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Monday, June 25, 2012


The U.S. Supreme Court did not issue a ruling today on the Patient Protection and Affordable Care Act (PPACA). The court plans to announce its decision on Thursday. We’ll issue a special EVPGram that day with the court’s ruling and a TMA statement regarding the decision.


The Texas delegation left the 2012 Annual Meeting of the American Medical Association House of Delegates pleased with two election victories and the adoption of four Texas policy statements but saddened by the defeat of two outstanding Texas candidates for AMA office. As I reported last week, former TMA President Sue Bailey, MD, won reelection as vice speaker of the house, and David Savage, a third-year MD/PhD student at The University of Texas Medical School at Houston, was elected speaker of the AMA Medical Student Section Assembly. Unfortunately, Carolyn Evans, MD, and Asa Lockhart, MD, lost tough races for the AMA Board of Trustees and Council on Medical Service. Delegates adopted our resolution to combine the interim meeting of the house with AMA’s National Advocacy Conference in the nation’s capital. “Things happen in Washington, D.C., and we need to be in Washington, D.C.,” said Texas delegate David Teuscher, MD. The house also approved our resolutions to help AMA prepare for the Supreme Court decision on the PPACA, study the potential increase in errors caused by computerized physician order entry systems, and analyze the costs and benefits of physicians adopting electronic health records. At the close of the meeting, the Texas delegates announced that Austin anesthesiologist Joe Annis, MD, will run for AMA president-elect next year. Also, Surendra Varma, MD, associate dean of graduate medical education and resident affairs at Texas Tech University Health Sciences Center, was named to the Governing Council of the AMA Section on Medical Schools.


Physicians representing the Border Health Caucus met with members of Congress in Washington, D.C., to discuss obstacles that interfere with health care delivery. For the past seven years, Texas physicians have traveled annually to the nation’s capital to discuss how Congress’ decisions — or lack of decisions — affect doctors’ ability to care for their patients. Top of mind is Medicare’s flawed Sustainable Growth Rate physician payment formula. If Congress doesn’t act soon, physicians face a pay cut of almost 30 percent Jan. 1, 2013, which will further jeopardize border Texans’ access to a doctor. They also discussed with the Texas congressional delegation the many problems with the Patient Protection and Affordable, what’s missing in the law, as well as what works and should be retained. 


With less than half the year gone, TMA’s payment advocacy programs already have helped our member physicians recover more than $25.3 million from health plans, Medicare, and Medicaid. Our intervention with Availity and the Texas Medicaid & Healthcare Partnership accounts for $23 million of that amount. Remind your colleagues that TMA’s Hassle Factor Log program is a members-only service to help resolve physicians’ billing and claims problems.


This fall’s switch from TrailBlazer Health Enterprises to Novitas Solutions to administer Texas Medicare claims will not cause problems for physicians, Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner assured U.S. Rep. Michael Burgess, MD (R-Texas). She said in a letter to Representative Burgess that CMS is working with Novitas and TrailBlazer to make sure the change does not disrupt services to physicians caring for Medicare patients. Ms. Tavenner wrote Representative Burgess in response to his letter expressing concern about the change and its impact on physicians. He had raised concerns over several issues, including physicians having to complete new electronic funds transfer agreements and using a new electronic claims filing system. Texas physicians will switch to Novitas, formerly known as Highmark Medicare Services, on Nov. 19. TMA is working worked closely with Novitas to make sure Texas physicians stay informed and have the information they need to make a smooth transition to Novitas.

