 by Rep. Tom Craddick (R-Midland). It includes TMA-backed language from Sen. Judith Zaffirini (D-Laredo) that would outlaw sending or reading emails or text messages while driving.
  • The TMA house asked the legislature to encourage natural gas production but protect Texas water from the risk of hydrofracking by requiring disclosure of fracking fluid components. Lawmakers passed HB Bill 3328 by Rep. Jim Keffer (R-Eastland) and Senator Nelson. The bill requires natural gas drillers to publicly disclose the chemicals they use in hydraulic fracturing.

2012-13 STATE BUDGET SPARES MEDICAID RATE CUTS, BUT NOT GME

By votes of 97 to 53 in the House and 20 to 11 in the Senate, lawmakers on Saturday approved the 2012-13 state budget. The bill cuts state spending by $15.2 billion from current levels, much of that in public and higher education. It avoids the proposed 10-percent cut in physicians’ Medicaid payments but does not take into account any growth in the Medicaid rolls. It avoids steep cuts in public health and mental health programs but slashes spending on graduate medical education (GME) and physician loan repayment programs. TMA supported the Senate version of the state budget, which was far less severe in its treatment of GME and the loan repayment programs, but budget negotiators chose to adopt the House version of those items.

DR. ROHACK TO ASSUME TWO NEW SPOTS POST-AMA SERVICE

Former TMA President Jim Rohack, MD, who will end his service as immediate past president of the American Medical Association next month, has a pair of new duties lined up. He was appointed the first holder of the William R. Courtney Centennial Chair in Humanities at the Texas A&M Health Science Center College of Medicine. Dr. Rohack also will represent Scott & White Healthcare on the steering committee of the new High Value Healthcare Collaborative (HVHC), a group of eight health systems working to “improve health care, lower costs, and move best practices out to the national provider community.”

Monday, May 23, 2011

A GREAT WEEK FOR TMA'S LEGISLATIVE AGENDA

Just seven days remain in the 2011 Texas Legislature’s regular session (holding our breaths on whether we’ll need a special session), and we can put a slew of checkmarks on TMA’s advocacy agenda for you and your patients. Several bills critical to our legislative program are nearly through the legislative process and close to the governor’s desk for signature. They provide physicians important employment protections and reform the Texas Medical Board (TMB). These bills complement the rural employment protection bill Governor Perry already signed. Last week:


  • The House passed Senate Bill 1661 by Sen. Robert Duncan (R-Lubbock) and Rep. Todd Hunter (R-Corpus Christi), which would provide whistle-blower protection and ensure clinical autonomy for thousands of physicians employed in 501(a) corporations.
  • The Senate passed House Bill 2351 by Rep. Ruth Jones McClendon (D-San Antonio) and Sen. Leticia Van de Putte (D-San Antonio), which would allow the Bexar County Hospital District to employ physicians with protections to meet its statutory mission of providing indigent care.
  • The Senate approved HB 1380 by Rep. Vicki Truitt (R-Keller) and Sen. José Rodríquez (D-El Paso), which would allow international medical graduates to apply for Texas licenses after two years of residency training.
  • The House passed SB 191 by Sen. Jane Nelson (R-Flower Mound) and Rep. Susan King (R-Abilene), which would bind TMB to the ruling of an administrative law judge.
  • The House passed SB 227 by Senator Nelson and Representative King, which would allow TMB to waive a fine in lieu of a remedial action plan for a minor administrative violation.
  • One critical bill — SB 190 by Senator Nelson and Representative King — was knocked off the fast track for House approval by special interests opposed to TMA. It now will be reassigned to the General House Calendar. SB 190 has many TMB reforms that we have worked to win over the past two sessions. We have other legislative strategies in play as a backup to this bill.
  • TMA witnesses at House and Senate committee hearings were Erica Swegler, MD, a Keller family medicine physician and chair of TMA’s Committee on Infectious Diseases; Alice Gong, MD, a San Antonio neonatal-perinatal specialist and a member of TMA’s Committee on Maternal and Perinatal Health; and Matt Murray, MD, a Fort Worth pediatrician and vice chair of TMA’s Health Information Technology Ad Hoc Committee. Thanks to each of you.

