About TMA Related Organizations TMA Calendar Site Map Contact Us

Monday, September 24, 2012

COUNTY EXECS' MEETING BOLSTERS GRASSROOTS STRENGTH

I spend a lot of my time in meetings, but none are as satisfying or important as the gatherings I have with our county medical society execs. We share information in all directions — from the grassroots up, from Austin down, and best practices all around. The latest execs meeting didn’t disappoint. We engaged in strategic planning sessions on our legislative agenda and the multiple forces that are rearranging the health care marketplace in every Texas community. We discussed membership opportunities and plans for meeting TMA President Michael Speer’s 50,000-member challenge. And we talked about what new services our members need from organized medicine in Texas. I never forget — our strength flows from our great relationship with the counties.

ABILENE PHYSICIANS, BLUE CROSS EXPLORE VIRTUAL MEDICAL COMMUNITY SAVINGS POSSIBILITIES

TMA Trustee Austin King, MD, and I met with other Abilene physicians and Blue Cross and Blue Shield of Texas officials to flesh out ideas for a pilot “virtual medical community” in that West Texas town. Plans call for participating physicians — in solo practice or small groups — to implement and use an electronic health record to better coordinate care for patients with chronic conditions like diabetes, heart disease, and depression. Savings and costs would be shared. If it’s successful, TMA will work to bring this collaboration model to physicians in other parts of Texas.

PHYSICIANS MEDICAID CONGRESS ORGANIZING

Invitations are going out this week to the group of Texas physicians who will devise TMA’s plan to repair or replace Texas’ broken Medicaid system. TMA’s Physicians Medicaid Congress will be charged with mapping the path to a system for providing health care to low-income Texans with realistic payment, less stifling state bureaucracy, and no fraud-and-abuse witch hunts. Dr. Speer will chair the Congress, which will convene its first session at the TMA 2012 Fall Conference next month. We’ll follow that up with regional hearings around the state. The Congress will reconvene in Austin at the TMA 2012 Advocacy Summit in December to incorporate the feedback received and finalize our proposal for the 2013 Texas Legislature and U.S. Congress.

FEDS TO TMA: YOU WERE RIGHT ABOUT THE FLU FINDER, AND WE'LL FIX IT

It’s always a pleasant surprise to get a positive response from a government office; it’s nearly amazing to have that happen within just two days of sending a complaint. Earlier this month, TMA and the Texas Pediatric Society; Texas Academy of Family Physicians; and American College of Physicians, Texas Chapter, wrote the U.S. Department of Health and Human Services (HHSC) to complain about an obvious problem with its new online Flu Vaccine Finder. The web app does not acknowledge the medical home as the first place to seek flu shots and appears to be populated primarily with freestanding and grocery-store pharmacies that provide the influenza vaccine. “Your point is well taken, and we are already exploring options to resolve the oversight,” an HHSC official answered just two days later. “The finder will become even more important later this year or early in 2013 when the finder will be expended beyond flu vaccine(s) to provide information about the availability of nearly a dozen adult vaccines.” We’ll follow up to make sure that happens.

AMA TO CMS: STOP RAC AUDITS OF MEDICARE E&M CODES

The American Medical Association has come out swinging against the federal government’s announcement that Recovery Auditor Contractor (RAC) Connolly, Inc. may begin auditing Medicare coding for CPT 99215 (evaluation and management [E&M] of an established patient) in physician offices in Texas and several other states. “Physicians who provide E&M care apply complex decisionmaking based on myriad clinical approaches, including research and review of patient medical history, analyses regarding appropriate medication, discussion of home situation and prescription distribution plan, preventive care planning, and many other variables,” AMA Executive Vice President James Madera, MD, wrote in a letter asking the Centers for Medicare & Medicaid Services to stop the audits before they begin. “In particular, based on our historical experience with the RACs, and in light of the fact that the RACs are not required to have same-specialty physicians review RAC determinations, we have no confidence that the RACs will be up to the task of understanding these variables or their clinical relevance.”

