About TMA Related Organizations TMA Calendar Site Map Contact Us

Tuesday, May 28, 2013

WOW! TEXAS LEGISLATURE DELIVERS FOR DOCTORS AND PATIENTS

It’s all over but the shouting — and the bill signings, and the special session that began last night. Clich├ęs and hyperbole aside, the 2013 Texas Legislature will earn an outstanding report card from medicine, as lawmakers delivered on so many pieces of our agenda.

  • BUDGET: Legislators wrote a big increase in funding for mental health services to go along with key changes in our mental health screening and education systems. The big cuts in women’s health services from 2011 were reversed — and then some. Funds to the State Physician Education Loan Repayment Program were restored. Graduate medical education took a return step towards the positive side.
  • RED TAPE CUT: Six of our hassle-busting bills passed, and one — letting patients sign in with a swipe of their driver license — already has Gov. Rick Perry’s signature. The others will bring uniform prior authorization forms for medications and medical services, a much more streamlined way for renewing your state Controlled Substances Registration, and significant simplifications in complying with the state’s medical privacy law.
  • INSURANCE: It took us more than six years, but we never gave up, and our bill to regulate silent PPOs is now law. Governor Perry signed it on Saturday. Waiting on his desk is a similar bill that would stop Medicaid HMOs from selling or trading your discounted rates.
  • SCOPE: Our landmark bill that sets up a more collaborative, delegated practice among physicians and advanced practice nurses or physician assistants is waiting for the governor to sign. It firmly establishes the physician-led medical team. Governor Perry already signed a truth-in-advertising law for identification badges in the hospital.
  • PUBLIC HEALTH: Better food choices in public schools, immunization policies at day care centers, and a tax break on vaccine stock in physicians’ offices are all just a signature away from becoming law.
  • MEDICAID: A bill passed to restore some due process rights to physicians accused of Medicaid fraud. We passed a prompt-pay law for Medicaid HMOs; no more low-pay, slow-pay, no-pay.
  • MORE: Tax relief for small businesses — like so many Texas physicians’ practices — passed. Attacks on our tort reforms, inappropriate scope-of-practice expansions, and bills weakening the Texas Medical Board did not. We won approval of a measure stopping off-shore medical schools from buying up clerkship spots in Texas hospitals, and we won repeal of a 2011 law that forced international medical graduates to spend three years working in medically underserved areas. New medical schools are coming to Austin and the Rio Grande Valley. 
Our outstanding lobby team burned far too much midnight oil and wore out far too many shoes keeping this whole thing on track for you. Much thanks goes to our Board of Trustees and Council on Legislation members who traveled here frequently to testify — as did so many other Texas physicians. First Tuesdays at the Capitol was another rousing success. Once again, wow!
 

TMA LAUNCHES PHYSICIAN SERVICES ORGANIZATION FOR PATIENT CARE

TMA — along with the Dallas and Harris county medical societies — announced the establishment of an organization to deliver doctors the survival tools they need to provide demonstrably better and more efficient patient care and compete in today’s health care marketplace. “We need to shift the balance of power away from the government and the large hospital systems, and back to the patients and their physicians,” said TMA President Steve Brotherton, MD. The organization will offer services that bolster physicians’ clinical and financial autonomy, tailored to a practice’s current level of sophistication. A key element will be providing physicians easy access to data to measure and improve their clinical performance and their financial viability. Look for more details, and announcement of our first pilot projects, in the very near future.

PERRY APPOINTS NEW INSURANCE COMMISSIONER

With the old insurance commissioner unable to win the votes for confirmation by the Texas Senate, Governor Perry appointed a new commissioner with strong ties to the Senate. Outgoing Commissioner Eleanor Kitzman so irritated so many groups on all sides of the political spectrum that she never even received a hearing before the Senate Nominations Committee. Her tenure ended with the final gavel drop of the regular session. The new commissioner is Julia Rathgeber, currently deputy chief of staff to Lt. Gov. David Dewhurst. We look forward to working with her.

DR. MASSINGILL TO HEAD TMA FOUNDATION

Congratulations to Fort Worth obstetrician G. Sealy Massingill, MD, the new president of the TMA Foundation. Other officers, elected at the foundation’s annual meeting for two-year terms, are Deborah Fuller, MD, of Dallas, vice president; D’Anna Wick of Tyler, secretary; and Jim Prentice, MD, of Austin, treasurer. Milla Perry Jones of Dallas, a vice president at United Surgical Partners International, was elected to a one-year term on the TMAF Executive Committee.

