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Monday, June 24, 2013

AMA HOUSE ENDORSES TMA POLICY PROPOSALS

Texas physicians took six resolutions to the American Medical Association House of Delegates annual meeting in Chicago and won positive responses on all six. Unfortunately, we didn’t fare quite so well in the elections, as Austin anesthesiologist Joe Annis, MD, lost an extremely close race for AMA president-elect to Robert Wah, MD, an OB-Gyn from Maryland. On the six Texas resolutions, the house:
  • Agreed that AMA needs to provide more detail on its positions of various pieces of the Patient Protection and Affordable Care Act (PPACA), and directed the AMA Board of Trustees to issue a report by November that focuses specifically on the budgetary, coverage, and physician-practice impacts of the law;
  • Agreed with our call for a plan to simplify — and remove potential legal landmines from — the Medicare opt-out process;
  • Directed AMA to push to remove sugar-sweetened beverages from the Supplemental Nutrition Assistance Program, which provides food stamps to 46 million Americans;
  • Approved our recommendation that the Bridges to Excellence program should align the time periods of its recognition program with those of the National Committee on Quality Assurance recognition programs;
  • Asked for more study on initiatives promoting open access to scientific literature; and
  • Called for further research into what vendors and government agencies need to do to make it easier for physicians to transfer data from one electronic medical record system to another.  

TMA: KEEP GOVERNMENT OUT OF THE EXAM ROOM

Whether it’s the Obama Administration, the Texas Legislature, or city hall, government has no place telling physicians how to practice medicine. That’s the purview of your profession and scientific evidence. And that’s the message TMA delivered to lawmakers in Austin debating a series of bills to add new state regulations to abortion. “Our concerns with Senate Bill 5 and House Bill 60 are not based on any position on abortion,” TMA President Steve Brotherton, MD, wrote in a letter distributed to Texas House members Sunday before a marathon debate that extended past 4 am. “Rather, our concerns are with legislative intrusion into the patient-physician relationship and the details of the practice of medicine, and with a legislatively created standard of care. … TMA is concerned this legislation sets a dangerous precedent of the legislature prescribing the details of the practice of medicine. These are determinations to be made by the medical community and science, not by the legislature.”

"WE GOT RESULTS"― LEGISLATURE DELIVERS FOR PATIENTS AND PHYSICIANS

Texas patients and their physicians won big at the state Capitol during the 2013 regular session. We had more wins than in recent sessions across all issues affecting patient care, as outlined in TMA’s Healthy Vision 2020. In fact, nearly every TMA bill made it to the finish line, either intact or as an amendment. And every bill TMA wanted stopped was stopped. Darren Whitehurst, TMA's vice president of Advocacy, and the TMA lobby team discuss our results in this 11-minute video. Watch the video below to learn what lawmakers did that will help you, your practice, and your patients.

 

HEALTHY VISISON 2020 BRINGS HOME SOME PRIZES

TMA’s Healthy Vision 2020 is not only our strategic roadmap for advocacy through the end of this decade; it’s now our award-winning strategic roadmap for advocacy through the end of this decade. The shiny hardware we’ve gathered recently includes:
  • A Platinum Hermes Creative Award (the highest honor) for design and publication, from the Association of Marketing and Communication professionals;
  • A Bronze Quill (the highest honor), from the Austin Chapter of the International Association of Business Communicators (IABC), for communication management in government relations; and
  • An Award of Merit from IABC Austin for creative publication design. 

Monday, June 17, 2013

GOVERNOR PERRY SIGNS STATE BUDGET, TMA RED TAPE BILLS, MANY MORE

In a flurry of black ink, Gov. Rick Perry signed into law more than a dozen TMA-backed bills, cementing 2013 as one of our most effective legislative sessions in decades. The bills:

  • Stop silent PPOs’ theft of physician services; 
  • Cut red tape and excessive regulations; 
  • Rein in Medicaid fraud-and-abuse investigations; 
  • Gain tax relief for physicians; 
  • Establish a more streamlined, less bureaucratic way of supervising allied health practitioners; 
  • Protect your independent medical judgment; 
  • Battle physician shortages; 
  • Reverse budget cuts, and invest more state money into mental health and women’s health care services; and 
  • Protect young Texans.

