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Monday, October 24, 2011

CALENDAR OF DOOM CAN KEEP YOU OUT OF REGULATORY HEAT

We unveiled a brand-new TMA service designed to help you keep up — and comply — with the onslaught of new state and federal regulations and insurance company rules governing medical practices. Our Calendar of Doom lists all of the key deadlines you need to know about and connects you with the resources you need to understand them and lead your practice away from the precipice. “As bad as it sounds, I am quite hopeful that the Calendar of Doom will be a good thing … a very good thing … for you and all Texas physicians,” TMA President Bruce Malone, MD, said as he unveiled the calendar at 2011 TMA Fall Conference. “I think it will be good because the demands to comply with growing state and federal regulations are so onerous, and because so few of us are really prepared for it all. The Calendar of Doom will provide a great opportunity for TMA to demonstrate tremendous value to our members.” Joining Dr. Malone in reviewing some of the key doomsday scenarios were Drs. Dan McCoy of the TMA Board of Trustees, Gary Floyd of the Council on Legislation, Matt Murray of the Council on Health Care Quality, Charles Stiernberg of the Council on Health Care Quality, Joe Todd of the TEXPAC Board, and some outstanding TMA staff members. We videotaped the presentations and will share a link in next week’s EVPGram.

TEXPAC ENDORSES PERRY, DEWHURST, PHYSICIANS, ALLIANCE MEMBERS, JUDGES

The TEXPAC Board of Directors unanimously endorsed Gov. Rick Perry’s run for president of the United States. The move to back the champion of Texas tort reform for president and Lt. Gov. David Dewhurst for U.S. senator was one of several early endorsements in 2012 races. Members of the family of medicine to earn TEXPAC’s backing included incumbents U.S. Rep. Michael Burgess, MD (R-Lewisville), State Sen. Bob Deuell, MD (R-Greenville), and State Reps. John Zerwas, MD (R-Simonton), and Susan King (R-Abilene). We hope to bring another TMA Alliance member to the Texas House with TEXPAC’s endorsement of Sonal Bhuchar (R-Sugarland) and another physician to the Senate with our backing of Rep. Mark Shelton, MD (R-Fort Worth).

REVISED ACO RULE WINS OPTIMISM/SKEPTICISM FROM PHYSICIANS

When the Centers for Medicare & Medicaid Services (CMS) released its draft rule for the Medicare shared-savings accountable care organizations (ACOs) earlier this year, the document was roundly panned by physician groups as unworkable, impractical, and unaffordable. Some observers think CMS was listening. “After a preliminary review, the AMA believes this final rule includes a number of positive changes,” said American Medical Association President Peter Carmel, MD. The American College of Cardiology and American Medical Group Management Association also had good first impressions of the rule. Other reviewers say the new rule is still way too proscriptive, gives hospitals too much power, and doesn’t address other fundamental flaws in the concept. Stay tuned for our take on the final rule and guidance on moving forward.

FALL CONFERENCE FOCUSES ON QUEST FOR ACCOUNTABLE CARE

From the first meeting of our new Council on Health Care Quality to the Calendar of Doom, 2011 TMA Fall Conference focused on how TMA can help physicians survive and thrive in the new health care landscape. Among the highlights:

  • Alice G. Gosfield, JD, one of the top 25 health lawyers in the country, kept the audience spellbound as she described numerous ways physicians can keep their independence and actually take advantage of all the health care financing schemes under development.
  • The TMA Board of Trustees heard about the latest round of our research into the needs of physicians employed by large groups and hospital organizations. The board also received presentations on four new sets of tools that will help solo practitioners and physicians in small practices measure their performance and take advantage of change.
  • Former TMA President Bohn Allen, MD, received the TMA Distinguished Service Award.
  • The second class of scholars in the TMA Leadership College spent four days soaking up advice on topics ranging from psychological profiles to active listening skills to thought leadership through social media.

TMA'S MEDICARE 2012 SEMINARS HIT THE ROAD

With Medicare a hot-button issue in Washington, the pressure is on to reduce costs and improve efficiency. Physicians and staff need to understand the ever-more-complicated Medicare system to ensure they can get paid accurately, benefit from incentives, and avoid allegations of fraud and abuse. TMA is bringing this important information to your city. Our “Medicare 2012” seminar covers Recovery Audit Contractor audits, claim denials, HIPAA 5010 billing standards, and incentives and penalties lying ahead.

