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Monday, October 29, 2012

ONE WEEK LEFT TO VOTE EARLY

Today through Friday are the final five days to vote early before the Nov. 6 elections. Check with your local elections offices to find early voting locations near you, and encourage your family, friends, colleagues, staff, and patients to go to the polls. If you’re still undecided on the races, check out the list of TEXPAC-endorsed congressional, legislative, and judicial candidates. While the outcome of the presidential contest surely will have a huge impact on medicine, it’s critical that we elect patient- and physician-friendly candidates to counter or help the next president’s agenda.

TMA MEMBERSHIP ROLLS PAST THE 46,000

Thank you so much! TMA membership passed the 46,000 milestone, and the year isn’t over yet. We are projecting ending 2012 near 46,500 members on our way to TMA President Michael Speer, MD’s, goal of 50,000. That means TMA remains the largest (and the best) state medical association in the country. The more members we represent, the stronger our collective voice, and the more we can accomplish for every Texas physician and the patients you serve. The next legislative and congressional sessions are right around the corner. Please renew your membership today if you haven’t yet — and recruit a new member — to make sure medicine’s voice is indeed strong in the fight to restore a sense of control, stop the tide of decisions made by others, make sure you are paid what you’re worth, and allow you more time for patient care.

THOUSANDS LISTEN IN TO NOVITAS TELE-TOWN HALL MEETING


TMA reached out and touched more than 20,000 members with news on how to prepare for the Nov. 19 transition to a new Medicare carrier for Texas. More than 2,000 stayed on the line for our Tele-Town Hall meeting with TMA staff experts and senior staff from Novitas Solutions, the new carrier. If you missed it, or want to listen again, the full recording is on the TMA website. Here are six things you need to do now to make sure your patient care and cash flow aren’t interrupted:
  1. Double check that you’ve sent your electronic funds transfer paperwork to Novitas;
  2. Review Novitas’ Local Coverage Determination policies;
  3. Familiarize yourself with the Novitas website;
  4. Take a close look at Novitas’ evaluation and management coding guidelines;
  5. Consider enrolling in TMA’s statewide fall Medicare seminar series; and
  6. If you have any questions, please call the TMA Knowledge Center at (800) 880-7955.  

"BECAUSE HE IS AN EXCELLENT DOCTOR"

Americans are very happy with their primary care physicians, according to a new national survey conducted by The Physicians Foundation. Among those who had visited a family physician or primary care doctor (at least once) in the past year, 79 percent said that they were “very satisfied” or “extremely satisfied” with the visit(s). When asked why, one typical respondent said, “Because he is an excellent doctor. He knows me and understands my medical needs.” Americans point away from physicians when asked who is to blame for the rising cost of health care. Three-quarters said insurance companies and pharmaceutical manufacturers were “very” or “completely responsible,” 62 percent cited the cost of liability insurance, and 59 percent laid the blame on the government. One last snapshot from this survey: When asked about the Patient Protection and Affordable Care Act, 39 percent believe it will have a negative impact on health care, 26 percent feel the impact will be positive, and 35 percent express no opinion. Harris Interactive conducted the survey of 2,236 adults for The Physicians Foundation in late July.

ALMA MATER PRAISES DR. VARMA

Congratulations to Lubbock pediatrician and longtime TMA leader Surendra Varma, MD. King George Medical University in Lucknow, India, bestowed a Doctor of Science Honoris Causa award on Dr. Varma for being an outstanding academician, clinician, and teacher “who has made India proud with his professional achievements and scientific contributions, keeping the Indian flag flying high at the foreign soil.” Dr. Varma, a leading pediatric endocrinologist, is best known for developing a newborn screening tool for congenital hypothyroidism.

SENDING OUR PRAYERS NORTHWARD


Right now, it looks as if Hurricane Sandy will strike a tremendous blow to the northeastern United States and inland to the Great Lakes. On behalf of TMA, I send our hopes and prayers that your family, friends, and colleagues in Sandy’s path will brave the storm safely. We know from our experience with Gulf Coast hurricanes how difficult it can be for communities to regroup and physicians to reopen flooded and damaged practices.

Monday, October 22, 2012

WOMEN'S HEALTH PROGROM GAG RULE DEFEATED

Responding to strong opposition from TMA and state specialty societies, Health and Human Services Commissioner Kyle Janek, MD, pulled the gag clause from rules governing the state’s redesigned Women’s Health Program. As proposed by Commissioner Janek’s predecessor, the rule would have prohibited a participating physician from discussing abortion with a patient. The new rule still prohibits Women’s Health Program funds from going to a physician or provider who promotes or performs abortion, but the definition of “promote” was revised to exclude “neutral, factual information and nondirective counseling.” TMA President Michael Speer, MD, praised the change. “It is very important that patients are able to trust that their doctor is giving the best medical advice for them — based on their medical needs and nothing else,” he said. TMA remains concerned for the program’s long-term viability — and for the women it serves — as the state next month tries to run the program on its own without $35 million a year in federal funding.