STATEWIDE SMOKING BAN ADVANCES

TMA and public health advocates joined with Rep. Myra Crownover (R-Denton) to win House adoption of an amendment that would ban smoking statewide in public places and indoor workplaces. The measure was attached to a must-pass piece of legislation.

APPARENT BUDGET DEAL GOOD FOR MEDICAID, PUBLIC HEALTH BUT BAD FOR MEDICAL EDUCATION

The House and Senate worked through the weekend to reach final agreement on a state budget for 2012-13 and on bills that will help to finance the budget. The good news is that the apparent budget deal includes no cuts to physicians’ Medicaid or Children’s Health Insurance Program payments, no cuts to state mental health programs, and significant reversals of proposed cuts to tobacco cessation and other public health programs. Here’s the bad news. As lawmakers worked to push every available education dollar into the public schools, they pulled money out of higher education. That means steep cuts to undergraduate and graduate medical education.

TMA FOUNDATION'S PICTURE OF GOOD HEALTH A PICTURE-PERFECT SUCCESS

More than 500 physicians, their spouses, and business and academic leaders enjoyed the TMA Foundation’s (TMAF’s) 18th annual gala at TexMed 2011 in Houston. Two new features, a live auction and Fund-A-Need campaign, helped TMAF raise a near-record $300,000 at the event. Special thanks to cochairs Martin and Kelli Cohen Fein, MD, and Dr. Russ and Mrs. Cheryl Kridel. They presented awards to the foundation’s Houston Health Leaders in Medicine, Business, and Community: Joel Dunnington, MD; H-E-B and its Houston president, Scott McClelland; and Gracie Cavnar, cofounder of Recipe for Success Foundation. All were recognized for their contributions to improve the health of all Texans. The evening’s proceeds benefit TMAF, and the TMA and TMA Alliance programs it supports, including Be Wise — ImmunizeSM, Hard Hats for Little Heads, Ernest and Sarah Butler Awards for Excellence in Science Teaching, TMA’s Minority Scholarship Program, and the Physician Oncology Education Program.

Be Wise — Immunize is a service mark of the Texas Medical Association.

DR. MULLINS TO HEAD TMA 50-YEAR CLUB

Charles B. Mullins, MD, of Austin is the new president of TMA’s 50-Year Club, a group of physicians who graduated from medical school at least 50 years ago but whose commitment to the advancement of medicine remains strong. He took the post at TexMed 2011 in Houston. Dr. Mullins has been teaching future physicians for more than 40 years and is executive vice chancellor for health affairs emeritus for The University of Texas System. In other TexMed news:
Minority students entering all nine Texas medical schools each received a $5,000 scholarship. To date, our Minority Scholarship Program has awarded 65 scholarships totaling $325,000.

TMA WINS PLATINUM

TMA’s Communications Division received three Hermes Creative Awards from the Association of Marketing and Communication Professionals. Hermes Creative Awards is an international competition for creative professionals involved in the concept, writing, and design of traditional and emerging media. In the Community Relations category, our Stop the Medicare Meltdown campaign received a Platinum award, cited as “among the most outstanding entries in this competition.” TMA’s Health Reform School received a Gold award, and www.texmed.org received an Honorable Mention certificate in the website overall category. Congratulations to Communications Vice President Steve Levine and his outstanding communication team.

Monday, May 16, 2011

MALONE, MCKEEVER TAKE OFFICE TO HEAD TMA, ALLIANCE

C. Bruce Malone III, MD, of Austin became TMA’s 146th president in an installation ceremony at TexMed 2011 in Houston. Bridget McKeever of Corpus Christi was installed as the 94th president of the TMA Alliance. “In this time of disruptive change, we cannot just say ‘no,’” Dr. Malone, an orthopedic surgeon, said in his installation address. “We have to help create a reorganized medical marketplace that creates value for the consumer and gives us a right to practice in the public system while having the option to privately contract with patients who want more.” Mrs. McKeever said, “I know that my collaboration with Dr. Bruce Malone will inspire me to take on new challenges to serve the medical family.”