REPORT PQRS DATA AT A DISCOUNT

Most practices already have all the data they need to qualify for the Medicare Physician Quality Reporting System (PQRS) incentive (for 2011, eligible physicians will be paid an additional 1 percent of their total allowed charges for Medicare services). Reporting the data is easy with the right tools. That’s why TMA has endorsed Covisint DocSite, a user-friendly portal for PQRS reporting. TMA members can register at a discount. New users pay $300 (a $50 discount; use code TMAPQRS11). Returning users pay $185 (call TMA at [800] 880-7955 to arrange this).

Monday, October 17, 2011

SEE YOU THIS WEEKEND IN AUSTIN FOR 2011 TMA FALL CONFERENCE

I’m really excited about this year’s TMA Fall Conference and hope to see you there. Throughout the conference, we’ll be talking about — and showing you— how physicians can regain control of their practices in today’s chaotic health care landscape. Our conference agenda includes a keynote address from one of the nation’s top health care lawyers. (And, yes, she is on our side.) We’re unveiling the TMA Calendar of Doom, a new tool that will help you keep up with the onslaught of state and federal regulations and keep your practice out of hot water. If you can’t make the conference, we will be sharing the Calendar of Doom presentation live on the Internet from 11 am to noon on Saturday. Our boards, councils, and committees are taking on some tough issues throughout the weekend. I hope you can join us Thursday at 6 pm at the Hyatt Regency Austin for a reception honoring the TMA Leadership College Class of 2012 scholars. And, of course, past president Bohn Allen, MD, will receive the TMA Distinguished Service Award. Online registration is closed, but you still can register at the TMA building on Friday or at the Hyatt on Friday or Saturday.

REPRESENTATIVE BURGESS SHARES INSIGHTS INTO CONGRESS

U.S. Rep. Michael Burgess, MD (R-Lewisville), the only TMA member in Congress, briefed association leaders on the key health care matters Washington will/could/might/should tackle in the closing months of 2011. Tops on everyone’s mind, of course, was Medicare’s Sustainable Growth Rate (SGR) formula and the pending 29.5-percent cut in physicians’ Medicare payments. Dr. Burgess told us he expects Congress will stop the cuts with a one- to three-year freeze, but he isn’t optimistic that we’ll see a replacement for the SGR this year. (If you haven’t yet, be sure to use TMA’s Grassroots Action Center to let the Texans on Capitol Hill know what we think of this annual disaster.) Dr. Burgess also discussed some ideas for controlling health care costs that don’t involve complete federal control of physicians’ offices. He is working on a plan that would recruit physicians to manage the care of the “dual eligibles” — the chronically ill seniors on both Medicare and Medicaid who eat up a disproportionate share of the health care budget. He is looking for Texas physicians who care for Medicare patients in a concierge-style practice. If you or someone you know has this type of practice, please let me know, and I’ll pass your name and contact information on to Dr. Burgess.

FORT WORTH PHYSICIANS LINE UP BEHIND SHELTON'S SENATE BID

Pediatrician and State Rep. Mark Shelton, MD (R-Fort Worth), announced his bid for a seat in the Texas Senate with an impressive array of Fort Worth physician and community leaders already on his list of supporters. His competition for the Republican nomination in Senate District 10 includes State Rep. Kelly Hancock (R-North Richland Hills), with whom TMA has tangled numerous times on important health care issues. The incumbent in a district that has been substantially redrawn is Sen. Wendy Davis (D-Fort Worth). The TEXPAC Board of Directors will look at the race this week.

TEXAS MEDICAL HOME INITIATIVE MOVING FORWARD

TMA, primary care specialty societies, and two of the state’s largest health insurance companies are supporting a program to improve health care quality, care coordination, and practice efficiency. The Texas Medical Home Initiative continues to grow in North Texas, project coordinators Sue Bornstein, MD, and Robert Jackson, MD told us. Blue Cross and Blue Shield of Texas and UnitedHealthcare are both participating in the program.

TMA WINS COURT BATTLE OVER HOSPITAL FINANCIAL RECORDS

A nonprofit Texas hospital cannot withhold its financial records from members of its medical staff, a state district judge ruled. TMA is supporting the physicians in the case of Knapp Medical Center vs. Grass. The battle for the Weslaco hospital’s financial information centers on alleged financial improprieties and poor application of the resources of the hospital resulting in a deteriorating hospital capacity and performance. TMA submitted an amicus curie brief in the case.

