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Monday, July 9, 2012

GOVERNOR SAYS "NO" TO EXCHANGES, MEDICAID EXPANSION

Texas will neither expand Medicaid nor establish a health insurance exchange, Gov. Rick Perry said in a letter to U.S. Health and Human Services Secretary Kathleen Sibelius. The Patient Protection and Affordable Care Act (PPACA) authorizes the two projects. “I stand proudly with the growing chorus of governors who reject the Obamacare power grab,” the governor said in a statement, the Texas Tribune reports. “I will not be party to socializing health care and bankrupting my state in direct contradiction to our constitution and our founding principles of limited government.” The U.S. Supreme Court ruled that PPACA cannot force a state to give up its current federal Medicaid funding if it does not want to expand Medicaid. The health insurance exchanges are not optional. If Texas does not implement its own exchange, the federal government will set up a Washington-devised one for us.

MEDICARE, MEDICAID ACCEPTANCE DROP DRAMATICALLY, TMA SURVEY SHOWS

The share of Texas physicians who will take new Medicare or Medicaid patients has dropped to an all-time low, according to the results of a TMA physician survey being released today. Hardest hit are low-income Texans who rely on Medicaid for their care. Texas physicians available to treat new Medicaid patients have plummeted from 42 percent in 2010 to 31 percent; that’s less than half the 67 percent who reported they would take all new Medicaid patients in 2000. The number of Texas physicians accepting all new Medicare patients dropped from 66 percent in 2010 to 58 percent in 2012. That’s part of a trend that’s seen the number decline steadily from 78 percent in 2000. “All the bureaucratic red tape and administrative burdens only serve to increase the cost of running a practice while diverting a physician’s attention away from patient care,” said TMA President Michael E. Speer, MD. “Every business has a breaking point; physicians’ practices are no different.”

TMA LEADERSHIP COLLEGE APPLICATIONS DUE THIS WEEK

Who will lead Texas medicine into the future? Will it be you? Someone you know or mentor? Applications for the third class in the TMA Leadership College are due Friday, July 13. The college can put physicians age 40 or under or in the first eight years of practice on the path to becoming leaders for the house of medicine. The program uses organizational education, skills training, mentoring, and guided experiences to develop tomorrow’s physician leaders. The 2012 Leadership College class graduated at TexMed 2012; many of the graduates moved immediately into spots on TMA boards, councils, and committees.

SUIT CHALLENGING PHYSICIAN OWNERSHIP RESTRICTIONS STILL ON

The lawyer for physician-owned hospitals seeking to overturn the PPACA restrictions against doctors owning hospitals says the lawsuit will continue despite the Supreme Court’s ruling last month that other parts of the PPACA are constitutional. The high court’s decisions on the individual mandate and Medicaid provisions of PPACA do not stop suits, such as this, challenging other portions of the law. TMA has consistently backed physicians’ right to own and operate hospitals and has filed several amicus briefs in this case. A physician-owned hospital in Tyler —Texas Spine & Joint Hospital — is the named plaintiff in the case, which is currently pending before the 5th U.S. Circuit Court of Appeals

GOVERNOR NAMES NEW THERAPEUTICS COMMITTEE MEMBER

Governor Perry appointed TMA member Scott Schams, MD, a College Station pediatrician, to the state Pharmaceuticals and Therapeutics Committee. He is an assistant clinical professor of pediatrics at the Texas A&M Health Science Center College of Medicine. The committee makes recommendations about preferred drug lists for programs such as Medicaid and the Children’s Health Insurance Program.

EVPGRAM TO TAKE SUMMER BREAK

It’s time for EVPGram to take its annual summer holiday. Don’t forget to vote in the party primary elections on July 31. We will, of course, send special editions to keep TMA leaders apprised of important breaking news. And you can keep up with TMA news via the Action newsletter and the TMA website. We’ll be back in your inbox around Labor Day.

Monday, July 2, 2012

PPACA IS CONSTITUTIONAL; NOW WHAT?

Now that the U.S. Supreme Court has ruled the Patient Protection and Affordable Care Act (PPACA) constitutional, we’ll focus our Washington lobby attention on finding what’s missing (like a replacement for Medicare’s Sustainable Growth Rate physician payment formula) and fixing what’s wrong (like eliminating the Independent Payment Advisory Board.) We also will continue to work to protect the good parts of the law, like the insurance consumer protections. Here at home, Gov. Rick Perry and legislative leaders have two important decisions to make: how, if at all, will they implement the health insurance exchange; and will they opt to expand Medicaid to low-income single adults? The Supreme Court ruled that PPACA cannot force a state to give up its current federal Medicaid funding if it does not want to expand its Medicaid program. We know physicians and patients have many unanswered questions about the law and how it will affect them. I’ve directed the TMA staff to begin work immediately on updating our Health Reform School educational materials for physicians and to develop some easy-to-understand brochures you can share with your patients. I welcome your suggestions on what would be most helpful. Email me at lou.goodman@texmed.org.

IT'S NOT TOO LATE. REGISTER TO VOTE BY TODAY FOR JULY 31 PRIMARY RUNOFFS

Today is the last day to register to vote in time to be eligible for the upcoming runoff elections. The Texas Secretary of State provides easy online systems to find out if you are registered, and to fill out and print a voter registration application. It must be postmarked by today. Once you’ve registered, of course, you need to vote. The 2012 party primary runoffs will occur on Tuesday, July 31; early voting will last from Monday, July 23, to Friday, July 27. TEXPAC is working hard to help our endorsed candidates win and to educate our physician and alliance members about the importance of engaging the political system.

IS OUR HEALTY VISION CLEAR ENOUGH FOR YOU

Have you told us yet what you think of TMA’s Healthy Vision 2020, our strategic roadmap for state and federal advocacy initiatives for the remainder of the decade? We’ve set up a special blog for TMA leaders like you to use to give us feedback on the draft document and help us get everything exactly right. Make sure we hear from you at www.texmed.org/vision.

EVALUATE HEALTH PLAN CONTRACTS

Patient Protection and Affordable Care Act or not, physician practices still have to decide for themselves how to deal with health plan contracts. Summer is a good time to study the question and make decisions before employers’ annual open-enrollment deadlines, many of which are in the fall. Physicians or practice managers should examine contract profitability and payer mix to make informed contracting decisions. Need some quick instruction on a simple way to do that? Join a short TMA lunchtime webinar on July 9. Log on to the TMA Education Center to register. And if you’re looking for an easy way to get continuing medical education, visit the CME page on our website.

HAPPY INDEPENDANCE DAY

 Even if you’re seeing patients or on call Wednesday, please take a moment to think about our great country. Despite its faults, no other nation in the history of mankind has ever offered so much freedom and opportunity to its citizens. Happy Fourth of July, everyone!