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Tuesday, December 13, 2011

TEXAS PHYSICIANS BUILD GRASSROOTS STRENGTH THROUGH COUNTY CONFERENCE

I joined the chief executives of more than a dozen Texas county medical societies in a day-long conference to discuss our shared challenges and opportunities in this tumultuous heath care environment. While health system reform and demands for physicians to join the information technology revolution are creating upheavals, they also give us new chances to provide value to Texas physicians. Issues on the table ranged from politics, Medicaid, and physician employment to TMA’s new online CME delivery system, concerns over grievances filed against physicians, and physician health and rehabilitation programs. I know this sounds like a broken record, but the strength of Texas medicine stems from the grassroots involvement of physicians at the county level and the tremendous relationship between TMA and the county societies.

SURPRISE! SGR PATCH CAUGHT UP IN CAPITOL HILL POLITICS

Here’s the relatively good news. The Republican leadership in the U.S. House of Representatives is pushing for a vote, perhaps as soon as tomorrow, on a year-end financial package that would stop the 27.4-percent cut in physicians’ Medicare payments scheduled for Jan. 1. In fact, the bill would increase the payment rates by 1 percent in both 2012 and 2013, provide some relief for physician-owned hospitals, and negate expected geographic adjustments of physicians’ Medicare payments that would have hit some Texas practices particularly hard. Here’s the sad news. The legislation doesn’t do away with the Sustainable Growth Rate (SGR) formula that drives the annual cuts, but it does require Congress and the Obama administration to study some possible alternatives before 2014, when physicians’ payments would be chopped by about 37 percent. Here’s the bad news. The bill has little chance of passing the Senate as it now stands. It’s not because of the SGR patch. Tacked onto the measure, which also would continue the payroll tax cut and extend unemployment insurance, is a provision to fast-track a permit decision on the Keystone XL oil sands pipeline. President Obama and Senate Democratic leaders oppose the pipeline for environmental reasons and are saying “no” to the whole package because of that. Meanwhile, uncertainty strengthens its grip on your practice, and the Big, Bad SGR continues to threaten Grandma.

TEXPAC ADDS TO 2012 ENDORSEMENT LIST

Judges, Texas lawmakers, and a pair of newcomers earned medicine’s support for the 2012 primary elections at the TEXPAC Board of Directors meeting. The list includes four judicial candidates, eight incumbent state senators, and 18 sitting state House members. Of interest:

  • We are backing John Raney (R-College Station) in tomorrow’s House District 14 runoff election. The winner will serve the remaining term of Rep. Fred Brown (R-College Station), who resigned.
  • The TEXPAC board voted unanimously to endorse Chris Paddie (R-Marshall) in House District 9 against an unfriendly incumbent who has developed a particularly egregious antiphysician, antipatient record during his tenure.
  • House Speaker Joe Strauss (R-San Antonio) picked up TEXPAC’s endorsement.
This adds to the list of TEXPAC endorsements for primary races, which already includes Gov. Rick Perry’s run for president, Lt. Gov. David Dewhurst’s bid for the U.S. Senate, and a record number of TMA and TMA Alliance members’ campaigns for Congress and the legislature. More endorsements will come in January, after the U.S. Supreme Court clears up the ongoing uncertainty over the maps for legislative and congressional districts in the 2012 elections.

JUDGE SAYS NO TO CHIROPRACTIC BOARD, AGAIN

An Austin state district judge ruled in TMA’s favor and granted our motion to stop chiropractors from performing vestibular testing. Judge Rhonda Hurley’s ruling invalidates the Texas State Board of Chiropractic Examiners’ (TBCE’s) vestibular testing rule, declaring it to be beyond chiropractors’ lawful scope of chiropractic. This is the fourth part of TBCE’s scope of practice rule that a court has overturned because it exceeded the scope of chiropractic as defined by law. The first three parts of the rule unlawfully authorized chiropractors to perform manipulation under anesthesia and needle electromyography, and to diagnose diseases.