Monday, June 18, 2012


One familiar Texan earned a rousing — and unopposed — reelection at the 2012 Annual Meeting of the American Medical Association House of Delegates, while a Texas medical student earned a top spot, and two other Texas physicians launched their campaigns for AMA leadership positions. Former TMA President Sue Rudd Bailey, MD, was unanimously reelected vice speaker of the AMA House of Delegates (video). Congratulations to David Savage, a third-year MD/PhD student at The University of Texas (UT) Medical School at Houston. David was elected speaker of the AMA Medical Student Section Assembly. Meanwhile, Dallas pediatrician Carolyn Evans, MD, announced her candidacy for the AMA Board of Trustees (video). Four candidates, including one incumbent, are seeking two open spots on the board. Asa Lockhart, MD, an anesthesiologist from Tyler, is one of five candidates, including one incumbent, running for two open seats on the AMA Council on Medical Service. Election day is tomorrow. Drs. Evans and Lockhart were guests of honor at our traditional chili reception for Texas candidates for AMA office. The chili reception proved to be quite the hot event, as hundreds of delegates and their families stopped by for a bowl of the red or a Frito pie and to meet the Texas candidates.


The Texans, it seemed, were everywhere at the AMA House of Delegates meeting. From Dr. Bailey on the dais as vice speaker to Texas physicians serving on — and running — reference committees to Texans offering testimony and introducing resolutions, the Lone Star twang was thick in the Windy City. Beaumont orthopedic surgeon David Teuscher, MD, launched the Texas show as he laid out a resolution that would combine AMA’s three yearly meetings into two, with the House of Delegates meeting once a year in Washington to advance the association’s lobby agenda. “I want to see a sea of white coats at the Capitol,” Dr. Teuscher said. The resolution calls on the AMA Board of Trustees to report in six months “on the logistics of inviting all American physicians, spouses, patients, and leaders, and members of state and specialty societies to participate in the newly reformatted annual advocacy meeting in Washington.” Drs. Gary Floyd of Fort Worth and Bob Morrow of Sugar Land presented TMA’s three other resolutions (video). Three Texas physicians served on House of Delegates reference committees, which take testimony on all reports and resolutions and then make recommendations for the full house to consider later in the week. Lyle Thorstenson, MD, an ophthalmologist from Nacogdoches and chair of the Texas Delegation to the AMA, continued his two-year service as chair of the Reference Committee on AMA Finance and Governance. Needville family physician Art Klawitter, MD, and John Gill, MD, an orthopedic surgeon from Dallas, both sat on the Reference Committee on Legislation.


I am grateful to four leaders of Texas physician groups for spending a morning with a health policy expert the Physicians Foundation hired to help us chart a path toward an affordable, high-quality health care delivery system for the future. Professor Jeff Goldsmith laid out the draft of his Blueprint for American Health Care, which outlines what the American health care system should look like from the physicians’ and patients’ perspective. Giving expert feedback to Jeff during a four-hour meeting at the TMA building were Immediate Past President Bruce Malone, MD; Austin Regional Clinic (ARC) CEO Norm Chenven, MD, and ARC internist Howard Marcus, MD; and Austin Diagnostic Clinic CEO Bob Spurck. The Physicians Foundation will issue the final report this year.


Congratulations to Beaumont neurosurgeon Mark Kubala, MD, the former TMA president and speaker of the TMA House of Delegates. The AMA Board of Trustees nominated Dr. Kubala for the 2012 AMA Distinguished Service Award, saying he “has been an indefatigable advocate for practicing physicians on such issues as professional liability reform and head and spine injury prevention.” I wholeheartedly agree with the board that “Dr. Kubala is well qualified to receive this year’s award for meritorious service in the art and science of medicine.”


Baylor College of Medicine student Raghuveer Puttagunta won election as Region 3 chair of the AMA Medical Student Section. Other Texans to pick up regional leadership positions were Kelli Gross from The University of Texas Medical Branch at Galveston (UTMB), secretary-treasurer; Aswathi Kumar from UTMB, community service chair; and Cecilia Benz from the Texas A&M Health Science Center College of Medicine, recruitment chair. TMA continues to develop leaders for medicine.


Austin anesthesiologist Cathy Scholl, MD, is a new physician representative to the Physician Consortium for Performance Improvement Anesthesiology and Critical Care Maintenance Workgroup. TMA nominated Dr. Scholl to serve on the workgroup, which develops performance measures that are then submitted to the National Quality Forum and the AQA Alliance (formerly the Ambulatory Care Quality Alliance) for use in national quality improvement programs.