GOVERNOR PERRY SIGNS TMA'S RURAL EMPLOYMENT PROTECTION BILL

The first component of TMA’s physician-employment protection package is now law. Gov. Rick Perry signed Senate Bill 894 by Sen. Robert Duncan (R-Lubbock). The new law allows critical access hospitals, sole community hospitals, and hospitals in counties of 50,000 or fewer to employ physicians. Most of these hospitals are run by local governments. The bill contains many features that protect the physician’s clinical autonomy against the corporate practice of medicine. “Hospitals want to employ physicians? Fine … but you’ll do it by our rules,” outgoing TMA President Sue Bailey, MD, told the House of Delegates. “And those rules say that doctors and our patients, not hospital administrators, make the decisions that count.” Our four remaining employment protection bills each has passed at least one chamber of the legislature and is in great shape to become law before the legislative session ends May 30.

SPEER CHOSEN TMA PRESIDENT-ELECT

The House of Delegates selected a new slate of TMA leaders. Michael Speer, MD, a Houston neonatologist, was chosen president-elect. He will take office as president at TexMed 2012 in Dallas. Here are the other election results:

  • House Speaker Steve Brotherton, MD; Vice Speaker Clifford Moy, MD; and Secretary/Treasurer Art Klawitter, MD, all won reelection.
  • The delegates reelected Carlos Cardenas, MD, and Austin King, MD, and elected Dan McCoy, MD, of Dallas to the TMA Board of Trustees.
  • Board members chose Tom Garcia, MD, as the new board chair. Dr. Cardenas is the new vice chair; Dr. McCoy is the new board secretary; and Don Read, MD, and Lewis Foxhall, MD, are the at-large members of the board’s Executive Committee.
  • In balloting for an open spot on the Texas Delegation to the American Medical Association, the house chose Jay Shah, MD, of San Antonio to be the newest alternate delegate.

HOUSE TACKLES PHYSICIAN DISPENSING, ACOs, TEXTING WHILE DRIVING

The TMA House of Delegates adopted new policy on a slew of important issues. The house agreed to support legislation to allow physicians to dispense and charge for pharmaceuticals, other than schedule I-V controlled substances. A bill allowing physician dispensing has passed the Texas Senate and is scheduled for a House committee hearing this week. In other action, delegates:

  • Voted to require these safeguards in any accountable care organization: voluntary physician and patient participation, physician leadership on the governing board, and physician supervision of economic and quality measures;
  • “Took a firm stand against the epidemic use” of cell phones and texting while driving because they often cause accidents;
  • Adopted policy requiring insurers to compensate physicians for the cost of seeking preauthorization for medications, studies, or procedures; and
  • Asked the legislature to encourage natural gas production but protect Texas water from the risk of hydrofracking by requiring disclosure of fracking fluid components.

HINCHEY TAGGED "YOUNG AT HEART;" LINDA ADKINS WINS JUNE BRATCHER AWARD

The well-deserved accolades and honors are always some of the most touching moments at TMA’s annual meetings. The Young Physician Section gave its Young at Heart Award to former TMA President Bill Hinchey, MD. He received the award for his commitment to organized medicine, and his willingness and openness to bringing young physicians up the ranks. Other winners:

  • Linda Adkins of Houston won TEXPAC’s June Bratcher Award, given every two years for political excellence to a TMA Alliance member.
  • The Medical Student Section Chapter of the Year Award went to the Texas College of Osteopathic Medicine students for their outstanding community service activities.
  • Kim Hawthorne of The University of Texas Medical School at Houston was named Student of the Year for her “reliable, effective, and passionate” leadership.
  • The medical students gave their C. Frank Webber Award to Angela Siler-Fisher, MD, for her work in helping students become involved in TMA.
  • The Board of Councilors nominated former TMA President Bohn Allen, MD, for the Distinguished Service Award. Because of a schedule conflict, Dr. Allen will receive it at TMA Fall Conference.

Monday, May 9, 2011

WHISTLE-BLOWER PROTECTIONS FOR EMPLOYED PHYSICIANS MOVING FORWARD

So hospitals want to employ physicians? Fine, but they’ll do it by our rules. The Texas House passed and sent to Gov. Rick Perry our bill (Senate Bill 894) that will allow rural hospitals to employ physicians — with important protections for physicians’ clinical autonomy. And SB 1661 by Sen. Robert Duncan (R-Lubbock), which will provide whistle-blower protections for the thousands of Texas physicians who already are employed by hospital-controlled 501(a) corporations, is on its way to passage in the House. It already passed the Senate. “Unlike other states that allow employment of physicians, Texas is different,” said TMA President Sue Bailey, MD. “We’re one of the first states to pass clinical protections for physicians who choose employment.”