EARLY VOTING BEGINS TODAY; VOTE THE PARTY OF MEDICINE

The end of the seemingly interminable 2012 election cycle is almost here. Early voting for the Nov. 6 general election begins today and runs through Nov. 2. TEXPAC has created a Voter’s Guide of our endorsed candidates that you can download, print, and take with you to the polls. “As physicians we must do our part both large and small to ensure the Texas Legislature adopts the best policy solutions available,” said Jerry Hunsaker, MD, chair of TEXPAC’s Candidate Evaluation Committee. “That starts in the voting booth. Medicine’s candidates need your support.” From U.S. Senate candidate Ted Cruz on down, medicine has endorsed a strong slate of patient- and physician-friendly candidates. Look for your customized list in your email in-box today.

ANSWER THE PHONE THURSDAY FOR NOVITAS ANSWERS

TMA will hold a tele-town hall meeting Thursday at 8 pm CDT to help you prepare for the Nov. 19 switch from TrailBlazer Health Enterprises to Novitas Solutions for processing Medicare claims. Novitas officials will join TMA physician and staff experts to give you a quick overview of what the transition means to you and to field your questions. No reservations are necessary. Just pick up your home phone when it rings at 8. (Let the TMA Knowledge Center know if you would prefer that we call you at another number or if you would like to include your office administrator or another staff member.) The tele-town hall is one of our many efforts to help you make sure the transition doesn’t affect your cash flow or office operations. Our statewide Medicare seminar series runs from Oct. 30 through Nov. 15. Topics include the switch to Novitas plus Medicare coding tips and advice on how to avoid a fraud-and-abuse investigation. See our Novitas Resource Center for more.

OUR HEALTHY VISION NEW EVEN CLEARER

Thanks to your feedback, and the Supreme Court’s ruling in June, we’ve reformulated TMA’s Healthy Vision 2020 in preparation for the coming legislative session. This is TMA’s roadmap for advocacy success in Austin and in Washington for the rest of the decade. Whether you’re concerned about payment, workforce, scope of practice, tort reform, obesity, measuring real quality of care, or maintaining your clinical autonomy, Healthy Vision addresses all of this and more. Read it online or order a limited number of hard copies from the Knowledge Center.

CANDIDATES WITH A CURE FIELD E-QUESTIONS AT FALL CONFERENCE

A highlight of 2012 TMA Fall Conference was our open forum with six physician and alliance candidates for the Texas Legislature and U.S. Congress. From veterans like U.S. Rep. Michael Burgess, MD (R-Flower Mound), and State Sen. Bob Deuell, MD (R-Greenville), to State House hopeful J.D. Sheffield, DO (R-Gatesville), panelists shared their predictions on coming legislative battles. But the candidates were the only ones with microphones. Our on-site audience asked their questions via text message and Twitter. Moderator Ross Ramsey, executive editor of The Texas Tribune, received them on his iPad then posed them to the panel. Topics ranged from Medicaid and medical education funding to the future of the federal health care reform law. Read more about what makes doctors run for office, in this preview from November’s Texas Medicine.

COUNCILS TACKLE TMA OF THE FUTURE PROJECTS


The fall conference was the first chance for our councils and committees to begin work on the many hands-on, practice-support ideas that came out of this summer’s TMA of the Future meeting. I’d specifically like to thank Carl Trusler, MD, and the Council on Practice Management Services; Frank Villamaria, MD, and the Council on Health Care Quality; and a new task force headed by Trustee Dan McCoy, MD, for diving headlong into:
  • An easy-to-use patient satisfaction tool kit,
  • A multistakeholder coalition to agree on a uniform set of meaningful clinical quality metrics and data processes across all payers in Texas, and
  • A management services organization to support physicians regardless of the practice setting or business strategy they are considering.
Our goal is to complete some of these projects, and more, and have a comprehensive action plan to present to the House of Delegates in May.