Monday, May 20, 2013

DR. AUSTIN KING CHOSEN TMA PRESIDENT-ELECT

 In the first three-way race for the top that any of us can recall, the TMA House of Delegates chose Abilene otolaryngologist Austin King, MD, as president-elect. Dr. King will take office at TexMed 2014 in Fort Worth. All three candidates ran excellent, competitive races. We also had an unprecedented eight outstanding candidates seeking four seats on the TMA Board of Trustees. I see this as a great sign of the vibrancy and strength of our organization. Election results include:
  • Drs. Tom Garcia and Doug Curran were reelected to the Board of Trustees. David Fleeger, MD, of Austin, and Linda Villarreal, MD, of Edinburg, won new seats on the board. The new resident trustee is Vinh Nguyen, MD, a family practice resident at Memorial Hospital in Houston. The new student trustee is Blair Cushing of the Texas College of Osteopathic Medicine.
  • Cliff Moy, MD, and Susan Strate, MD, were reelected speaker and vice speaker of the house.
  • Newly elected alternate delegates to the Texas Delegation to the American Medical Association are Drs. Greg Fuller, of Fort Worth, and Bill Gilmer, of Houston.
  • The Board of Trustees elected Carlos Cardenas, MD, as chair; Don Read, MD, as vice-chair; Dr. Villarreal as secretary; and Drs. David Henkes and Lewis Foxhall to the Executive Committee.

BANNER WEEK FOR TMA LEGISLATION

I don’t have enough space this week to spell out all the great steps our legislative agenda is taking. In summary, our delegated-practice bill cleared the House, and our Medicaid fraud due-process bill won preliminary House approval. Several of our red-tape cutters and immunization bills moved forward as well. The budget still looks very good, especially for mental health and women’s health services. Thanks to Robin Watson, MD, of Round Rock; Sara Austin, MD, of Austin; and Cynthia Jumper, MD, of Lubbock, for testifying for TMA in the session’s penultimate week.




BOARD OF TRUSTEES APPROVES MSO PROJECT

A new business model that will help physicians exercise the option to remain independent if they choose won the unanimous approval of the TMA Board of Trustees. Our Management Services Organization project will work with county medical societies and technology companies to give physician practices the tools they need to succeed in today’s tumultuous health care marketplace. “This is the most important thing TMA has done since tort reform,” Dr. Read said before the vote.




DR. BROTHERTON, CHERYL JONES TAKE THE HELM OF TMA, ALLIANCE

Congratulations to Fort Worth’s Steve Brotherton, MD, and Cheryl Jones, of Temple, the new presidents, respectively, of TMA and the TMA Alliance. They took the oath of office before the House of Delegates. In his installation address, Dr. Brotherton used some familiar nursery rhymes to lay out his presidential agenda. He asked, for example, if all the king’s horses and all the king’s men couldn’t put Humpty Dumpty back together again, “Where were the king’s surgeons?” He also stressed the need to maintain strong county medical societies. In other action, delegates:
  • Adopted the Board of Trustees’ position statement on expanded coverage and Medicaid reform;
  • Voted to “oppose any policy that hinders the autonomous clinical decision-making authority of a physician”; and
  • Approved TMA’s participation in the Choosing Wisely Campaign.

DISTINGUISHED SERVICE AWARD GOES TO ERNEST BUTLER, MD

 Retired otolaryngologist but still very active Austin philanthropist Ernest Butler, MD, received this year’s TMA Distinguished Service Award. Dr. Butler is a tremendous supporter of the TMA Foundation. With his wife, Sarah, he has underwritten our Excellence in Science Teaching Awards. Dr. Butler is a great example for physicians who want to give back to their communities. Other awards bestowed during the House of Delegates sessions include:
  • Houston trauma surgeon Ken Mattox, MD, received the first-ever Platinum Award, the top honor in TMA’s Award for Excellence in Academic Medicine.
  • The Young Physician Section gave its Young at Heart Award to Austin’s Bruce Malone, MD.
  • The Resident and Fellow Section’s J.T. “Lamar” McNew, MD, Award went to Troy Fiesinger, MD, of Sugar Land.
  • Men named “Berk” seemed to have an advantage in the Medical Student Section awards. The C. Frank Webber, MD, Award went to Steven Berk, MD, Lubbock; and the Student of the Year was his son, Justin Berk, of Texas Tech Health Sciences Center School of Medicine in Lubbock. The students’ Chapter of the Year is the University of North Texas Health Science Center, Texas College of Osteopathic Medicine chapter.

