Blogged Arteries

 ... Images from the opening two days of the 2013 Annual Session of the American Medical Association House of Delegates in Chicago. At least the Texas perspective.

U.S. Surgeon General Regina Benjamin, MD, visits with Dallas pediatrician Carolyn Evans, MD

We're excited, too! Susan Rudd Bailey, MD, of Fort Worth is unanimously reelected vice speaker of the AMA House of Delegates

Austin anesthesiologist Joe Annis, MD (right) squares off against Maryland's Robert Wah, MD, in the debate between the two candidates for AMA president-elect.

Will Bradley, MD, of Mansfield chairs the Reference Committee on AMA Constitution and Bylaws	Les Secrest, MD, of Dallas serves on the Reference Committee on Legislation	David Lichtman, MD, of Fort Worth serves on the Reference Committee on Medical Education

"This process is an abomination." Drs Dawn and Ed Buckingham of Austin speak out at the AMA House of Delegates on the many problems with the maintenance of certification process.

Gary Floyd, MD, of Fort Worth testifies for a Texas resolution calling on AMA to identify the pros, cons, and costs of the Patient Protection and Accountable Care Act.

Left to right: Janning, Coffee, Chhabra

(CHICAGO) Congratulations to three Texas medical students who won positions on the Region 3 Board for the American Medical Association Medical Student Section.

Kaitlin Janning, the new Region 3 secretary, and Elizabeth Coffee, the membership chair, are both students at the Texas A&M 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.

The Texas Medical Association has long beat the drum for bolstering graduate medical education, cutting red tape that hinders patient care, promoting transparent insurance markets, and preventing unqualified health professionals from delivering care outside their expertise. This was the year those and other messages got through to lawmakers and paid off in long-sought, even precedent-setting victories at the conclusion of the 2013 Texas Legislature.

As this article was prepared, all of TMA's priority bills either became law or were on their way to Gov. Rick Perry's desk for signature following House and Senate approval. He has 20 days to act, whether signing it into law, vetoing it, or allowing the legislation to become law without signature.

Key milestones include:

• First regulation of so-called "silent PPOs" that share physician-contracted discounts without doctors' knowledge or consent; 
• A new model for physician-led, team-based care, and for future legislative scope of practice discussions;
• Wide-ranging reductions in practice red tape, including development of uniform prior-authorization forms for medications and health care services;
• Due process protections in Medicaid fraud investigations;
• Increased access to immunizations;
• More money for GME, mental health, and women's health; and
• Preservation of tort reforms and a strong Texas Medical Board.

Medicine's success this session was due on large part to seeds TMA planted early on, said Darren Whitehurst, vice president for advocacy.

"We took a very good preventive approach," he said. "We did a good job educating legislators back in their districts before the session. We had a good game plan in the political cycle in getting elected people who look to their doctors to understand medicine's issues. And that paid dividends in the legislature."

Even though not all of TMA's bills made it to the finish line, medicine did not lose any ground, TMA leaders add.

Additional money to boost Medicaid physician payment rates never materialized, but neither were rates reduced. Reforms to the Texas Medical Board and medical liability laws stayed intact. Heated debates halted compromise end-of-life legislation put forth by prominent pro-life and religious groups in Texas in collaboration with TMA, hospitals, and disability groups. But physicians still have access to existing safe harbors under the Texas Advance Directives Act for resolving conflicts out of court, without being forced to violate their moral beliefs and professional ethics.

Read all the details.

Texas Medical Association, Dallas and Harris County Medical Societies Team Up

Texas’ premier physician associations today 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.

“I am confident the Physician Services Organization for Patient Care will save local practices,” said Stephen L. Brotherton, MD, president of the Texas Medical Association (TMA). “Texas doctors are determined to make health care better and more affordable for Texans.

“To do that, 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.”

Read more about the Physician Services Organization for Patient Care.

The Texas Medical Association House of Delegates adopted the Board of Trustees' position statement on expanded health care coverage and Medicaid reform, and added a provision calling for equality in Medicaid and Medicare fees during its May 17-18 meeting in San Antonio.

Earlier this year, trustees said political leaders in Washington and Austin must immediately develop a bipartisan solution to reform the state's Medicaid program and expand coverage for low-income adults.

TMA leaders called on state leaders and lawmakers to "look beyond the federal government expansion solution and design a solution that works for Texas and for Texans."

TMA officials emphasized that the association is seeking expansion of coverage for poor adults that is nottraditional Medicaid. The state, they say, has the ability to work with the Centers for Medicare & Medicaid Services on a proposal that:

• Has patient copays and deductibles,
• Allows the state to develop a benefit package that makes sense for this patient population, and
• Allows the state to drop out of the program if conditions change.

TMA calls on Texans to use their ingenuity to "devise a comprehensive solution that:

1. Draws down all available federal dollars to expand access to health care for poor Texans;
2. Gives Texas the flexibility to change the plan as our needs and circumstances change;
3. Clears away Medicaid's financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program; and
4. Relieves local Texas taxpayers from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors."

During their debate, delegates voted to add additional points to TMA's position. They call for a system that "provides Medicaid payments directly to physicians for patient care equal to at least those of Medicare payments" and that continues to "uphold and improve due process of law for physicians in the State of Texas as it relates to the Office of Inspector General."

The house also voted against a resolution urging TMA to oppose Medicaid expansion, and against another resolution asking TMA to support repeal of the Patient Protection and Affordable Care Act.

Since the adoption of the new ICD-10 medical coding system is mandatory, will physicians' electronic health record vendors charge medical practices to help with the transition to the new system? Steve Arter, CEO of Complete Practice Resources (CPR), and Denny Flint, CPR's president, have answers and suggestions for doctors in this interview with Heather Bettridge, a TMA practice management consultant.

Six Republican senators voiced "significant concerns" with the government's implementation of the HITECH Act and meaningful use program in a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. The letter says their concerns include "the lack of data to support the Administration's assertions that this taxpayer investment is being appropriately spent and actually achieving the goal of interoperable health IT."

Read more about "REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT," which the senators sent to Secretary Sebelius.