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Tuesday, February 25, 2014

TELL CONGRESS TO PASS SGR REPEAL BILL NOW

It seems like there are two kinds of votes that take place on Capitol Hill. One kind, usually accompanied by lots of drama and debate flourishes, is intended more to make a political or policy statement and is cast in full knowledge that the other chamber or the other party would never even consider voting on the bill in question. The other kind of vote usually happens quickly, with House and Senate leaders unified behind a good piece of legislation they expect the president will sign. It’s our job to make sure that the vote on the Medicare Sustainable Growth Rate (SGR) repeal bill (HR 4014/S 2000) is the second kind. We don’t need a vote just for show; we need a vote that finally removes the SGR albatross from physicians’ necks. The Coalition of State Medical Societies, which includes Texas and eight other states, is doing its part. We published a post in the widely read KevinMD blog this weekend. We’ll be in Washington next week to lobby Congress personally. What have you, as a leader of Texas medicine, done? Have you called or written Sens. John Cornyn and Ted Cruz and your U.S. representative using TMA’s Grassroots Action Center? Have you encouraged your friends, colleagues, patients, and staff to do the same? Have you shared our award-winning Grandma and the Big, Bad SGR video via email and your social media networks? Medicine’s grassroots power can make sure the vote on HR 4014/S 2000 is the right kind of vote, that we can repeal this annual disaster-maker and get on to working with Congress on casting some votes that begin to fix our health care system’s many other problems.

TMA WORKS TO UNTANGLE CONTROLLED SUBSTANCE PERMIT REFORMS

Red tape appears to have entangled one of the medical practice red-tape-busting bills the Texas Legislature passed last year. TMA is working with two state agencies to cut it loose. Physician complaints about hassles and delays in renewing their annual Controlled Substances Registration through the Department of Public Safety (DPS) led lawmakers to give the permits two-year lifespans, align their renewal dates with physicians’ medical licenses, and authorize the Texas Medical Board (TMB) to coordinate the whole process beginning Jan. 1. Unfortunately, DPS has been slow to act, leaving physicians whose permits expired in the past two months just as frustrated as ever. TMA has pushed DPS and TMB officials to the conference table, and we’re now hearing assurances that the renewals will work as the legislature intended “in the near future.” In the meantime, DPS officials tell us the agency will automatically renew current permits that expire in February or March with a temporary, one-year expiration date. DPS will complete the renewal before the permit expires, and those physicians do not have to submit a renewal application or pay a fee. Stay tuned.

EARLY VOTING AND OTHER EVPGRAM CALENDAR ITEMS

Remember, early voting in the party primaries runs through Friday, Feb. 28. Please check out TEXPAC’s slate of endorsements and vote for the Party of Medicine. Other items for your calendar:

TRAVIS COUNTY KICKS BUTT ON MEMBERSHIP

Congratulations to the staff and physician leaders of the Travis County Medical Society. Competing against the other metro county medical societies, Travis won our first ever “Kicked Butt” award in recognition of its membership performance in 2013. The award went to the metro county with the best percent gain in new members in the active and first-year-in-practice categories. Travis saw an increase of 5.6 percent, or 160 members. Do your part — remind your colleagues to join or renew.

DR. BROTHERTON'S OTHER, OTHER JOB

As if being an orthopedic surgeon, Sunday school teacher, and TMA president doesn’t keep him busy enough, Steve Brotherton, MD, spent most of last week at his other, other job: serving on the American Medical Association’s Council on Ethical and Judicial Affairs (CEJA). The nine-member council is responsible for maintaining and updating the 165-year-old AMA Code of Medical Ethics, and for setting ethical and professional standards for American physicians.

GET $100 DISCOUNT ON SPECIALTY-SPECIFIC ICD-10 CODE TRAINING

TMA has arranged a $100 member discount for specialty-specific ICD-10 documentation courses offered by AAPC. There are different three-hour courses for 21 specialties. Use coupon code 10DOCTMA at checkout to secure your discount. Be as ready as you can for the Oct. 1 switch.