TMA GIVES YOU TWO CHANCES TO GO BACK TO THE FUTURE OF HEALTH CARE

If you’re coming to Houston this weekend for TexMed 2011 at the George R. Brown Convention Center, don’t miss the keynote address, “The Future of Medicine Under the New Health System,” with Jeff Goldsmith, PhD. Can’t make it to Houston for Dr. Goldsmith’s crystal ball? Just tune in to TMA TV at 5:30 pm (CT), Friday, May 13, for a tape-delayed broadcast of his general session address. If that doesn’t fit your schedule, we’ll show it again at 7 am (CT), Monday, May 16. Other TexMed highlights for those of you heading to Houston:

  • Join us Friday evening at a new event — a reception honoring incoming TMA President C. Bruce Malone, MD, and TMA Alliance President Bridget McKeever.
  • Eat, drink, and be merry at TMA Foundation’s 18th annual gala, Picture of Good Health.
  • Take part in Friday’s health system reform programming, which includes discussions on accountable care organizations and other practice models, as well as physician employment.
  • Attend Saturday morning’s featured breakout during the Quality track, “Preparing Your Practice for New Delivery and Payment Models.”
  • Raise a toast to Linda Swan Adkins of Houston, the 2011 Recipient of the June Bratcher Award, at the TEXPAC reception Friday night.
Watch, or take part in, the House of Delegates decisions Friday and Saturday on TMA policy and election of new TMA leaders.

CONTACT YOUR REPRESENTATIVES TODAY TO STOP FAT AMENDMENTS TO HB 400

Why are some members of the Texas House trying to gut successful programs that can help us stop Texas’ terrible obesity epidemic? Please contact your state representative today through the TMA Grassroots Action Center. Ask him or her to “Vote No” on amendments to HB 400 that repeal school-based fitness measurements and coordinated school health education. “Texas physicians like you and me see the health effects of childhood obesity every day,” Dr. Bailey wrote in an action alert to TMA members that went out this morning. “We know that, ultimately, it is more expensive to treat an obese adult than to prevent obesity among our children.”

PUT SOME CHECKS ON YOUR TMA LEGISLATIVE SCORECARD

Our lawmakers have just three weeks left in the 2011 Texas Legislature regular session. The state budget and a few other high-profile issues might bring them back this summer for a special session. But here’s some progress to report on our priority issues:

  • The House Public Health Committee passed three bills that are critical to our Texas Medical Board reform agenda. The bills, SBs 190, 191, and 237 by Sen. Jane Nelson (R-Flower Mound), would improve how TMB handles complaints against physicians.
  • The Senate passed SB 1533 by Sen. Juan “Chuy” Hinojosa (D-McAllen). It would restrict the availability of foods with industrially produced trans fats served in Texas public schools.
  • The Smoke-Free Texas Bill, HB 670 by Rep. Myra Crownover (R-Denton), is on the House calendar for tomorrow.
  • We have quite a few bad bills — for example, those that would inappropriately expand the scope of practice of nonphysician practitioners — bottled up or slowed so they won’t pass.

YOU CAN LEAD THE HOUSE OF MEDICINE

Who will lead medicine into the future? Will it be you? If you are 40 or under, or in the first eight years of practice, the TMA Leadership College (TMALC) can put you on the path to becoming a leader in TMA and organized medicine. The leadership college now is accepting applications for the TMALC Class of 2012. There is no tuition. This is a free TMA member benefit. June 15 is the deadline to apply. Class of 2010-11 scholars, who graduate Saturday afternoon at TexMed 2011, already are putting their training to work. Most of them have been placed in TMA leadership positions, and all have been placed in positions at their county and/or Texas specialty society

COMING NEXT MONTH: HEALTH REFORM AND ACCOUNTABLE CARE

We’re preparing to launch our next statewide seminar series, “What Health Reform and ‘Accountable’ Care Mean to Physicians.” This evening program will help physicians explore pros and cons of participating in accountable care organizations (ACOs), evaluate employment options, and consider other collaborative relationships in the post-reform marketplace. TMA will give all seminar participants a free bonus webinar update when the federal government finalizes its ACO rules.