Monday, October 15, 2012

LOOKING FORWARD AT 2012 TMA FALL CONFERENCE

This weekend’s Fall Conference has a decidedly forward-looking feel to it. Keynote speaker Tom Miller tells us what’s next for the patient-physician relationship and the overall health care marketplace in the wake of the Supreme Court ruling on the Patient Protection and Affordable Care Act. A host of incoming and hopeful physician and alliance lawmakers handicap the coming sessions of the Texas Legislature and U.S. Congress. The third class in the TMA Leadership College begins its studies. We get a sneak preview of coming new Medicaid fraud rules. And our Physicians Medicaid Congress convenes for the first time. Plus Twitter and Facebook schools. See you there.

TEXPAC BACKS CONGRESSIONAL HOPEFULS

The outcome of the Nov. 6 presidential race obviously will be the major determinant of the flavor and direction of health care reform in the 113th U.S. Congress. But whether President Obama or Mitt Romney is in the White House, we need to elect congresswomen and men who turn to their local physicians for guidance on the tough decisions. Redistricting added three new positions to the Texas delegation. In contested races, TEXPAC has endorsed newcomers Randy Weber (R-Pearland), Beto O’Rourke (D-El Paso), Joaquin Castro (D-San Antonio), Roger Williams (R-Weatherford), Marc Veasey (D-Fort Worth), and Filemon Vela (D-Brownsville). These incumbents in contested races got the TEXPAC nod: Reps. Louie Gohmert (R-Tyler), Ted Poe (R-Humble), Ralph Hall (R-Rockwall), Jeb Hensarling (R-Dallas), Joe Barton (R-Ennis), John Culberson (R-Houston), Kevin Brady (R-The Woodlands), Al Green (D-Houston), Michael McCaul (R-Austin), Mike Conaway (R-Midland), Kay Granger (R-Fort Worth), Ruben Hinojosa (D-Mercedes), Sheila Jackson Lee (D-Houston), Lamar Smith (R-San Antonio), Pete Olson (R-Sugar Land), Francisco “Quico” Canseco (R-San Antonio), Kenny Marchant (R-Coppell), Michael Burgess, MD (R-Flower Mound), Blake Farenthold (R-Corpus Christi), Henry Cuellar (D-Laredo), Eddie Bernice Johnson (D-Dallas ), John Carter (R-Round Rock), Pete Sessions (R-Dallas), and Lloyd Doggett (D-Austin). Here’s the full list of this fall’s TEXPAC endorsements. And here’s an order form for our famous slate cards.

DR. DICKEY STEPS DOWN AT TEXAS A&M

After 11 years in the corner office, Nancy Dickey, MD, resigned as president of the Texas A&M Health Science Center. “This is an opportunity for me to return to my passion regarding health policy, health care delivery solutions, medical ethics, and professionalism — and the importance of these topics in the education of health professionals,” Dr. Dickey said in a statement. She has been a staunch ally of TMA and Texas physicians throughout her career, including her term as the first female president of the American Medical Association. She was a tremendous strategic leader and visionary — the kind of person medicine really needs. We wish her the best. E.J. “Jere” Pederson, former executive vice president and chief operating officer of The University of Texas Medical Branch at Galveston, will serve as acting head of the Texas A&M Health Science Center.

PHYSICIANS TAKE LEGISLATIVE AGENDA TO DAVID DEWHURST

Medicaid funding and end-of-life issues topped the agenda when TMA President Michael Speer, MD, led a delegation of physicians meeting with Lt. Gov. David Dewhurst. We reviewed much of our Healthy Vision 2020 plan with Lieutenant Governor Dewhurst, who has reappointed Sen. Jane Nelson (R-Flower Mound) to chair the Senate Committee on Health and Human Services. In addition to Dr. Speer and TMA staff, our team included Drs. Bruce Malone, Dawn Buckingham, Sara Austin, Travis Bias, and David Fleeger, all of Austin. Later that day, Dr. Speer headlined a health care reform panel discussion convened by the McLennan County Medical Society. Others speaking at the Waco event included former TMA (and AMA) President Jim Rohack, MD; county society president Charles Stern, MD; and American Academy of Family Physicians Board Chair Roland Goertz, MD.

MEDICAID WOES PROMPT FIRST JOINT MEDICAL SOCIETY MEETING IN RIO GRANDE VALLEY

The still-unresolved payment crisis for dual-eligible patients was the impetus for the first-ever joint meeting of the Hidalgo-Starr and Cameron-Willacy county medical societies. TMA Board Vice Chair Carlos Cardenas, MD, and a contingent of TMA legislative, legal, and policy staffers took part. About 40 physicians attended, expressing their frustration over the problem. Resolution of the dual-eligible payment disaster will be a key goal of our new Medicaid agenda.

HEARTY CONGRATULATIONS TO ...