Tuesday, February 18, 2014

SGR REPEAL BILL A "MARKED IMPROVEMENT OVER THE STATUS QUO"

When you spend months lobbying an issue through the truly byzantine halls of Congress, it’s always gratifying to know that your arguments have been heard. Since the last flurry of public activity in early November, TMA, the other members of the Coalition of State Medical Societies, and the American Medical Association have worked furiously with senators, representatives, and their staffs on a bill to repeal Medicare’s disastrous Sustainable Growth Rate (SGR) formula. The outcome was a solid piece of legislation that offers physicians your best chance in history to overthrow the SGR albatross. “We are pleased to announce our support for HR 4015/S2000,” the coalition wrote in a letter to the House and Senate committee chairs that produced the bill. “While we have concerns with aspects of HR 4015/S2000 … this legislation represents a marked improvement over the status quo.” As we requested, this latest draft not only would repeal the SGR immediately, but also it:
  • Provides five years of 0.5-percent positive annual payment updates;
  • Simplifies, adds more funds for bonuses, and reduces the potential penalties in Medicare’s “quality incentive” programs;
  • Starts to cut the federal red tape and hassles that interfere with physicians who are just trying to provide good care for your patients; and
  • Helps prevent new causes of legal action against physicians.
If you haven’t done so yet, please call or write U.S. Sens. Ted Cruz and John Cornyn and your House member to urge them to support the bill. Use the TMA Grassroots Action Center — it’s fast and easy. Finally, I want to once again thank two Texans in Congress — U.S. Reps. Michael Burgess, MD (R-Lewisville), and Kevin Brady (R-The Woodlands) — for their outstanding leadership on this issue and, most of all, for listening to the voices of practicing physicians.

TEXPAC ENDORSES GREG ABBOTT FOR GOVERNOR

Attorney General Greg Abbott has earned physicians’ votes in his bid for governor, the TEXPAC Board of Directors decided. His support of Texas’ medical liability reforms, and TEXPAC’s decades-long alliances with General Abbott in races for district judge, Supreme Court of Texas, and attorney general certainly were factors. But most persuasive was the strength of his backing among grassroots physicians. More than 200 TMA members called or wrote the TEXPAC offices on General Abbott’s behalf. And the candidate himself made a personal call to TEXPAC Board Chair Jerry Hunsaker, MD, asking for the endorsement. “Grassroots physician backing for a candidate is one of the pillars of our endorsement process,” Dr. Hunsaker said. “General Abbott hit that one way out of the park.” We look forward to electing him governor and, in General Abbott’s own words, “together, we will create a superior health care environment for all Texans.."

EARLY VOTING BEGINS TODAY; VOTE THE PARTY OF MEDICINE

Well, the 2014 election season is officially here. At 7 am today, early voting stations for the March 4 party primaries opened around the state. You can cast your ballot at any early voting location in your county, not just in your home precinct. TEXPAC has endorsed a superior slate of medicine- and patient-friendly candidates. In addition to Greg Abbott, our top-of-the-ballot endorsements include Senator Cornyn and Lt. Gov. David Dewhurst for reelection, State Rep. Dan Branch for attorney general, and State Rep. Harvey Hilderbran for comptroller. Early voting runs through Friday, Feb. 28. As Dr. Hunsaker says, “Vote early: Beat the crowds … and our opponents.”

MY LATEST ON FORBES.COM: MEDICINE'S CULTURE OF QUALITY

No other profession can match the educational rigor and continuing education requirements of medicine. Physicians, dedicated to each patient encounter, live deep in a culture of quality. So why does the federal government insist on finding so many new ways of measuring and imposing its own version of health care quality? That’s the gist of the argument Physicians Foundation CEO Tim Norbeck and I make in our latest Forbes.com blog post. “No other nation in the world comes close to having the enormity of bureaucratic medical infrastructure that exists in the U.S. today,” we wrote. “Just adding layer upon layer of administrative burden to an already oppressive system is not the answer to ensuring quality.”