Monday, May 2, 2011

COME TO THE FINAL FIRST TUESDAYS AT THE CAPITOL

Tomorrow is the final white coat lobby day of the 82nd legislative session. Will you be there? Around 100 physicians, medical students, and TMA Alliance members are participating in First Tuesdays at the Capitol tomorrow. We’re specifically inviting international medical graduates to take part. It’s not too late to register. We will be asking lawmakers to move a number of bills to the governor’s desk by the end of this month. They include:

  • The committee substitute for House Bill 1— the Senate’s $176.5 billion budget plan. Legislators must move this bill; otherwise, they will be writing the state’s budget in a special session. If that happens, health care will not be funded nearly as generously. Watch this video from TMA Council on Legislation Chair Dan McCoy, MD, to learn more. And then contact your senator.
  • Senate Bill 1661 Sen. Robert Duncan (R-Lubbock). It would provide solid protections for clinical autonomy and independent medical judgment for the thousands of physicians employed by nonprofit health care corporations (501[a] corporations) established by hospitals. The bill gives the physician board of directors of these 501(a)’s the responsibility for all policies related to clinical care. Plus it strengthens the role of the Texas Medical Board in supervising these nonprofit corporations. The bill will be sponsored in the House by Rep. Todd Hunter (R-Corpus Christi).

PHYSICIANS TESTIFY FOR PATIENTS AND THE PROFESSION

Thanks to these two TMA member physicians who came to the Texas capitol last week:

  • Janet Realini, MD, MPH, a San Antonio family physician and a volunteer for the Healthy Futures Alliance, testified before the Senate Health and Human Services Subcommittee. Dr. Realini testified on Senate Bill 1854 by Sen. Bob Deuell, MD (R-Greenville). It would extend the Women’s Health Program. The program provides gynecological exams and birth control to low-income women. It is set to expire this year.
  • Debra Patt, MD, an Austin oncologist, testified in support of HB 669 before the House Public Health Committee. The bill by Rep. James White (R-Hillister) fosters dialogue between a physician and a patient regarding reconstructive breast surgery.

TMA HELPS THE FEDERATION OF MEDICINE MANAGE ITS DATA

For membership organizations, nothing is more valuable than our membership database. When the staff of five state medical associations want to update or use their databases, they connect to servers right here in the TMA building. Thanks to the expertise we’ve picked up in managing these complex databases, state societies in Florida, Nebraska, New Jersey, Georgia, and Wisconsin found it more cost effective to turn to TMA than to build their own. All of their data resides in Austin, and they access it remotely. We give them access to the tools our technology team has developed to view and manipulate their data. We also let five other states (Illinois, Indiana, South Dakota, Ohio, Virginia) use those tools on membership data that they keep on their own servers. TMA has consulted with five other states on various issues related to their membership data.

KEEP UP WITH YOUR COLLEAGUES WHO TWEET

What are TMA-member physicians saying on Twitter each day about health care, politics, science, and more? You don’t need a Twitter account to be part of the conversation. Our TMA Member Physicians Daily comes out around 10 am each day. You can subscribe via e-mail or RSS feed. TMA’s own Twitter feeds reach more than 20,000 unique individuals online each week. Follow us @texmed.

RECs CAN HELP YOU KEEP YOUR EHR FROM BECOMING A WRECK

Are you looking to buy, install, or improve an electronic health record (EHR) system? Have you signed up yet for your area’s health information technology regional extension center (HIT REC)? The federal government set up four Texas RECs to make sure physicians don’t have to make this journey alone. If you are a primary care physician, you can get $5,000 worth of services through the Texas RECs for just $300 per eligible physician each year. We’re also trying to take some of the confusion out of the Medicare and Medicaid EHR incentive programs. Check out our timeline.

TEXMED 2011: YOU STILL CAN COME

Registration is now closed for TexMed 2011, TMA’s annual meeting and expo at the George R. Brown Convention Center in Houston May 13-14. But that doesn’t mean it’s too late for you to drink in all the free continuing medical education, or the exhibit hall, House of Delegates, or TMA Foundation gala. Please register on site at the Hyatt Regency on Thursday, May 12, 8:30 am-7 pm, or at the Brown Center on Friday, May 13, 7 am-6 pm and Saturday, May 14, 6 am-12:30 pm.