MEMORIAL INFORMATION FOR THE MOTHERS OF DRS. MALONE AND BAILEY

In a previous EVPGram, we promised more details on services for Florence Elizabeth Buck Malone, mother of TMA President Bruce Malone, who passed away Sept. 9. Family members held a graveside service this past weekend. Gifts of remembrance may be made to the Michael Scott Malone Scholarship Fund at Austin Community Foundation or the charity of your choice. I am saddened also to report that Sarah Evelyn Dickson Rudd, mother of TMA Immediate Past President Sue Bailey, MD, passed away last week. Memorial services were this morning in Fort Worth. Memorials in Mrs. Rudd’s name may be made to the Fort Worth University Christian Church Children’s Closet or the Cystic Fibrosis Foundation.

Monday, October 10, 2011

TELL CONGRESS: FIX SGR BEFORE BOOSTING ANY MEDICARE PROVIDERS' PAYMENTS

TMA President Bruce Malone, MD, has a message he wants you to deliver to U.S. Sens. John Cornyn and Kay Bailey Hutchison and your U.S. representative. With a nearly 30-percent cut in physicians’ Medicare payments set to kick in Jan. 1 absent congressional intervention, it’s time to stop treating physicians like the low profession on the Medicare totem pole. “For the past decade, Congress has recognized the value that hospitals, nursing homes, home health services, durable medical equipment, and other health care professionals provide Medicare patients,” Dr. Malone writes in an action alert going out to all TMA member physicians today. “They all have received annual payment updates. Physicians should, too. Before any future updates are given, Washington needs to fix the broken physician payment system.” Please use the TMA Grassroots Action Center to deliver Dr. Malone’s message to Congress today. We’re also activating our Me and My Doctor networking, asking your patients to make the same request to replace the broken Sustainable Growth Rate (SGR) formula before pouring more money into other Medicare providers’ payments.

TMA SURVEY: HALF OF TEXAS PHYSICIANS WILL DROP MEDICARE IF CUTS GO THROUGH

The planned 29.5-percent SGR cut in physicians’ Medicare payments in January would devastate access to care for senior citizens, Texans with disabilities, and military families, a new TMA survey found. “Our survey indicates that half of all Texas physicians are considering opting out of the Medicare program altogether if the planned cuts go through,” Dr. Malone said at a news conference unveiling the results. “We knew some physicians would consider leaving the program, but we didn’t think the number would be that high.” Even considering a possible “compromise cut” of 10 percent, physicians’ responses were the same — they would be forced to leave Medicare. The gaping problem has eroded access for both Medicare and Medicaid patients. One-third of all Texas physicians put limits on new Medicaid patients. Medicaid access would suffer even more if Congress lets the Medicare cuts go through: More than one-quarter of Texas physicians say they will impose more Medicaid limits if the cuts occur; another 27 percent are considering such limits

CPRIT GRANTS TMA CANCER PROGRAM $350,000

TMA’s 24-year-old Physician Oncology Education Program (POEP) has won a nearly $350,000 grant from the Cancer Prevention and Resource Institute of Texas (CPRIT). The grant, which provides the bulk of POEP’s operating funds, will finance live conferences and the POEP Speakers’ Bureau, the development of two new iPhone/iPad applications, more cancer-prevention-and-detection education modules for Texas physicians, and promotion and dissemination of the revised Texas Cancer Plan to be released in January 2012.

HUMANA OFFICIALS EXPLAIN NEW MEDICARE PPO FOR RETIRED STATE EMPLOYEES

A big, new Medicare Advantage plan is about to hit Texas. Beginning in January, all retired state employees in the Texas Employees Group Benefits Program will be enrolled in a new Medicare preferred provider organization from Humana. George Smith, MD, president of Humana Senior Products, Texas, met with Dr. Malone and TMA staff to explain the new Humana Medicare Advantage Plan. Retired employees who want to keep their HealthSelect coverage, provided by Blue Cross and Blue Shield of Texas, will have to opt out of the new program by Dec. 9.

HONORING DR. ALLEN, PREVENTING DOOM ON TMA FALL CONFERENCE AGENDA

We typically honor the winner of TMA’s Distinguished Service Award at our annual TexMed conference, but this year’s winner had a conflict he couldn’t avoid. The wait will make the presentation to former TMA President Bohn Allen, MD, at TMA’s 2011 Fall Conference even more special. Dr. Allen’s colleague — former TMA Trustee Paul Handel, MD — will present the award. After we honor Dr. Allen for a lifetime of achievements, we look ahead to all of the new rules and regulations being heaped onto physicians’ practices. We will unveil TMA’s Calendar of Doom, a web-based regulatory compliance tool designed to give physicians a strategic view of upcoming state and federal compliance timelines. Registration is still open for the conference, Oct. 21-22 at the Hyatt Regency Austin.