Tuesday, June 12, 2012


Our new president, Michael E. Speer, MD, is hard at work fulfilling his goal of increasing TMA membership to 50,000 in the coming year. Dr. Speer is prepared to go anywhere in the state and speak to any group, no matter how large or small, to make sure physicians know the incredible value of TMA membership. He wants to reach out to all physicians in Texas to join TMA to represent their patients and present a unified voice in Austin and Washington, D.C., and to make sure physicians remain the trusted leaders of the health care team. Dr. Speer outlined his goals for the coming year in his installation address when he took office on May 19.


Health system reform, errors caused by entering orders on computers, electronic health records (EHRs), and change in the American Medical Association meeting schedule are the subjects of four resolutions our Texas Delegation to the AMA will take to the AMA Annual Meeting June 16-20 in Chicago. The TMA House of Delegates approved the resolutions at TexMed 2012 last month.
The resolutions ask AMA to:
  • Be ready to work for new health system reforms if the Supreme Court throws out the Patient Protection and Affordable Care Act;
  • Study the potential increase in errors caused by hospitals and clinics adopting computerized physician order entry systems and suggest possible alternatives;
  • Analyze the current cost and/or benefit of implementing an EHR system to determine if it produces a financial return and improves quality of care, and advocate that those who benefit the most financially share fairly in the implementation costs; and
  • Revise AMA meetings to make them more efficient.
In addition, former TMA President Sue Bailey, MD, of Fort Worth, is running unopposed for reelection as vice speaker of the AMA house. Former TMA Board of Trustees Chair Carolyn Evans, MD, of Dallas, is running for a seat on the AMA Board of Trustees. Asa Lockhart, MD, of Tyler, is one of five candidates, including one incumbent, running for two open seats on the Council on Medical Service.
Follow all the house policy debates and election results on TMA’s Twitter feed.


The Physicians Foundation is accepting applications for grants to fund innovative programs to improve health care in the United States. This year, the foundation, of which I am president, will focus on a variety of issues to fulfill our mission to promote improvements in the physician practice environment to support high-quality patient care. We'll address these issues through grants, research, and educational activities. Since 2003, the foundation has awarded multiyear grants totaling more than $28 million. For information about the foundation's grants and programs, email Program Officer Mo Reed-McNally.


If you know someone making a difference in decreasing obesity in Texas, consider nominating him or her for the Texas Health Champion Award. July 2 is the deadline for nominations.

The award, part of the annual Texas Obesity Awareness Week, will be presented to a community, an organization, or an individual who has mobilized community efforts to prevent and reduce obesity and to promote physical activity and nutritional health through research, practice, policy development, social marketing, behavioral interventions, or innovative partnerships.

Texas Obesity Awareness Week is sponsored in part by Live Smart Texas and the Michael and Susan Dell Center for Healthy Living at The University of Texas School of Public Health.

Monday, June 4, 2012

Party of Medicine Fares Well in Primaries

Nearly three-quarters of TEXPAC’s endorsed candidates in congressional, legislative, and judicial elections won their party’s primary nomination in last week’s elections. Another 12 of them are in the July 31 runoffs. Among the big winners: U.S. Rep. Michael Burgess, MD (R-Lewisville); State Sen. Bob Deuell, MD (R-Greenville); and State Reps. Susan King (R-Abilene) and John Zerwas, MD (R-Simonton), all won reelection nominations. State Reps. Charles Schwertner, MD (R-Georgetown), and Mark Shelton, MD (R-Fort Worth), both won the GOP nomination to move up to the Senate. Newcomer Greg Bonnen, MD (R-Friendswood), is in a runoff in his race for the House. Congratulations to Sonal Bhuchar (R-Sugarland) and Susan Todd (R-Fort Worth) for running great campaigns. I know they both will remain outstanding voices for medicine at the Capitol. Other May 29 winners of note include incumbent Supreme Court Justices Don Willett and Nathan Hecht, and House Speaker Joe Straus (R-San Antonio). TEXPAC-endorsed challengers Chris Paddie (R-Marshall) and Trent Ashby (R-Lufkin) also knocked off House incumbents who we believed were not friendly to patients and physicians. The biggest name in the July 31 runoffs is Lt. Gov. David Dewhurst, who is battling for the Republican nomination for the U.S. Senate. Other TEXPAC-endorsed candidates who have another two months to run include State Sen. Jeff Wentworth (R-San Antonio), State Rep. Chuck Hopson (R-Jacksonville), and Bennett Ratliff (R-Coppell), who is battling an optometrist in his bid for the House. TEXPAC-endorsed State Reps. Pete Gallego (D-Alpine) and Marc Veasey (D-Fort Worth) are both in runoffs for Democratic nominations to the U.S. House. July 2 is the last day to register to vote for the runoffs.