TWO DEC. 31 OPPORTUNITIES AWAIT ON TMA'S CALENDAR OF DOOM

Dec. 31 marks the end-of-year reporting deadline for you to claim a 1-percent Medicare bonus for electronic prescribing. But if you haven’t adopted e-Rx, you face a 1-percent penalty next year. Dec. 31 is also the end of the reporting year for the Medicare electronic health record incentive program. Register by Feb. 29, 2012, to claim your incentive payment. Details on these and many more regulatory deadlines — and help for your office to comply — are on TMA’s Calendar of Doom.

FINAL EVPGRAM OF THE YEAR

It’s holiday time for the EVPGram. We’ll be back in your inbox on Jan. 9, 2012. Happy New Year!

Monday, December 5, 2011

SPECIALTY SOCIETIES LAY OUT PRIORITIES AT TMA ADVOCACY RETREAT

Preserving tort reform, defeating scope of practice expansions, preventing Medicare and Medicaid cuts, restoring graduate medical education funding, growing the physician workforce, protecting physician ownership, and stopping the corporate practice of medicine. Those issues came up again and again at the TMA Advocacy Retreat as 15 state specialty societies from allergy to urology laid out their legislative priorities for the coming year. “Please remember that while each of you is here representing your specialty society, each of you is really representing your patients,” TMA Board of Trustees Chair Tom Garcia, MD, said at the start of the two-day conference. “Throughout today’s discussions, I urge you all to focus on what unites us. Please don’t dwell on what separates us from each other. We all need each other … and our patients need all of us.”

BURGESS: NO MEDICARE FIX THIS YEAR, BUT "NO CUTS WILL HAPPEN"

U.S. Rep. Michael Burgess, MD (R-Lewisville), told Texas medicine’s leaders he sees no permanent fix this year for Medicare’s Sustainable Growth Rate (SGR) formula. But, appearing at the advocacy retreat via a Skype video call from his Capitol office, the only TMA member in Congress predicted “with 95-percent certitude” that “no cuts will happen” in physicians’ Medicare payments on Jan. 1. Under current law, the SGR mandates a 27.4-percent cut when the new year begins. Dr. Burgess said he expects Congress will intervene at the last hour, again, stopping the cuts for two years with perhaps a small increase, while work for a permanent SGR replacement continues.

TMA HONORS "FRIENDS OF MEDICINE"

Fifteen Texas legislators picked up TMA’s Friends of Medicine award at the retreat for their relentless energy, dedication, and steady leadership on behalf of Texas’ patients and physicians during the 2011 session. Since 1995, TMA has honored lawmakers who have gone above and beyond to champion important legislation on behalf of Texas patients. TEXPAC Board Chair Joe Todd, MD, and Candidate Evaluation Committee Chair Jerry Hunsaker, MD, hosted the awards dinner, which began with some political prognostications from Texas Monthly Senior Editor Paul Burka. From the House, the winners were State Reps. Rep. Dan Branch (R-Dallas), John Davis (R-Houston), Sarah Davis (R-West University Place), Todd Hunter (R-Corpus Christi), Susan King (R-Abilene), Elliot Naishtat (D-Austin), Charles Schwertner, MD (R-Georgetown), Mark Shelton, MD (R-Fort Worth), Vicki Truitt (R-Keller), and John Zerwas, MD (R-Richmond). On the Senate side, the friends are State Sens. Bob Deuell, MD (R-Greenville), Robert Duncan (R-Lubbock), Juan Hinojosa (D-McAllen), Joan Huffman (R-Southside Place), and Jane Nelson (R-Flower Mound).

"GRANDMA & THE BIG, BAD SGR" VIDEO GOING VIRAL

Medical societies from around the country are sharing the link to TMA’s new animated video that explains the Medicare financing conundrum in terms even a child can understand. Launched late last week to help garner public support for replacing the SGR formula, “Grandma & the Big, Bad SGR” already has nearly 1,400 views on YouTube. Please share the link with your colleagues, staff, patients, family, and friends via email or social media. “Doctors have no choice but to consider limiting the number of Medicare patients they see,” Dr. Malone said. “No doctor wants that to happen. Our Medicare patients and military families deserve better.” Brent Annear, TMA’s media relations manager, conceived and produced the video. The tremendous, sweet voice belongs to the daughter of TMA Assistant General Counsel Andrea Schwab.