Monday, February 10, 2014

SGR 1: BIPARTISAN, BICAMERAL REPEAL BILL FILLED

Late last week brought some excellent news from Capitol Hill. The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4014/S. 2000), was introduced in the U.S. Senate and House of Representatives. Its author is our own U.S. Rep. Michael Burgess, MD (R-Lewisville). It features the handiwork of Rep. Kevin Brady (R-The Woodlands). And it has the support of key congressional leaders from both parties and in both chambers. The bill calls for the immediate repeal of the Sustainable Growth Rate (SGR) formula. The irrational cuts mandated by the SGR have hung like an annual albatross around the necks of physicians and Congress for more than a decade. It includes five years of 0.5-percent positive annual payment updates. While it is doubtful these updates will keep up with physicians’ cost of providing care to Medicare patients, the cumulative 2.5-percent update is larger than all of the increases in the past 12 years combined. Since the last versions of SGR repeal introduced in December, H.R. 4014/S. 2000 contains numerous changes requested by TMA and the American Medical Association, including:
  • Significant improvements in the proposed Merit-Based Incentive Payment System, with more funding for positive incentives and less of a down side in penalties;
  • Deleting the repeated opt-out affidavit submissions for physicians who want to contract privately with their Medicare patients; and
  • Requiring that electronic health records be interoperable by 2017.
The new version also retains important language that helps limit the establishment of new causes of action against physicians.

SGR 2: CALL AND WRITE CONGRESS TODAY

Filing the SGR repeal bill alone is not sufficient. We must make sure it passes. “We may not get this opportunity again,” said TMA President Steve Brotherton, MD. “Take action now to support permanent SGR repeal.” In a membership-wide TMA action alert, Dr. Brotherton urged all Texas physicians to call and write Washington immediately. “Congress is now closer than it ever has been to enacting fiscally prudent legislation that would permanently repeal the SGR, “he said. “That will happen only if Washington hears our loud voice. Please contact U.S. Sens. John Cornyn and Ted Cruz and your U.S. representative today.” Physicians can send an email through TMA’s Grassroots Action Center, and call lawmakers via AMA’s Physicians Grassroots Network hotline at (800) 833-6354. Please reach out and ask your partners, colleagues, and staff to take action now. Right now, the most likely alternative to passing H.R. 4014/S. 2000 is a nine-month patch attached to the debt ceiling bill. That would have us fighting this fight, again, in December.

NEW TMA SEMINARS PREPARE YOUR STAFF FOR ICD-10

 Your staff needs hands-on, detailed training to make ICD-10 work in your practice. Our newest statewide seminar series, starting Feb. 25, delves into how to use the new ICD-10-CM code book and its guidelines, and how to audit physician documentation in day-to-day practice. Register for ICD Documentation and Auditing: Success Is in the Details before Feb. 14 and get the early-bird discount; use coupon code ICD10EARLY at checkout.

DR. CIGARROA TO STEP DOWN AS UT SYSTEM CHANCELLOR

Numerous news outlets are reporting that The University of Texas (UT) System Chancellor Francisco Cigarroa, MD, a member of a great South Texas physician family, will announce today he will resign his post to return to the clinical practice of medicine. The Texas Tribune says Dr. Cigarroa will become the head of pediatric transplant surgery at the UT Health Science Center at San Antonio once his successor is named. Dr. Cigarroa is a longtime TMA member. “My father continues to practice medicine daily at age 89, and three of my brothers are physicians,” the Tribune quoted him as saying in an email to UT administrators. “It is time to honor what my parents did for me by returning to my father’s and my first love, the practice of medicine.”

FREE DOCBOOKMD UPDATE NOW AVAILABLE

 Version 5.3 of TMA's endorsed secure communication app DocbookMD is now available for free in the Apple App Store and on Google Play. This latest update sees some major improvements to the user interface, most noticeably in the organization and navigation of messages, and upgrades for your "Favorites" list.

SGR 3: RELAUNCHING "GRANDMA AND THE BIG, BAD SGR"

Now that we are back in a new fight to repeal the SGR, I want to remind you of a still-useful relic of our past battles. “Grandma and the Big, Bad SGR” is an animated TMA video that explains the SGR problem in terms that even a child can understand. Use this short video to help your friends and family understand what we’re up against and why passage of H.R. 4014/S. 2000 is so critical. Please watch it again, and share it through email and social media.