GOVERNOR PERRY APPOINTS SIX TMA MEMBERS TO TEXAS MEDICAL BOARD

Gov. Rick Perry made eight new appointments to the Texas Medical Board (TMB). All six of the physicians appointed are TMA members: psychiatrist Michael Arambula, MD; thoracic surgeon Devinder Bhatia, MD; anesthesiologist Scott Holliday, DO; pediatrician Margaret McNeese, MD; emergency medicine physician Robert Simonson, DO; and neurosurgeon Karl Swann, MD

Tuesday, May 14, 2013

FINAL FIRST TUESDAYS CROWD HELPS NAIL DOWN TMA AGENDA

Fanning across the Capitol to help kill bad bills and promote good ones, more than 100 physicians, medical students, and TMA Alliance members gave a resounding finish to 2013’s First Tuesdays at the Capitol. They witnessed House passage of our bill to regulate silent PPOs, which is just one short procedural move away from Gov. Rick Perry’s desk. Two of our key bills are already there:
  • Senate Bill 166 by Sen. Bob Deuell, MD (R-Greenville), and Rep. Lyle Larson (R-San Antonio) allows physicians to check in patients using the electronic strip on their Texas driver license.
  • Senate Bill 945 by Sen. Jane Nelson (R-Flower Mound) and Rep. Sarah Davis (R-West University Place) requires physicians and nonphysicians to wear photo ID badges clearly stating their name; hospital department; title; and status as a student, intern, trainee, or resident.
 

TEXMED 2013 KICKS OFF ON THURSDAY

TMA’s annual meeting always seems to sneak up on me in legislative years. But TexMed 2013 starts Thursday at the Grand Hyatt San Antonio and Henry B. Gonzalez Convention Center. Pre-registration is closed, but TMA members can still register onsite for free. Highlights include the keynote address from best-selling author Abraham Verghese, MD; a three-way race for TMA president-elect; hundreds of policy decisions before the House of Delegates; more than 100 hours of free continuing medical education; and the TMA Foundation gala. See you in San Antonio!

NEW YORK TIMES FEATURES TMA RED-TAPE-CUTTING BILL

Senate Bill 166 and other pieces of TMA’s anti-red-tape agenda were the focus of a piece in Sunday’s New York Times. The story quotes TMA President Michael Speer, MD, and Council on Socioeconomics Chair Buddy Swift Jr., DO. Along with the driver license swipe bill, the story discusses our bills to standardize health plan preauthorization forms for prescriptions and medical services. The bills are part of our Healthy Vision 2020 plan for “legislative solutions to cut through the red tape, regulations, and other unproductive elements that do nothing to improve quality and everything to interfere with doctors’ ability to practice medicine efficiently and effectively.”

AIR WAR COLLEGE DELIVERS CRITICAL LEADERSHIP TRAINING

I was tremendously privileged to spend much of last week with civilian and military leaders from around the country, and around the globe, at the Air War College National Security Forum. In place for 60 years, the forum focuses on education “on the application of air, space, and cyberspace within the context of international security.” The content included strategic assessments, critical thinking, and tactical approaches to issues from military, economic, and political perspectives. It was an exhilarating week with many take-home lessons for me and TMA.

COUNTIES COLLABORATE TO PUSH MEMBERSHIP

The Metro County Medical Society Executives and their membership staff were at TMA to discuss membership recruitment strategies. The group meets several times a year to collaborate and share ideas and plan recruitment and retention campaigns for the coming several months. The group talked at length about how to better serve, recruit, retain, and represent large group practices and how to streamline the membership application process. We made sure they have the resources they need to explain all the benefits of TMA membership. You don’t know them all? Check here.

TICKETS SELLING FAST FOR TMA FOUNDATION'S 20TH GALA

Join your colleagues, and gala co-chairs Drs. Rajam and Somayaji Ramamurthy and Dr. Buddy Swift and Mrs. Kathy Swift on Friday at TMA Foundation’s 20th anniversary gala, Roaring Twentieth. Jazz and ragtime entertainment, signature cocktails of the era, a 1920s photo booth, and silent and live auctions are just a few of attractions. VIP tickets (greater recognition and early entrance) may be purchased for $225, and regular tickets are $175 through tomorrow. Ticket prices go up on Wednesday. The gala benefits TMA outreach activities like Be Wise — Immunize and our Minority Scholarship Program.