TMA PHYSICIANS SPEAK OUT FOR PATIENTS AND THE PROFESSION

Three member physicians assumed high-profile positions in the capital city last week, speaking and testifying for TMA. Board of Trustees Vice Chair Carlos Cardenas, MD, told the House Committee on Human Services that physicians along the Texas-Mexico border cannot keep caring for patients without immediate action by lawmakers to lessen the dual-eligible payment cuts that went into effect in January. Pflugerville family physician Travis Bias, DO, urged the Legislative Budget Board to support the Texas Department of State Health Services’ proposed 2014-15 budget, including requests for additional funding to address costly and threatening public health concerns such as obesity and mental illness. And Austin obstetrician-gynecologist Kimberly Carter, MD, participating in a Texas Tribune Festival panel discussion on family planning, said Texas “should champion ways to make individuals responsible for their contraception and personal health.”

Monday, September 17, 2012

AMA SEEKS TEXAS PHYSICIANS' INPUT ON SGR, PRIVATE CONTRACTING

TMA leaders are answering the American Medical Association’s calls for help. Last week (and again this week), AMA’s senior management and advocacy team reached out to the leadership of TMA and other key state societies to discuss strategy on a handful of looming federal issues. Top on the list is devising a plan to win enactment of a permanent and fair new Medicare payment formula while avoiding the 27-percent cut scheduled for Jan. 1 because of the Sustainable Growth Rate disaster. The federal budget nonagreement earlier this year also has physicians facing an additional 2-percent cut in Medicare payments in 2013. TMA joined with AMA and more than 100 state and specialty medical societies urging Congress to nullify both cuts. Another priority is the Medicare Patient Empowerment Act, which would allow Medicare patients and their physicians to freely enter into private contracts for care. Any action on these contentious issues likely will wait until after the November elections. Stay tuned for alerts asking you to send your calls and letters to Capitol Hill.

REGISTER TO VOTE, JOIN TEXPAC TO MAKE MEDICINE'S VOICE HEARD

Here are two easy things you can do to help elect a record number of TMA and TMA Alliance members to the Texas Legislature in the Nov. 6 general election. First, make sure you’re registered to vote. The deadline is Oct. 9. Second — if you’re a TMA or alliance member — please consider joining TEXPAC. Every dollar will be spent to better position TMA for the 2013 legislative session and beyond. TEXPAC wants you to be on our team and be a part of our success.
Political observers already have tagged the Fort Worth Senate race of Rep. Mark Shelton, MD, as the contest to watch this fall. Don’t just watch it — do something.

NO SOLUTION YET TO DUAL ELIGIBLES CRISIS

Despite ongoing pressure from TMA and South Texas lawmakers, the Health and Human Services Commission still has not found a viable way to reverse the huge cut in state payments to physicians caring for patients who are eligible for both Medicaid and Medicare coverage. We are continuing to work with new Health and Human Services Commissioner Kyle Janek, MD, to eliminate the cap on Medicaid-allowable payments that affects more than 320,000 dual-eligible patients. The issue will top the agenda at the TMA Board of Trustees meeting next month.

WORRIED ABOUT E&M RAC AUDITS? TMA CAN HELP

TMA’s payment advocacy team is ramping up to investigate the details of the federal government’s announcement that Recovery Auditor Contractor (RAC) Connolly, Inc. may begin auditing Medicare coding for CPT 99215 (evaluation and management [E&M] of an established patient) in physician offices in Texas and several other states. As soon as we get it, TMA will share the specifics of where and when the audits of the highly subjective coding determinations will begin. TMA offers several online courses and publications to help you avoid trouble. TMA Practice Consulting has certified professional medical auditors and coders on staff to review physicians’ documentation. Finally, if you find yourself on the wrong side of a RAC overpayment decision, we’ve put together this checklist of your discussion, rebuttal, and redetermination options.

TMA JOINS WITH SPECIALTY SOCIETIES TO PREPARE FOR LEGISLATIVE SESSION

The voice of medicine at the Capitol can be loud but, unfortunately, sometimes discordant. Our lawmakers appreciate it when we all sing from the same page, and we’re much more effective that way. That’s why TMA leaders are meeting with our state specialty society counterparts now — four months ahead of the start of the legislative session. TMA President Michael Speer, MD; Immediate Past President Bruce Malone, MD; Board Chair Tom Garcia, MD; and Council on Legislation Chair Les Secrest, MD, got together with the leadership of the Texas Radiological Society. The conversation focused on issues of joint interest like scope of practice, protecting our tort reforms, and securing appropriate payment for services. More specialty society meetings are upcoming.