  • Ray Callas, MD, whom Gov. Rick Perry appointed to the Jefferson and Orange County Board of Pilot Commissioners. A Beaumont anesthesiologist, Dr. Callas is a member of the TMA Council on Legislation and the Texas Delegation to the AMA House of Delegates.
  • Michael Darrouzet, named to the Dallas Business Journal’sWho’s Who in Health Care” for Dallas-Fort Worth. Michael is the long-time CEO of the Dallas County Medical Society.

Monday, October 8, 2012

PICKING WISCONSIN'S BRAIN OVER CLAIMS DATABASE

Several senior TMA staff and I met with leaders of the Wisconsin Medical Society to discuss that state’s all-payer claims database. We expect that could become an issue in the 2013 Texas Legislature. Knowing the limitations of harvesting useable data from claims forms, we want to make sure such a database would give Texas physicians helpful ways you can compare your practice with your peers. It’s very important that the data be used for process improvement, and not for physician ranking schemes.

TEXPAC UNVEILS JUDICIAL ENDORSEMENTS


“Now more than ever, we need qualified individuals on the bench,” TEXPAC Chair Joe Todd, MD, said as he released the list of Supreme Court and appeals court judges that won our endorsement:
  • Texas Supreme Court: Justices Don Willett and Nathan Hecht;
  • 1st Court of Appeals (Houston): Justices Jane Bland, Harvey Brown, Rebecca Huddle, Terry Jennings, and Michael Massengale;
  • 3rd Court of Appeals (Austin): Justices Diane Henson, Robert Pemberton, David Puryear, and Jeff Rose;
  • 4th Court of Appeals (San Antonio): Justices Karen Angelini, Marialyn Barnard, Steve Hilbig, Rebecca Simmons, and Phylis J. Speedlin;
  • 5th Court of Appeals (Dallas): Justices Robert Fillmore, Douglas Lang, and James Moseley;
  • 6th Court of Appeals (Texarkana): Justice Bailey Moseley;
  • 8th Court of Appeals (El Paso): Justice Christopher Antcliff;
  • 13th Court of Appeals (Corpus Christi and Edinburg): Tom Greenwell and Justices Gina Benavides and Nelda Vidaurri Rodriguez; and
  • 14th Court of Appeals (Houston): John Donovan and Justices Jeffrey Brown, Brett Busby, and Martha Hill Jamison.

ARE YOU READY FOR SOME BIG MEDICARE CHANGES?


Are you ready for Novitas? On Nov. 19, Florida-based Novitas Solutions replaces TrailBlazer Health Enterprises as the Medicare carrier in Texas. That means a new way to get payments into your bank account, new local coverage determination policies, and new names and phone numbers for questions and problems. TMA has a quartet of helpful servings to make sure you’re prepared:
  1. Your first stop should always be our transition resource center at www.texmed.org/novitas.
  2. Don’t miss our free transition webinar this Wednesday at noon (CT), especially for office managers and administrators.
  3. Pick up your home phone at 8 pm (CT) Oct. 25 for a TMA tele-town hall meeting, hosted by TMA President Michael Speer, MD, with our staff experts and the Novitas transition leader.
  4. Beginning Oct. 30, our can’t-miss Medicare seminar series begins touring the state. We have last-minute tips for the Novitas transition plus our usual array of news and suggestions to keep your practice out of trouble and keep your Medicare payments arriving on time.  

PROJECT TO BUST PHYSICIANS' RED TAPE

 TMA is one of seven state medical societies to begin working with the American Medical Association on an in-depth study of physician satisfaction. The purpose of the research is to identify those factors that affect practicing physicians’ satisfaction with the profession, and to identify and reduce red tape. The study will include up to 60 practices of various sizes and types. AMA has asked us to recommend practices of various sizes to participate in the research. If you’re interested, let me know. All data collected will remain confidential.

TMA MIGHT BUILD SOME ORANGE-BLOODED LEADERS

I’ve begun talking with the team at Texas Executive Education at The University of Texas McCombs School of Business about developing leadership and management education programs for TMA-member physicians. This would be part of our ongoing initiative on physician leadership training, such as TMA Leadership College. I will discuss this with our Board of Trustees next week.

PHYSICIAN-LEGISLATORS IN THE SPOTLIGHT AT FALL CONFERENCE


A record number of TMA and TMA Alliance members are poised to enter the Texas Legislature and U.S. Congress after the November elections. Almost all of them will join us for a lively panel discussion Oct. 20 at 2012 TMA Fall Conference. Ross Ramsey, executive editor of The Texas Tribune, will moderate the event. Don’t forget, tomorrow is the last day to register to vote in the Nov. 6 general election. Early voting begins Oct. 22.