Meanwhile, we rejected every single attack on our 2003 liability reforms and every single inappropriate attempt to expand scope of practice. For more details on all of this, see the special issue of TMA Action coming out this week and August’s edition of Texas Medicine.

BAILEY REELECTED; HYER HITS HIGH NOTES; STUDENTS WIN AMA POSTS; ANNIS RUNS TUESDAY

Sue Bailey, MD, the former TMA president from Fort Worth, won a third term as vice speaker of the American Medical Association House of Delegates by acclamation. Outgoing AMA Alliance President Pat Hyer of Fort Worth told the house of the huge improvements that organization has made in the past year. Three Texas medical students won positions on the Region 3 board for the AMA Medical Student Section. Kaitlin Janning, the new Region 3 secretary, and Elizabeth Coffee, the membership chair, are both students at Texas A&M Health Science Center College of Medicine. Divya Chhabra, the new community service chair, attends The University of Texas Southwestern Medical School. All three are rising second-year students. And we’ll know the outcome of the race by Joe Annis, MD, for AMA president by this time tomorrow. He did an excellent job in Saturday’s debate.

TECH TUESDAY STARTS TOMORROW

Plug in to the future with Tech Tuesday, TMA’s new webinar series that explores how technology and the law are affecting your practice. Registration is still open for tomorrow’s inaugural session on how to meaningfully use your electronic health record. (Sad how the feds have stolen that phrase from our lexicon.) Tune in on the third Tuesday of each month to learn about health information exchanges, HIPAA, patient portals, and more.

CALLING ALL DOCTORS JUNE 25

Lawmakers delivered for you and your patients during the 2013 legislative session. TMA wants to make sure you know what happened that affects you, your practice, and your patients. That’s why at 8 pm CT on June 25, TMA President Steve Brotherton, MD, will call you at your home telephone number. All you have to do is stay on the line for TMA’s Tele-2013 Legislative Update — and earn continuing medical education credit, too. If you prefer, we call you on your cell or office phone. Please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by e-mail by June 25, and let us know.

SUPREME COURT LETS SCOPE RULING STAND

The Texas Supreme Court decided not to review our case against the Texas State Board of Chiropractic Examiners, in which we argued that chiropractors are not allowed to diagnose. The ruling leaves standing TMA’s successful challenge to the board’s manipulation-under-anesthesia and needle electromyography regulations. It also has the effect of allowing chiropractors to make a chiropractic diagnosis limited to their scope of practice, as statutorily defined. We are considering whether to continue with our constitutional challenge when it is remanded back to the trial court.

DR. WILLIAMS NAMED SOLE FINALIST FOR UNT HEALTH SCIENCE CENTER POST

Michael R. Williams, DO, MD, who has served as interim president of the University of North Texas (UNT) Health Science Center since December, is now the sole finalist for the permanent job. The UNT Health Systems Board of Regents announced that decision last week but must wait at least until July 3 to formally offer him the position.

Monday, June 10, 2013

GRASSROOTS COALITION STORMS CAPITOL HILL

Leaders from several other state medical societies joined TMA Advocacy VP Darren Whitehurst and me in working meetings on key health care issues with members of Congress. TMA is collaborating with representatives of state societies from California, New York, Florida, Louisiana, North Carolina, Oklahoma, Arizona, and South Carolina in this grassroots education effort. We’re assembling a cross-pollination of ideas from state leaders in organized medicine, and visiting not just with Texas’ congressional delegation but also with virtually anyone who will listen to us, to rally for better patient care across America. In addition to meeting with key Texas congressmen like Reps. Michael Burgess, MD (R-Lewisville), and Kevin Brady (R-The Woodlands), we educated freshman members about Medicare’s failing Sustainable Growth Rate (SGR) formula and some important bills to cut red tape for physicians. Those include a call to stop implementation of the ICD-10 coding system by passing HR 1701 by Rep. Ted Poe (R-Humble); allowing physicians to own hospitals, under HR 2027 by Rep. Sam Johnson (R-Plano); and repeal of the Independent Payment Advisory Board through passage of S 351 by Sen. John Cornyn of Texas.