TWO TEXANS NAMED TO AMPAC BOARD OF DIRECTORS

Congratulations to Lyle Thorstenson, MD, and Amy Ho on their selection to serve on the AMPAC (AMA’s political action committee) Board of Directors. Dr. Thorstenson, of Nacogdoches, is chair of the Texas Delegation to the AMA. Ms. Ho is a third-year medical student at The University of Texas Southwestern Medical School.

Monday, September 10, 2012

TMA: Medicaid Inspectors’ Proposals Go Way Too Far

In a strongly worded 35-page letter to the Health and Human Services Commission, TMA is opposing proposed new “program integrity” rules that cast every Medicaid billing error as a possible target for fraud-and-abuse prosecution. “TMA strongly opposes the proposed rules because they expand [the Office of Inspector General’s] authority, minimize the rights of physicians and other providers, and have a tenor that implies a presumption of wrongdoing,” John Holcomb, MD, chair of TMA’s Select Committee on Medicaid, CHIP and the Uninsured, wrote. Without due process protections and other important changes in the draft rules, Dr. Holcomb wrote, “the pervasive fear among physicians that they will be incorrectly accused of fraud, waste, or abuse, or denied meaningful recourse in a fraud investigation will continue to contribute to the decline in physician participation in Medicaid.”

Thirty-Five Win TEXPAC Support in Contested State House Races

Friendswood neurosurgeon Greg Bonnen, MD, and Gatesville family physician J.D. Sheffield, DO, head the list of 35 candidates who have earned TEXPAC’s endorsement in contested races for the Texas House of Representatives. The 23 Republicans and 12 Democrats — 28 incumbents and seven newcomers — with medicine’s backing in the Nov. 6 general election also include: Rep. Byron Cook (R-Corsicana); Kyle Kacal (R-Bryan); Reps. John Raney (R-Bryan), Tim Kleinschmidt (R-Lexington), Craig Eiland (D-Galveston), and Ron Reynolds (D-Missouri City); Ed Thompson (R-Pearland); and Reps. Geanie Morrison (R-Victoria), Ryan Guillen (D-Rio Grande City), Connie Scott (R-Corpus Christi), Mando Martinez (D-Weslaco), J.M. Lozano (R-Kingsville), Jason Isaac (R-Dripping Springs), Paul Workman (R-Austin), and Jimmie Don Aycock (R-Killeen). Also on the list are Reps. Larry Phillips (R-Sherman) and Myra Crownover (R-Denton); Ron Simmons (R-Carrollton); Reps. Dee Margo (R-El Paso), Four Price (R-Amarillo), Charlie Geren (R-Fort Worth), and Linda Harper-Brown (R-Irving); Bennett Ratliff (R-Coppell); Reps. Joe Farias (D-San Antonio), Roland Gutierrez (D-San Antonio), Dan Huberty (R-Houston), and Sarah Davis (R-West University Place); Gene Wu (D-Houston); and Reps. Sylvester Turner (D-Houston), Senfronia Thompson (D-Houston), Ana Hernandez Luna (D-Houston), Garnet Coleman (D-Houston), and Hubert Vo (D-Houston). All have solid relationships with the physicians in their districts.

Academic Physicians: Get the Credit You’re Due

Be among the first to qualify for TMA’s new Award for Excellence in Academic Medicine. This multilevel award program recognizes teaching physicians who are clinicians and have a record of TMA leadership, scholarly activity, mentoring, professional development, advocacy, and community service. We are accepting self-nominations through Dec. 31. Apply today.

“Medicaid Is Broken,” Texas Doctors Say


More than two-thirds of Texas physicians surveyed in TMA’s latest survey agree, or strongly agree, with the statement, “Texas Medicaid is broken.” But the nearly 1,200 doctors responding to the survey have a prescription to fix it. Almost 90 percent say, “We need a system for providing health care to low-income Texans with realistic payment, less stifling state bureaucracy, and no fraud-and-abuse witch hunts.” Here’s a snapshot of some physician attitudes toward Texas Medicaid.
Click for Larger Image
 

JUDGE RULES MEDICAL BOARD IS RIGHT IN TELADOC CASE

The Texas Medical Board (TMB) is correct to require a face-to-face meeting before a physician can diagnose or treat a patient, Travis County District Judge Amy Clark Meachum ruled in a case Teladoc, Inc. brought against TMB. The judge has not yet released a copy of her decision or order.