Monday, February 3, 2014

PASSION REIGNS AT TMA WINTER CONFERENCE

About 600 physicians joined us in Austin for an exciting group of work and education sessions that made up our 2014 Winter Conference. As always, TMA leaders and our speakers demonstrated their passion for the profession and for improving patient care. Among the highlights:
  • A panel of engaging speakers with wide-ranging expertise shared their insights into the ongoing transformation of the health care marketplace. (Watch the video.) They gave us a glimpse at the future and how, together, we are going to help physicians regain control of health care. Within TMA, we are committed to giving you the tools to do that.
  • U.S. Sen. John Cornyn brought us a sane look at the insanity that is Washington, D.C., these days. (Watch the video.) He discussed the Affordable Care Act, Medicare’s Sustainable Growth Rate formula, and the Independent Payment Advisory Board. I was particularly impressed with his call for the Senate to return to what he called the “80-20 rule,” where senators from both parties focus on the 80 percent of issues on which they agree rather than the 20 percent on which they vehemently differ. Good advice.
  • TEXPAC hosted a forum for the four Republican candidates for Texas comptroller of public accounts. (Watch the video.) After the forum, the TEXPAC Board of Directors voted to endorse State Rep. Harvey Hilderbran (R-Kerrville) in the March 4 primary.
  • The Texas Delegation to the American Medical Association elected David Henkes, MD, of San Antonio as its new chair. Drs. Asa Lockhart of Tyler and Sheldon Gross of San Antonio are the new vice chairs.

TEXPAC ENDORSES 125 IN 2014 FOR 2015

We had an excellent conversation when TEXPAC Board Chair Jerry Hunsaker, MD, came to visit the TMA Board of Trustees. The topic was how to encourage more members to join the PAC. One conclusion was to remind physicians that our big successes for them at the Capitol begin by electing candidates who support patients and physicians. Here are two ways to do that:
  1. If you’re not registered to vote in the March 4 party primaries, today’s the day. Registration cards must be postmarked by midnight tonight.
  2. Take a close look at the slate of 125 candidates TEXPAC has endorsed. Vote for them, and consider volunteering your time or making a donation. At its Winter Conference meeting, the PAC board added a strong group of Supreme Court justices to the list.

FOUNDATION HONORS HOMELESS, REFUGEE CARE PROGRAMS

A health care program for Houston’s homeless and a medical case management system for refugees in Austin won the TMA Foundation’s 2014 John P. McGovern, MD, Champion of Health Awards. The top award winner ($5,000) is the HOMES (Houston Outreach Medicine, Education, and Social Services) Clinic, which was founded in 1999 by David Buck, MD, and students from The University of Texas Medical School at Houston and Baylor College of Medicine. Students and preceptors from the two schools operate a free clinic every Sunday for the thousands of homeless people in Houston. Refugee Services of Texas, Inc., which provides a broad array of services to 400 refugees a year in Austin, was the secondary winner ($2,500). Both winners certainly honor Dr. McGovern’s legacy.

TMLT PUTS $20 MILLION INTO POLICYHOLDER REWARDS

The Texas Medical Liability Trust (TMLT) is dedicating $20 million to its Trust Rewards Program for 2014. TMLT uses Trust Rewards to reward policyholders for their loyalty. This brings the Trust Rewards total to $150 million. Each year when a physician’s policy renews, TMLT sets aside funds in his or her Trust Rewards account. The funds are allocated to policyholders primarily when they retire. TMLT, the largest medical liability insurance provider in Texas, is the only medical professional liability insurance provider created and exclusively endorsed by TMA.

ZDOGGMD INVITES YOU TO FORT WORTH FOR TEXMED 2014

Our TexMed 2014 general session speaker has a dual identity. By day, he’s Zubin Damania, MD, a Las Vegas, Nev., hospitalist and dedicated health care revolutionary. At TexMed 2014 in Fort Worth, Dr. Damania will delve into the ethical challenges of delivering excellent care in our dysfunctional health care system, while proposing ways to revitalize it. In his new clinic in Las Vegas, Dr. Damania is looking to mend the system and bring autonomy back to health care — and to redefine the culture of medicine. Dr. Damania is also known by his online alter ego, ZDoggMD, whose parody videos are posted around social media and the medical community. And ZDoggMD has put together one of his signature videos to stir up excitement about our annual meeting. Like? Registration is open.

PAPER SPOTLIGHTS TMA DIRECTOR OF CLINICAL ADVOCACY

The Victoria Advocate profiled one of its hometown ladies who’s done well. And she’s doing well for TMA. Angie Ybarra, RN, MSN, our director of clinical advocacy, earned her master of science in nursing from the University of Houston-Victoria School of Nursing last year, just before she joined our staff. Angie’s responsibilities include educating physicians about performance improvement systems and opportunities to prepare for value-based payment systems. “When I read the job description, I felt compelled to apply,” she told the paper. And we’re glad she did.