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

JENNINGS CHOSEN ACOG PRESIDENT-ELECT

Congratulations to John Jennings, MD, of Odessa, the new president-elect of the American Congress of Obstetricians and Gynecologists. Dr. Jennings is the long-time chair of the Texas Medicine Editorial Board and former regional dean of the Texas Tech University Health Sciences Center at the Permian Basin. It’s great to see TMA members take the helm of national societies.

Monday, May 6, 2013

TMA's LEGISLATIVE AGENDA LOOKING GOOD — RIGHT NOW


Three weeks remain in the 2013 Texas Legislature. Lots can happen — some of it good — in those 21 days. But I’ll stick my neck out today and venture that medicine will come out of the session as one of the big winners. Here’s why. We laid out our agenda in a comprehensive, straightforward way well before the session began. We’ve flooded the halls with hundreds of white coats on three — this week makes four — First Tuesdays at the Capitol. Dozens of practicing physicians have shown up to testify before House and Senate committees and to lobby their own legislators. So:
  • Both Senate and House versions of the next state budget have significantly more money for more residency slots, more mental health services, and more women’s health services.
  • Our delegated practice bill — Senate Bill 406 — has passed the Senate, won approval from the House Public Health Committee, and is waiting for debate on the House floor.
  • Our bill to improve due process protections for physicians accused of Medicaid fraud — Senate Bill 1803 — passed the Senate and had a House committee hearing.
  • Our red-tape cutters — including standard prior authorization forms and simplified renewal of your state controlled substances permit — have all made significant progress in both chambers.
  • And House Bill 620, which would finally bring some regulation to silent PPOs, is scheduled for House debate on Tuesday. Please contact your representative today and ask for a “YES” vote.
Thanks to last week’s physician witnesses for TMA: John Holcomb, MD, of San Antonio testified for our Medicaid fraud bill. And Eugene Toy, MD, of Houston testified for a bill that aims to improve the quality of care and birth outcomes for pregnant women and their babies.

 

SGR FIX MUST COME FROM THE BOTTOM UP

TMA President Michael Speer and our senior lobbyist, Darren Whitehurst, travelled to Washington, D.C., for the American Medical Association’s work group on a replacement payment system for Medicare’s Sustainable growth rate (SGR) formula. A lot of work has gone into models that would reward physicians for the quality of care they provide. Here’s how I think we should do it: Base annual payment increases on growth in the number of Medicare patients and the number of patient visits. Then advocate strongly for physician-developed, population-management models that reward according to an increasing scale of clinical difficulty. Those are the types of programs our Management Services Organization Task Force is proposing, where we work with county medical societies and technology companies to provide physicians the tools they need to succeed.

TEXAS LIABILITY SUIT PAYOUTS IN THE BASEMENT

A new national study of all 2012 health care liability suit judgments and settlements reports Texas is at the absolute bottom in payments per-capita. I think this is a direct result of our 2003 liability reforms and just one more piece of evidence as to why we have to fight so hard to protect them. Once again this session — working with the Texas Alliance for Patient Access, Texas Medical Liability Trust, and others — we’ve made sure no bills weakening our reforms got any traction.

POE INTRODUCES BILL TO BLOCK ICD-10

U.S. Rep. Ted Poe (R-Humble) filed legislation to stop the federal government from requiring physicians to use the ICD-10 code set. It also would require a study of a more practical replacement standard for ICD-9. TMA and AMA strongly support this bill because of the extensive costs the ICD-10 transition would impose on physician practices, with no commensurate improvement in patient care. Congressman Poe has received widespread, positive publicity for pointing out that ICD-10 has nine different billing codes for injuries caused by turkeys.

TMA EXPLORES COLLABORATION IDEAS WITH TOP RESEARCH FIRM

TMA senior staff and I met with the executive team from the Merritt Hawkins search and consulting firm to discuss a possible relationship around education, services, and research related to physician employment, changing practice settings, and compensation models. Merritt Hawkins has performed outstanding research work over the past several years for The Physicians Foundation.