Monday, October 1, 2012

PHYSICIANS FOUNDATION SURVEY PAINTS GLUM FUTURE

Physicians are working fewer hours, seeing fewer patients, and limiting access to their practices in light of significant changes to the medical practice environment. That’s according to a huge and comprehensive new survey of practicing physicians by The Physicians Foundation. As president of the foundation, I spend a good bit of time sharing the findings — and their implications — with national and regional news media. As dire as the national data look, Texas physicians are even more pessimistic about the future. Fifty-three percent of the Texans mostly agree that the medical profession is declining, compared with 41.6 percent nationally. Whether it’s advocacy or practice management education, organized medicine in the U.S. needs to step it up to help our members.

FOCUS GROUPS FIND STRONG SUPPORT FOR PATIENT-PHYSICIAN RELATIONSHIP

The preliminary results of our focus groups with pro-life voters on women’s health issues start with some very good news. Conservative Texans have a lot of trust in the patient-physician relationship and don’t want the government anywhere near the exam room. Even when the talks might veer into abortion or other political hot buttons, these voters don’t want the government thwarting these intensely personal discussions between patients and their physicians. Although our position on the state’s proposed gag order has drawn heavy flak from some anti-abortion groups, this research tells us that those organizations are not in synch with their so-called constituents.

GET FLU SHOTS, LEARN TO TWEET AT 2012 TMA FALL CONFERENCE

Online registration is still open for 2012 TMA Fall Conference, Oct. 19-20 in Austin. In addition to the usual great speakers — this time on the federal health reform law and physicians on the ballot — you can pick up some useful skills and a little health care for yourself. Learn how to be an effective witness at a legislative committee hearing by signing up for one of two advocacy training classes on Friday, Oct. 19. Afraid to admit you don’t know a tweet from a like? We’re teaching beginner Twitter and Facebook classes Friday afternoon and Saturday morning. Or drop by the on-site flu clinic, where you can get your flu shot ($25) or nasal spray flu vaccine ($40) before the General Session on Saturday morning. Your family and office staff are welcome, too.

"TMA'S JUNKYARD DOG" TAKES A BITE OUT OF INSURANCE SNAFU

Despite all the warnings and training and preparation on all sides, we knew we’d see some patient care problems during the transition from Blue Cross and Blue Shield of Texas (BCBSTX) to UnitedHealthcare for the huge state Employee Retirement System. And we knew TMA had to be ready to help. One Austin surgeon is grateful for the intervention of our Payment Advocacy Department, which he calls “TMA’s Junkyard Dog.” One phone call from our team reversed a decision that would have required major surgery on an outpatient basis and rehab in a skilled nursing facility. Woof!

COMMISSIONER JANEK RECEIVES OUR STATE HEALTH PRIORITIES

Chief TMA Lobbyist Darren Whitehurst and I had our first official meeting with Kyle Janek, MD, Gov. Rick Perry’s newly appointed head of the Texas Health and Human Services Commission. We are, of course, quite familiar with Dr. Janek from his days as a TMA member, state representative and state senator, and health care lobbyist. We spoke with Commissioner Janek about TMA’s state priorities. Among the most pressing right now: finding a way to reverse the steep state cuts in payment for services to dual-eligible patients covered by both Medicaid and Medicare.

WOULD-BE MEDICAL PARLIAMENTARIANS GET SOME GAVEL TRAINING

New TMA House of Delegates Vice Speaker Susan Strate, MD, and five of her colleagues spent the weekend learning the ins and outs of debatable motions, second-order amendments, and calls for the question. Barry Glazer, MD, a certified professional parliamentarian and teacher from Indianapolis, focused on how to preside at meetings using the Sturgis conduct code as the parliamentary authority. In addition to Dr. Strate, his pupils included Drs. Dawn Buckingham and Michelle Berger of Austin, Lisa Erlich and Bill Gilmer of Houston, and Ray Callas of Beaumont.

UNIVERSITY OF HEALTH SESSION FOCUSES ON OBESITY

“We need to spend more time preventing disease so we can spend less money treating disease,” Texas Agriculture Commissioner Todd Staples said at the Texas Public Health Coalition’s third University of Health class. Speaking to policy analysts and legislative aides from the Texas Senate and House, Commissioner Staples and BCBSTX Chief Medical Officer Eduardo Sanchez, MD, discussed obesity, “the health issue eating Texas’ economy.” Commissioner Staples said the focus needs to be on lifestyle changes through education and improved nutrition standards. The Department of Agriculture developed the 3E’s of Healthy Living in Texas to tackle obesity: Education, Exercise, and Eating Right.