TMA TO CONGRESS: TRASH SGR, KEEP UPDATES STABLE, KEEP PHYSICIANS IN CHARGE

We spent a lot of time talking with Representative Burgess about the brewing congressional plan to replace the SGR with a formula that won’t underpay physicians year after year after year. With hearings coming up this week, he encouraged us to send our thoughts in a formal comment letter to the House Energy and Commerce, and Ways and Means committees. TMA President Steve Brotherton, MD, wrote that any plan must:
  • Eliminate the SGR immediately and create a period of stable Medicare payments that includes annual increases at least equal to the growth in the Medicare Economic Index;
  • Include payment for services rendered (fee for service) as a major payment option;
  • Replace — rather than add to — the Medicare value-based payment modifier plan for assessing and rewarding quality care;
  • Evaluate any new payment methods, incentives, or efficiency or quality measures in actual medical practices before they are widely implemented;
  • Prohibit performance measurement methods that are dependent on patient compliance;
  • Reject incentives to withhold treatment and testing for Medicare patients; and
  • Avoid any new administrative requirements that will not produce proven, quantifiable returns.

WHY PHYSICIANS ARE UNHAPPY

On June 5, Forbes.com published a commentary that Tim Norbeck, chief executive officer of The Physicians Foundation, and I wrote to examine how regulations impact physicians’ morale and patient care. “Your Doctor Is Likely Unhappy: Do You Know Why?” includes statistics from the foundation’s 2012 Biennial Physicians Survey. Government regulation is the No. 1 least satisfying aspect of medical practice, the survey found. This is the second of our commentaries that Forbes has published. The first addressed what drives health care costs.

KEY TMA BILLS AWAIT GOVERNOR'S SIGNATURE

The 2013 Texas Legislature (the regular session that ended, not the special session on redistricting that is still ongoing) passed a huge portion of TMA’s 2013 legislative agenda. Now we’re waiting on Gov. Rick Perry to sign the bills into law. Some of the highlights include:
  • The 2014-15 state budget, which reverses cuts made in graduate medical education and women’s health services spending, and significantly increases mental health spending.
  • Our landmark bill that sets up a more collaborative, delegated practice among physicians and advanced practice nurses or physician assistants. It firmly establishes the physician-led medical team.
  • Our red-tape cutting package, which includes a new law to make it easier and faster for physicians to renew their Controlled Substances Registration permit as well as standard preauthorization forms for pharmacy and medical services. 

DR. BROTHERTON ENGAGES TMA STAFF

We were lucky enough to have a full day of Dr. Brotherton’s time. He joined us in celebrating some milestone anniversaries for TMA employees and then shared the agenda for his presidential year at our quarterly staff meeting.

NO, WE DIDN'T FORGET SUE

Several astute EVPGram readers questioned last week’s item that said the only candidate we’re running at the upcoming meeting of the American Medical Association House of Delegates is Joe Annis, MD, who is campaigning for AMA president-elect. We omitted, unfortunately, that Sue Bailey, MD, our dynamo of a former president, is running unopposed for her third term as vice speaker of the AMA house. The elections are June 18.