WHAT'S ON YOUR MIND

In these turbulent times, physicians across the country are worried about their practices, their patients, and their profession. I spend the next two days with the board of the Physicians’ Foundation, established to advance the work of practicing physicians and to improve the quality of health care for all Americans. What’s bothering you today? What can TMA do to help? What strong advocacy do you need? What expert services would help your practice survive? Send me an email with your ideas, questions, and suggestions.

Monday, October 3, 2011

TEXPAC ENDORSES DRS. SCHWERTNER AND BONNEN

The TEXPAC Board of Directors endorsed two outstanding physicians for open seats in the Texas Legislature in the 2012 elections. State Rep. Charles Schwertner, MD (R-Georgetown), earned TEXPAC’s endorsement for State Senate District 5, which is being vacated by the retiring Sen. Steve Ogden (R-Bryan). Greg Bonnen, MD, a neurosurgeon from Friendswood (we incorrectly listed Dr. Bonnen’s hometown in last week’s EVPGram), won our endorsement for House District 24. The incumbent, Rep. Larry Taylor (R-Friendswood) is running for an open Senate seat. We know both candidates would work diligently on behalf of their patient and physician constituents.

HOW VALUABLE IS YOUR TMA MEMBERSHIP?

TMA and county medical societies have begun mailing dues invoices for 2012. I encourage you to rejoin immediately and recruit any of your nonmember colleagues to become a part of America’s best medical society. You might be wondering — though you, as a TMA leader, shouldn’t be — just what you get in return for your dues dollars. Austin otolaryngologist Daniel Leeman, MD, found out. He gained a 1,520-percent return on his TMA and county society annual dues investment. What about you? Find out by visiting the interactive TMA Return on Investment Calculator. TMA developed the tool to help you learn more about the value of your membership and the benefits that come to you from TMA and your county society.

GET YOUR TMA POLICIES AND PROCEDURES GUIDE FOR MEDICAL PRACTICES

Our new Policies & Procedures guide contains more than 200 up-to-date policies and procedures, tools, sample letters, and forms you can customize for your office. It is specific to Texas medical practices and Texas law. Based on best practices, it is vital to running an efficient practice — from solo physicians to large groups. Written by practice management and health law experts, this guide includes new policies on human resources, front desk, business office, management responsibilities, medical records, safety, compliance, HIPAA, and more. Each guide contains a customizable CD. Call (800) 880-7955 to order your copy today or order online.

HEALTH COMMISSIONER HEARS TMA BUDGET CONCERNS

Department of State Health Services (DSHS) Commissioner David Lakey, MD, met with TMA senior staff and me to review the department’s critical budget reductions and several key policy issues. We discussed Dr. Lakey’s vision for the future of DSHS for the next couple of years, pending rules on hospital licensure and health care worker vaccinations, and the still contentious problems with the state’s electronic death registry. We talked about cutbacks at local health departments and explored the potential consequences of the new state budget to physicians and patients. Dr. Lakey will give a budget presentation to the TMA Board of Trustees later this month along with Jason Terk, MD, chair of the Council on Science and Public Health.

NEW TMA QUALITY COUNCIL GETS SOME EXPERT DIRECTION

Frank Villamaria, MD, chair of the new TMA Council on Health Care Quality, is passionate about quality and determined to get his new council off on the right foot. Dr. Villamaria and I met with TMA President Bruce Malone, MD, and Ken Shine, MD, executive vice chancellor for health affairs at The University of Texas System and former president of the Institute of Medicine. Among the issues we agreed the council should address are patient safety, clinical effectiveness, and what the focus on measuring quality will mean to practicing physicians.

HOT NEWS FROM WICHITA FALLS FOR DRS. MALONE AND STRATE

A few weeks ago, EVPGram reported on Dr. Malone’s visit to physicians in Wichita Falls and the Wichita Falls Record-News. The reporters there listened well and today published an excellent story on what the pending Medicare payment cut would mean to physicians and patients. “We fear the future may see a wholesale drop out of physicians, forced to leave practice,” Dr. Malone said. Also in our inbox today is a news release announcing the College of American Pathologists honored Wichita Falls pathologist Susan Strate, MD, with its Lifetime Achievement Award. It lists the many leadership roles Dr. Strate has held in the college, which is really quite amazing considering how many assignments she has accepted here at TMA. Congratulations!