Three Texans Vie for AMA Leadership Spots

Speaking of elections, we have some more of our own to support in American Medical Association leadership contests at the June 16-20 meeting of the AMA House of Delegates. They are:
  •  Former TMA President Sue Bailey, MD, who is running for reelection as vice speaker of the AMA House. So far, Dr. Bailey is unopposed.
  • Carolyn Evans, MD, of Dallas, former chair of the TMA Board of Trustees, who is running for a seat on the AMA Board of Trustees. Four candidates, including one incumbent, are seeking two open spots on the board.
  •  Asa Lockhart, MD, of Tyler is one of five candidates, including one incumbent, running for two open seats on the Council on Medical Service.

Follow all the house policy debates and election results on TMA’s Twitter feed.

TMA Backs Houston Woman in Lactation Dispute

A Houston federal judge was wrong when he ruled against a woman who says her employer fired her because she wanted to pump breast milk, TMA and the Texas Pediatric Society contend in a brief filed with the Fifth Circuit U.S. Court of Appeals. We urge the appeals court to overturn an opinion by U.S. District Judge Lynn Hughes that childbirth ends pregnancy-related medical conditions, and that Title VII of federal law does not protect women from being discriminated against or fired for lactation and breast pumping. Judge Hughes ruled that the woman could not claim discrimination because lactation is not pregnancy, childbirth, or a related medical condition. We entered the case on the recommendation of the TMA Committee on Maternal and Perinatal Health and the Council on Science and Public Health.

The Checks Are in the Mail

Payments are on the way to Texas physicians who used MCAG Group to file claims in a class action lawsuit against UnitedHealth Group over its out-of-network payment practices. MCAG tells us more than 1,300 checks totaling almost $5 million are in the mail to Texas practices and individual physicians. TMA supported this and other suits challenging insurer practices by joining with other state medical societies in pursuing class action litigation against for-profit insurance companies and by being a founding member of The Litigation Center of the American Medical Association and State Medical Societies. This particular case, brought by AMA and several other plaintiffs, alleged that UnitedHealth Group colluded with others to underpay physicians for out-of-network services. The suit sought relief for physicians who were seriously harmed by the insurer’s long-term use of the Ingenix database that has been shown to be rigged to allow insurers to shortchange payments.


Bob Horth of Wichita Falls won this year’s TMA Alliance President’s Award for his outstanding medical mission work in Guatemala, Indonesia, and Pakistan. His passion for helping those in need is unsurpassed. Other TMA Alliance winners are:
  • Pat Durham Membership Award, for the county with the best overall membership campaign: Smith County Medical Society Alliance, which also won the Global Service Award as the county that best responds to the health-related needs of the worldwide community;
  • Joan Timmins Milburn Award for Doctors’ Day, for the county with the best overall recognition of Doctors’ Day: Cameron-Willacy (North) Medical Society Alliance;
  • Advocates of Health Award, for the county with the most outstanding execution of the current statewide health project, Be Wise — ImmunizeSM: Fort Bend Medical Society Alliance;
  • Alliance of the Future: Dallas County Medical Society Alliance for the most innovation;
  • Mary Ann Homer Award for Legislative and Political Action, for the county with the best legislative project: Bexar County Medical Society Alliance; and
  • Dedication to the Mission Award, for the county with the project that most clearly epitomizes the promotion of the TMA Alliance mission: Travis County Medical Alliance.

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