Monday, June 3, 2013

TMA TO AMA: COME CLEAN ON AFFORDABLE CARE ACT

As we move closer to full implementation of the Patient Protection and Affordable Care Act (PPACA), TMA is asking the American Medical Association to prepare a report on “identifying the portions of the PPACA that are in accordance with AMA policy and those that are not, including a review of the costs for full implementation of the PPACA.” We’re also asking AMA to prepare “analyses (including relevant AMA policy and public positions) of all aspects of the [law] that could harm patients’ access to care and/or dilute physician autonomy.” The Texas delegation is taking the resolution to the AMA House of Delegates, acting on a proposal the TMA House of Delegates approved. Rob Tenery, MD, of Dallas, a former TMA president, first brought forward the plan. Other resolutions we’re taking to the AMA meeting in Chicago, June 14-19, include:
  • A plan to simplify — and remove potential legal landmines from — the Medicare opt-out process;
  • A call for AMA to remove sugar-sweetened beverages from the Supplemental Nutrition Assistance Program, which provides food stamps to 46 million Americans;
  • A resolution in support of initiatives promoting open access to scientific literature;
  • A proposal for the Bridges to Excellence program to align its recognition program validation periods with those of the National Committee on Quality Assurance recognition programs; and
  • A call for AMA to work with vendors and government agencies to make it easier for physicians to transfer data from one electronic medical record system to another.  

CALL GOVERNOR PERRY ON PRIOR AUTHORIZATIONS BILLS

Please call the governor’s office now at (512) 463-2000 and ask Gov. Rick Perry to sign Senate Bill 644 and Senate Bill 1216 today. These bills, part of our red-tape-reduction package, will streamline prescription drug and health care prior authorizations so patients receive their medications and health care services sooner. SB 644 creates a standard prior-authorization form for prescription drugs, which SB 1216 would do for health care services and supplies. Insurance companies and pharmacy benefit managers require too many prior-authorization forms. All these forms cost physicians time and money, and detract from patient care. These were among TMA’s top-priority bills in the legislative session. A short phone call from you to the governor will help us make sure that they become law.

DR. ANNIS AIMS FOR THE TOP

The Texas Delegation is running only one candidate in the elections at the AMA House of Delegates, but we’ve got our sights aimed at the top of the ballot. Austin anesthesiologist Joe Annis, MD, is the first Texan to vie for AMA president-elect since Jim Rohack, MD, of Temple, won a race for the top in 2009. Dr. Annis brings impeccable credentials as a practicing physician and a teacher at Dartmouth Medical School, and with service on the AMA Board of Trustees and Council on Medical Service. You can boost his campaign by liking his Facebook page or following him on Twitter. If you know delegates from other states or specialties, please ask them to “vote for Joe.”

GOVERNOR SIGNS "SILENT PPO" BILL

Governor Perry signed into law our legislation to rein in companies that sell, lease, or share physician-contracted discounts without your knowledge or consent. These “silent PPO” practices mislead patients and cause needless, costly hassles for physicians who fall victim to them. The legislation, Senate Bill 822 by Sen. Charles Schwertner, MD, and Rep. Craig Eiland, was TMA’s No. 1 priority this session for establishing fair and transparent insurance markets for patients, employers, and physicians. The new law takes effect Sept. 1.

The legislature is in special session. For now, lawmakers are dealing only with redistricting, but TMA is monitoring the session closely in case the governor directs them to take up issues that concern physicians and patients.

TECH TUESDAYS COMING

Our new Tech Tuesdays series kicks off June 18 with Meaningful Use: Useful for Your Practice. Tech Tuesdays is a new live webinar series on the third Tuesday of every month from noon to 1 pm CDT. Each session will highlight issues and trends surrounding medical technology and how they affect your practice. Future sessions will include expansion of health information exchanges and HIPAA security.

DR. HORWITZ HONORED

Congratulations to Melton J. Horwitz, MD, of Houston. He received the Lifetime Achievement Award from the Texas Association of Otolaryngology-Head and Neck Surgery for his dedication and service to the specialty. He’s a graduate of Baylor College of Medicine and practices at Medical Center Ear, Nose & Throat Associates of Houston, PA.