STATE AGAIN LICENSES RECORD NUMBER OF NEW PHYSICIANS POST-TORT REFORM

A record 3,630 physicians received new Texas medical licenses in the fiscal year that ended Aug. 31. TMB broke the old record of 3,621, set in 2008.

Tuesday, September 4, 2012

LEADERS PLAN BREAKTHROUGH STRATEGIES TO HELP PRACTICES SURVIVE

Practice performance metrics, an easy-to-use patient satisfaction survey, business education for physicians, and other crucial TMA services and products are what Texas physicians need most in today’s rapidly changing health care economy. Those are the bottom-line recommendations the TMA Board of Trustees and more than 70 other leading Texas physicians reached after an intensive and unique weekend strategy session. The goal of the DesignShop® was to accomplish in a couple of days what could usually take three to six months using traditional approaches. I am confident we achieved that goal. We will have a full report and action plan to present at 2012 TMA  Fall Conference in October. Watch this video to get a better idea of what we did and why.

TEXPAC ENDORSES 12 FOR STATE SENATE

TEXPAC is moving quickly to keep the momentum going after an extremely successful primary season. The PAC endorsed a dozen Texas Senate candidates who have great support from — and relationships with — their local physicians. The Senate candidates with opposition in the Nov. 6 election who have the TEXPAC endorsement are incumbent Sens. Kevin Eltife (R-Tyler), Mario Gallegos (D-Houston), Dan Patrick (R-Houston), John Whitmire (D-Houston), Carlos Uresti (D-San Antonio), Juan “Chuy” Hinojosa (D-McAllen), Judith Zaffirini (D-Laredo), Royce West (D-Dallas), and José Rodríguez (D-El Paso). Looking to move up to the Senate with TEXPAC backing are current State Reps. Ken Paxton (R-McKinney), Mark Shelton, MD (R-Fort Worth), and Larry Taylor (R-Friendswood). Look for news of additional TEXPAC endorsements in coming weeks.

REGISTER TODAY FOR 2012 TMA FALL CONFERENCE

Health care economist Thomas Miller will discuss the impact of the U.S. Supreme Court’s ruling on the Patient Protection and Affordable Care Act (PPACA) on physicians and patients at TMA’s 2012 Fall Conference Oct. 19-20 at the AT&T Conference Center in Austin. Mr. Miller is a former senior health economist for the Joint Economic Committee of Congress and has been at the forefront of health care policy on the national level. Also on tap: a panel discussion including current and hope-to-be physician and TMA Alliance members of Congress and the Texas Legislature; Twitter 101 and Facebook 101 classes in the TMA Social Media Lab; legislative testimony training, and flu shots.

AVOID EMPLOYMENT LAW MINEFIELDS WITH NEW TMA SEMINAR SERIES

Is your practice at risk for allegations of harassment and discrimination? Are you paying your hourly employees correctly? Do you know how to properly counsel or terminate employees? Are you prepared to meet staff training regulations under the new Texas privacy law? If you don't know the answers to these questions, your practice may be in big trouble down the road. Learn to safeguard your practice by developing sound practice policies. TMA’s new half-day seminar series, “Policies and Procedures: Avoiding Minefields in Employment Law,” will show you how. The seminars run from Sept. 18 through Oct. 31 across the state.

TMA FOUNDATION BRINGS MEDICINE, BUSINESS, COMMUNITY TOGETHER

Read, hear, and see how TMA and TMA Alliance members are collaborating with business and community groups to help Texans achieve great health in TMAF’s 2011 Annual Report (try out the QR codes featured in the report, too). Medicine + Business + Community = A Prescription for Great Health celebrates how medicine’s visible and trusted leadership is improving the health of all Texans. You also can support your colleagues’ efforts by making a tax-deductible gift to TMAF.

NEW AND UNDERREPORTED NEWS ITEMS


Here are a few interesting and important stories that crossed our radar during the summer: