Dec 30, 2010

TMA Challenges Chiropractors' Rules Again

Chiropractors are trying to get around a court ruling and expand their scope of authority beyond what they are trained to do, TMA charges in a letter to Glenn Parker, executive director of the Texas State Board of Chiropractic Examiners.

Dec 24, 2010

State Revises Foster Care Drug Rules

With help from TMA and the psychiatric, pediatric, and family practice specialty societies, the state updated parameters for use of psychotropic drugs for foster children. TMA and the societies helped develop the original parameters and also provided input on the latest version.

Don't Stop Electronic Death Registering

Even though the Texas Medical Board has suspended disciplinary action for not completing death certificates electronically, physicians should continue signing up for and using the Texas Electronic Registrar Death Registration system.

Medicare Won’t Deny Ordered/Referred Services Sans PECOS File Just Yet

Still trying to enroll in PECOS to avoid rejected Medicare claims? Keep trying, but meanwhile, here are three facts that will help ease your mind:

Nov 30, 2010

Health System Reform Affects Prevention

One of the provisions of health system reform that is already having an impact on physician practices is the provision on preventive health care services. Read TMA's Health Reform School white paper on prevention to make sure you're ready for this change.

Nov 29, 2010

Congress Grants Medicare Stay of Execution

The U.S. House of Representatives joined the Senate Nov. 29 in delaying the 23-percent cut in Medicare payments to physicians, just two days before the reduction was to take effect.

Learn How TMA Makes Policy

Do you ever wonder how TMA physician leaders and staff develop association policies? This free video explains it all.

State Starts Medicaid Buy-in

Starting Jan. 1, families of children ineligible for Supplemental Security Income (SSI) for reasons other than disability can buy in to the state Medicaid Program.

Nov 22, 2010

Five Fresh Faces Bring Health Care Perspective to 2011 Texas Legislature

The “Rookie Report” is always one of the most interesting segments of the TMA/Specialty Society State Advocacy Retreat. This year five incoming House members shared war stories from the campaign trail. I was quite impressed with this year’s crop of featured freshman, all of whom bring some important health care connections to the 2011 legislature. They were:
  • Rep.-elect Jose Aliseda (R-Beeville), whose father Jose is a retired anesthesiologist in McAllen.
  • Rep.–elect Sarah Davis (R-Houston), a cancer survivor whose Houston Medical Center district has more physicians and TMA Alliance members than any other in the state.
  • Rep.-elect J.M. Lozano (D-Kingsville), whose father, sister, and brother-in-law are all Texas physicians.
  • Rep.-elect Dan Huberty (R-Kingwood), who defeated two TEXPAC-member physicians in the spring primaries and now has a great working relationship with TMA.
  • Rep.-elect Charles Schwertner, MD (R-Georgetown), a surgeon who will become the fourth TMA member in the legislature next year.
(L-R) TMA EVP Lou Goodman, State Rep.-elect J.M. Lozano, and TMA Board Member Carlos Cardenas discuss the upcoming 2011 session of the Texas Legislature.

Nov 17, 2010

TMA and Texas AARP Team Up to Stop Medicare Meltdown

FORT WORTH – Today, the nation’s largest state medical society and one of the largest patient-advocacy groups united to stop the Medicare Meltdown. This is the first time these two immense patient-advocacy groups have joined forces to ensure Texas’ 3 million Medicare patients receive the care promised by the U.S. government.

Texas Medical Association (TMA) physicians, AARP representatives, and more than 30 patients gathered at the Trinity Terrace Retirement Community in Fort Worth, Texas, and called on Congress to fix the crisis.

Texas patients picked up their phones and asked their U.S. senators and representatives to stop a 23-percent cut to their physicians’ Medicare payments scheduled to go into effect Dec. 1. The cut grows even larger after the New Year.

“I can’t believe we are here again, for the fifth time this year, asking Congress to stop another drastic cut to physician payments,” said TMA President Susan Rudd Bailey, MD. Watch the video excerpt below (it will automatically right itself!) and read the full story.

Nov 15, 2010

TMB Drops Death Certificate Fines

Physicians already fined by the Texas Medical Board (TMB) for not filing death certificates electronically will get their money back, and pending cases will be dismissed because of physicians' problems in registering to use the state's registration system.

TMA's Flu Fighters Back in Action

TMA's Flu Fighters are back this fall. Their goal is to ensure you have the information you need for 2010-11 seasonal influenza.

TMA Developing BlueCompare Appeals Toolkit

Blue Cross and Blue Shield of Texas plans to send letters to about 18,000 Texas physicians in 14 specialties informing them of their ratings under its BlueCompare program by the end of the year.

Nov 10, 2010

Advocacy Retreat Prepares You for 2011

The 2010 elections are over, now it's time to get ready for the 2011 sessions of the Texas Legislature and Congress, and the 2012 elections.

OIG Starts Anti-Fraud Training Program

The federal Office of Inspector General (OIG) has developed a training program to help physicians avoid Medicare or Medicaid fraud and abuse.

Nov 8, 2010

Busy, Successful Day for Texans at AMA Meeting

Texas physicians spent more than their usual amount of time at the microphone today at the interim meeting of the American Medical Association House of Delegates, but they came away with some big victories.

The quick-thinking, slow-talking Texans kept AMA out of some potential public relations and membership messes. They also pushed the house to force AMA leadership to articulate the major flaws in the Patient Protection and Affordable Care Act and devise a plan to correct those flaws.

The delegates also unanimously approved a Texas resolution asking AMA to support pending federal legislation that would exclude from consumer credit reports, within 30 days, medical debt that has been fully paid or settled. This would motivate patients to pay off their medical debt as quickly as possible.

Finally, the house sent the AMA Board of Trustees a Texas resolution asking AMA to take a closer look at turning itself into an organization of organizations instead of an individual-membership association. AMA is losing membership at an unsustainable rate at a time of unprecedented change and upheaval in the American health care system. It’s a time when physicians and patients need the support and strength that comes from the ability of AMA to say it represents the majority of America’s physicians.

Nov 7, 2010

Texans Offer Priorities for Reforming Health Reform

Texas physicians attending the 2010 Interim Meeting of the American Medical Association House of Delegates pushed AMA to set priority items for reforming the new health system reform law. Among the items on the Texans' agenda:

  • Medical liability reform
  • Repeal the IPAB
  • Loosen restrictions on physician-owned hospitals
  • Make physicians responsible for defining quality care.

The recommendation and many others will come before the house Monday and Tuesday. Stay tuned for more AMA news.

In the meantime, enjoy this slideshow from Sunday's Reference Committee hearings:

Dunnigan Wins Again

Congratulations to Erin Dunnigan, MD, a fellow in endocrinology at Parkland Hospital in Dallas. She was reelected alternate delegate to the AMA House of Delegates from the Residents and Fellows Section.

Nov 6, 2010

Dallas Cardiology Fellow Nabs AMA Leadership Post

Justin Bachman, MD, a cardiology fellow from the University of Texas Southwestern Medical School in Dallas, is the new chair-elect of the American Medical Association Resident and Fellow Section Governing Council. Congratulations, Dr. Bachman.

Texas Med Students Elected AMA Delegates

Congratulations to four Texas medical students on their election as Region 3 delegates and alternates to the American Medical Association Medical Student Section House of Delegates.
The two delegates are Neil Parikh and Archit Gulati, both from Baylor College of Medicine in Houston. The alternates are Jasmeet Kaur from the University of Texas Medical Branch at Galveston and David Savage, who is a student at the UT Houston School of Medicine.
Shown below, left to right, are Ms. Kaur, Mr. Savage, Mr. Gulati and Mr. Parikh.

Nov 5, 2010

Texas Health Reform School Principal Shares Successes With Other States

"When I became president of TMA in May, I also became principal of the Health Reform School," Texas Medical Association President Sue Bailey, MD, told her colleagues at the Organization of State Medical Association Presidents (OSMAP) today.

Dr. Bailey described the live and telephone conferences, the analyses, and the information pieces that TMA has used to educate thousands of members on the intricacies of the new health system reform law.

"We used education, education, education," she said, "to bring our physicians to a place where they can survive, and perhaps thrive, in the new health care landscape."

More than 1,000 physicians have attended the 13 free Reform School classes TMA has conducted so far in conjunction with county medical societies around the state. In addition to record attendance at some of these meetings, Dr. Bailey said the presentations "brought out doctors who had never been to a county medical society or TMA meeting before."

Five more Reform School classes are already on the schedule.

Are You Going to Stay in Medicare?

Physicians must decide their level of participation in the 2011 Medicare program by Dec. 31, even if Congress fails to stop the 23.5-percent cut scheduled for Dec. 1 or the 6.1-percent reduction slated for Jan. 1.

The Texas Medical Association cannot tell you what to do, but it is offering some help in making a decision through a record Web seminar, Evaluating Your Medicare Options, on the TMA website. The one-hour webinar, featuring TMA's in-house Medicare specialists, provides detailed information about participation options and the consequences of those choices. It also offers one hour of continuing medical education credit.

Keep Up With AMA Meeting at

More than 100 Texas physicians and medical students will be in San Diego for the next five days for the American Medical Association's Interim House of Delegates meeting. Check back on -- or subscribe to the feed from -- Blogged Arteries for all the news. The Texas Delegation to the AMA has submitted four resolutions — including one that would reorganize AMA membership — for the house to consider at its interim meeting, which starts this weekend in San Diego:
  • First, we ask AMA to take another hard look into turning itself into an organization of organizations (PDF) instead of an individual-membership association. AMA is losing membership at an unsustainable rate at a time of unprecedented change and upheaval in the American health care system. It’s a time when physicians and patients need the support and strength that comes from the ability of AMA to say it represents the majority of America’s physicians.
  • Second, we ask AMA to sponsor an annual, state-by-state study of retention rates (PDF) for medical students and residents trained in each state. Such a study will help states, and state medical societies, plan how to invest in undergraduate and graduate medical education.
  • Third, we ask the house to support pending federal legislation (PDF) that would exclude from consumer credit reports, within 30 days, medical debt that has been fully paid or settled. This would motivate patients to pay off their medical debt as quickly as possible.
  • Finally, we ask AMA to restate its recent position on antitrust protections (PDF) for accountable care organizations (ACOs) to emphasize that those protections should apply only to physician-led ACOs. We need to give physicians — not hospitals or insurance companies — those protections.

Oct 15, 2010

Measure Twice, Cut Once: Be Careful Choosing an EMR

The way one high-tech expert sees it, converting a medical practice from paper medical records to an electronic medical record (EMR) system is like building a house. It requires adequate research, preparation, time, patience, money, monitoring, and follow-through.

Oct 14, 2010

Conference Addresses Stem Cell Research

Ongoing stem cell research and the promise it offers in treating myriad diseases and conditions is the focus of the Texans for Stem Cell Research Learn & Live Educational Symposium Oct. 27 in Austin.

TMA Seminar Explains ACOs

What do you know about accountable care organizations (ACOs)? Chances are the answer is little or nothing. But you'll know a lot more if you attend TMA's newest seminar, Accountable Care Organizations: Opportunity or Threat?

TMA Webinar Explains 'Meaningful Use'

You'll learn everything you need to know to comply with the federal government's 'meaningful use' requirements in adopting an electronic medical record (EMR) by listening to a 'meaningful use' webinar on the TMA website.

Oct 13, 2010

Medicare Meltdown Worsens as Cuts Loom

The ongoing failure of Congress to fix the Medicare physician fee schedule continues to force physicians out of the Medicare system and threaten patients' access to care. A recent TMA survey shows that more than a third of Texas physicians say they already have to limit the number of new Medicare patients they see.

Sep 17, 2010

Be a TEXPAC-Alliance Volunteer

To be an effective legislators for patients and physicians, candidates must first be elected. TEXPAC Alliance Volunteers use shoe leather and folding skills to help get the job done. Become a TEXPAC Alliance Volunteer.

Sep 15, 2010

Tele-Health Reform School Tonight at 8 #hsr

All you have to do to enroll in the Texas Medical Association's second Tele-Health Reform School tonight at 8 pm (CT) is answer your home telephone. If you do, you'll learn what you need to know about the new health system reform law.

TMA Supports Physician Hospital #Ownership

Federal law should not interfere with physician ownership of hospitals because physician-owned hospitals provide a significant contribution, and studies show their exceptional quality results in a ranking at the top in patient satisfaction, TMA has told a federal court.

The Expense of Charity Care and Bad Debt

According to responses to TMA's August survey, the average dollar value of the charity care delivered per physician in 2009 was $41,000, and the average amount of uncollectible debt was $70,500. Both have decreased since 2007.

Stay Informed With the TMA #Mobile App

The new TMA Mobile App offers 24/7 access with up-to-the-minute data on nearly 45,000 of your Texas colleagues.

Sep 10, 2010

Look Out for Mumps

Although Texas Department of State Health Services (DSHS) officials say they don't believe the general public is at risk, they are advising physicians of a mumps outbreak in the San Antonio area. Since July 16, 21 cases of mumps have been confirmed and three more are suspected, 20 of them in inmates at two correctional facilities in the area.

Newborn Screening Rules

State newborn screening rules allow parents, legal guardians, or managing conservators of newborn babies to request destruction of their baby's newborn screening blood spot card after testing. The rules also require physicians who submit blood spots for screening to give them the Use and Storage of Newborn Screening Blood Spot Card form they need to make such a request.

Is That Ambulance Really Necessary?

TrailBlazer Health Enterprises, the Texas Medicare administrative contractor, says many physicians are incorrectly certifying that their patients need ambulance transportation, thus wasting a lot of Medicare money.

Sep 8, 2010

TMA Opposes Tax Break for Lawyers

Asserting that there is “no compelling justification” to do so, TMA, the American Medical Association, and 88 other medical organizations urged the U.S. Treasury Department not to change the tax code to allow trial attorneys to deduct litigation expenses from their taxes in certain cases.

Diabetes Resources Available

The Texas Department of State Health Services, Texas Diabetes Council, and the Central Texas Diabetes Coalition have developed two free resources to help physicians and health care providers provide optimal care to patients with diabetes.

Medicare to Cover Smoking Cessation

Starting Jan. 1, Medicare will add evidence-based tobacco cessation counseling to the list of covered services.

The Business of Cancer Care

Cancer care has become big business. The National Institute of Health in 2009 estimated that the 2008 cost of cancer care was $228.1 billion. Of this, only $93.2 billion was due to direct medical costs; $18.8 billion was due to lost productivity of the patient because of illness; and $116.1 billion was due to lost productivity secondary to premature death. Multiple government and payer initiatives are focused on reducing the costs of cancer care.

In the September issue of Texas Medicine, a special symposium issue on cancer.

Aug 31, 2010

Lace Up Your Sneakers for Medicine

Want to improve health care in America? Want to be a catalyst for change? Want to help elect politicians who will put patients and physicians first? Participate in the upcoming TEXPAC Alliance Volunteer Days.

Big Health Law Changes Start Sept. 23

Several provisions of the new health system reform law take effect Sept. 23.

Aug 30, 2010

Health Care Workers, Get Your Flu Shots

TMA’s Be Wise — ImmunizeSM program is launching a new initiative to encourage health care workers to get immunized against the flu.

TMLT Cuts Rates Again, Declares Dividend Again

Tort reforms that TMA and its allies worked so hard to achieve in 2003 continue to pay off for physicians as the Texas Medical Liability Trust (TMLT) cut liability insurance premiums by 1 percent, effective Jan. 1, and announced a 24–percent dividend for renewing TMLT policyholders.

Aug 23, 2010

CAUTION: Six Things You Need to Know About ACOs

The health system reform law establishes a new breed of health care delivery system called accountable care organizations (ACO). Be wary and be informed. TMA strongly suggests that you take the time to learn about these systems, and understand their differences and what they could mean to your practice and your patients, before you sign any agreements.

Confused? TMA Demystifies Health Reform

If you're confused about the new health system reform law and its many new provisions, you're not alone. That's why the Texas Medical Association will host its second Tele-Health Reform School next month.

Judge Sides with Physicians Again

TMA won another round in its ongoing effort to protect the safety of patients in mid-August when an Austin district judge said he intends to limit chiropractors' right to diagnose medical conditions.

Aug 11, 2010

FDA Warns Against Unapproved IUDs

The U.S. Food and Drug Administration (FDA) is warning physicians not to use unapproved intrauterine devices (IUD) and intrauterine systems (IUS) or face the possibility of going to jail.

CMS Schedules PQRI, E-prescribing Call

Physicians interested in the 2010 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive (eRx) programs can ask questions and learn how to join during a conference call from 2 to 3 pm CDT on Tuesday, Aug. 17.

Congress Approves Medicaid Funds

Texas will gain about $850 million in federal money for Medicaid, thanks to congressional approval of legislation extending enhanced matching federal Medicaid payments through mid-2011. The U.S. House of Representatives joined the Senate in approving the bill Aug. 10.

Aug 10, 2010

Podiatrists Can't Expand Scope to Ankle

It's final. The Texas State Board of Podiatric Medical Examiners cannot go beyond its statutory authority and the will of the Texas Legislature.

Patient Safety CME Course Updated

The TMA Patient Safety and Medical Errors continuing medical education (CME) course has been revised and reposted on the TMA website.

CIGNA to Post Physician Ratings

CIGNA says it will soon make public the results of its annual evaluation of physician quality and cost efficiency. Almost 20,000 physicians in Houston, Dallas-Fort Worth, San Antonio, and Austin will be rated.

Aug 9, 2010

Closing the 'Pill Mills': New State Law Requires Certification

A new law requires pain management clinics to be certified by the Texas Medical Board (TMB). The Texas Medical Association supported Senate Bill 911, which directs TMB to adopt rules to ensure quality of patient care and to set personnel requirements at pain management clinics. The new law also gives TMB authority to inspect pain management clinics, or entities believed to be pain management clinics, to determine whether they're operating legally.

Quashing Ownership: Health Reform Law Bans New Physician-Owned Hospitals

With nearly 70 Texas hospitals with some type of physician investment, the state is a national leader in the physician-owned hospital industry. And, members of that industry say it has been good for patients. But the health system reform law Congress passed earlier this year slams the door on new physician-owned hospitals by prohibiting them from obtaining a Medicare provider number.

From August's Texas Medicine.

Losing the Match Game: Few Residency Slots Leave More Graduates Unmatched

An increasing number of medical graduates in the country, particularly in Texas, are finding it hard to match to a residency program in their preferred specialty. While medical educators say there are various reasons for that, almost all point to a growing imbalance in the ratio of medical graduates to residency slots. That imbalance is particularly apparent in Texas, where the state offered fewer first-year residency positions in 2010 than it had medical graduates.

From August's Texas Medicine.

If You Like the SGR … You'll Love the IPAB

Physicians hoped the health system reform law would eliminate the Sustainable Growth Rate (SGR) formula that drives down Medicare fees. The SGR, however, remains in place, and the law created a new board, the Independent Payment Advisory Board (IPAB), with the authority to cut fees even further, possibly on top of cuts under the SGR.

From August's Texas Medicine.

TDI: Post Drug Formularies Online

State law should require insurance companies and pharmacy benefit managers (PBMs) to post accurate and complete drug formularies online that physicians can access when prescribing medications for patients, the Texas Department of Insurance (TDI) recommends in a report to state officials and legislative leaders.

Sued? You're Not Alone

An American Medical Association survey shows an average of 95 medical liability claims filed for every 100 physicians in the U.S. That's almost one per physician and demonstrates the need for the rest of the country to adopt liability reform like Texas did.

Aug 3, 2010

Uninsured: How Big Texas Counties Stack Up

After I received some comments and questions on a previous post showing the uninsurance rate for all 254 Texas counties, I decided to dive just a little deeper into the data. Here are the rankings for the 20 most populous counties, first for everyone under age 65 and then for children (under age 19.) Recall that the under-65 statewide rate is 26.8% in this 2007 data. For children under age 19, it's 19.5%.

Note that Webb, Cameron, El Paso, and Hidalgo counties -- all poor counties along the border -- lead the list for people under 65. But four of the five move down the list for people under 19. The top five there are Dallas, Webb, Tarrant, Harris, and Montgomery.

Texas 20 Most Populous Counties, Uninsured Rate for People Under 65

  • Harris County: 31.3%
  • Dallas County: 30.8%
  • Tarrant County: 26.0%
  • Bexar County: 22.8%
  • Travis County: 25.0%
  • Collin County: 16.6%
  • El Paso County: 33.0%
  • Hidalgo County: 31.5%
  • Denton County: 19.9%
  • Fort Bend County: 22.8%
  • Montgomery County: 25.1%
  • Williamson County: 18.7%
  • Cameron County: 33.7%
  • Nueces County: 22.8%
  • Brazoria County: 25.3%
  • Galveston County: 21.5%
  • Bell County: 20.4%
  • Lubbock County: 26.4%
  • Webb County: 38.7%
  • Jefferson County: 22.7%

Texas 20 Most Populous Counties, Uninsured Rate for People Under 19

  • Harris County: 21.9%
  • Dallas County: 25.5%
  • Tarrant County: 22.7%
  • Bexar County: 16.2%
  • Travis County: 17.4%
  • Collin County: 10.3%
  • El Paso County: 19.9%
  • Hidalgo County: 17.4%
  • Denton County: 17.5%
  • Fort Bend County: 19.5%
  • Montgomery County: 20.9%
  • Williamson County: 16.4%
  • Cameron County: 19.2%
  • Nueces County: 13.8%
  • Brazoria County: 19.9%
  • Galveston County: 15.4%
  • Bell County: 13.0%
  • Lubbock County: 15.9%
  • Webb County: 25.4%
  • Jefferson County: 13.5%

Jul 30, 2010

Loan Repayment Funds Still Available

The state's Physician Education Loan Repayment Program will continue accepting applications from physicians who agree to practice in a Health Professional Shortage Area (HPSA), and treat patients in Medicaid and the Children's Health Insurance Program.

TMA Fall Conference Set for Oct. 15-16

In the coming months, TMA will focus its grassroots efforts on achieving its pro-medicine goals in the 2010 state and federal elections, and in the 2011 Texas Legislature. To help the association achieve legislative and political success, TMA invites you to 2010 Fall Conference Oct. 15-16 at the Hyatt Regency in Austin.

Physicians Guide HIT Extension Centers

TMA member physicians play an important role in the newly formed regional extension centers (RECs) created as part of the Obama Administration's 2009 economic stimulus bill.

Jul 29, 2010

Medicare Seeks Imaging Proposals

Physicians interested in participating in the Medicare Imaging Demonstration program have until Sept. 21 to submit a proposal to the Centers for Medicare & Medicaid Services.

Terminating Contracts Can Get Results

According to early results of the July TMA survey on health plan contracts, 29 percent of practices have terminated one or more contracts within the last two years.

Jul 28, 2010

Texas County-by-County Uninsured Stats Now Available

The U.S. Census Bureau today released its state-by-state and county-by-county uninsured figures for 2007.

We already knew that Texas is the Uninsured Capital of the U.S. For those 65 and younger, 26.8 percent of Texans lacked insurance -- trailed only by New Mexico at 26.7 percent. For children (those under 19), the Census Bureau lists 19.5 percent of Texans and 18.1 percent of New Mexicans as not having insurance. Florida came in third in both lists.

The updated county lists provide some new views of things. For residents under age 65, eight of the top nine counties are in Texas. The most uninsured county in the country is Kenedy County, south of Corpus Christi, headquarters of the fabled King Ranch.

Here are the top five most- and least-uninsured counties in Texas, for the under-65 population and the under-19 group. Interesting to note that four of the five least-uninsured counties for Texans under age 19 are very poor South Texas counties. Looks like Medicaid and CHIP have quite good penetration there.

Most Uninsured, Under 65
  • Kenedy, 49.5%
  • Hudspeth, 48.5%
  • Jeff Davis, 44.2%
  • Culberson, 42.6%
  • Presidio, 40.8%
Least Uninsured, Under 65
  • Collin, 16.6%
  • Duval, 16.7%
  • Carson, 17.3%
  • Brooks, 17.8%
  • Orange, 17.9%
Most Uninsured, Under 19
  • Kenedy, 40.2%
  • Glasscock, 38.9%
  • Reagan, 36.7%
  • Sherman, 36.1%
  • Hudspeth, 36.0%
Least Uninsured, Under 19
  • Brooks, 8.8%
  • Duval, 9.4%
  • La Salle, 9.6%
  • Collin, 10.3%
  • Jim Hogg, 10.4%

Check out the table with figures for all 254 counties. We published census figures for those under 65 and those under 19. I would have included them in this post, but blogger doesn't play well with HTML tables. Sorry.

Medicaid, CHIP Fees Drop Sept. 1

Fees paid to physicians for treating patients in Medicaid and the Children's Health Insurance Program will be cut by 1 percent across the board on Sept. 1. The reduction will apply to all physician/professional services, as well as hospitals and other providers.

Jul 27, 2010

TMB Has Online Delegation Page for PAs and ANPs

The Texas Medical Board has launched an online Supervision and Prescriptive Delegation Registration System that allows physicians to immediately register:

  • Notice of a physician assistant's intent to practice with a particular doctor (Supervision must be registered before a physician assistant may begin work.);
  • Notice of a physician's intent to supervise a physician assistant;
  • Termination of a supervisory relationship; and,
  • A physician's delegation of prescriptive authority to a physician assistant or advanced practice nurse.

CDC Issues Dengue Advisory

An outbreak of dengue fever in the tropics and subtropics prompted an advisory to physicians from the Centers for Disease Control and Prevention (CDC).

Jul 23, 2010

Earn CME at Health Reform School

As part of its campaign to help Texas physicians survive and thrive in the new health care environment, TMA offers Health Reform School. Not only will you learn how the new health affects you and your practice, but also you will earn continuing medical education (CME) credit for your time.

United Sets Premium Designation Training

UnitedHealthcare has scheduled webinar training sessions on its 2010 Premium Designation Program in August.

BCBSTX Increases Prevnar 13 Reimbursement

Blue Cross and Blue Shield of Texas (BCBSTX) has increased reimbursement for Prevnar 13, the new substitute for Prevnar 7 vaccine, to $131 for claims dated July 23 and after.

Jul 16, 2010

Dr. Bailey on Money Rocks Tonight

Tune into tonight to Eric Bolling’s show, Money Rocks, on Fox Business News. TMA President Susan Rudd Bailey, MD, discusses how the new Medicaid cuts in Texas will affect physicians and their patients.

You can catch the program tonight at 7 and 10 pm CT tonight. Or download the video after the program at

Nominate an Outstanding Science Teacher!

TMA encourages you to nominate exceptional science teachers for the 2010-11 Ernest and Sarah Butler Awards for Excellence in Science Teaching.

DEA Modifies Electronic Rx Rules

Under new Drug Enforcement Agency (DEA) rules, physicians can now write electronic prescriptions for Schedule III, IV, and V controlled substances. However, Texas law still requires physicians to use a written prescription form for Schedule II drugs.

TMA Advocacy Pays Off Again

Texas Medical Association's work on behalf of physicians paid dividends again as Blue Cross and Blue Shield of Texas agreed with the association's payment advocacy staff and changed the way it processes claims with modifier 22.

Jul 12, 2010

Trauma Fund Headed for Crash Landing?

Funding for uncompensated trauma care is under attack in Texas. Some local judges, lawyers, and lawmakers take issue with the controversial Driver Responsibility Program (DRP), which raises about $200 million every biennium for uncompensated trauma care. The program levies surcharges on people for Driving While Intoxicated (DWI), driving without insurance, driving without a license, and other violations. Opponents argue the DRP clogs state courts and increases the dismissal rate for DWI cases. And it doesn't help that Texas is facing a potential $11 billion to $18 billion budget deficit next year.

Download the show now.

Supporters -- including trauma physicians and nurses, Emergency Medical Services officials, hospital administrators, trauma survivors, and others -- stress that the DRP allows trauma centers to improve patient care. They say the funds make it possible for trauma facilities to purchase new, life-saving equipment and stay in business.

This installment of Podcast TMA features commentary from Christopher Ziebell, MD, medical director of the Department of Emergency Medicine at University Medical Center Brackenridge in Austin. The cover story of the July 2010 issue of Texas Medicine makes the case for preserving the DRP and explains how the state allocates program funds.

This installment covers:

  • How DRP funds benefit Texas' trauma centers;
  • Information on additional proposed funding cuts for indigent care in Texas hospitals; and
  • What physicians can do to show support for the DRP.

Want to Subscribe to Podcast TMA through iTunes?

  • Here's the link. It takes you to the iTunes store. Subscription is free.
  • Catch up on all the old Podcast TMA episodes on the TMA Web site.
  • What's a Podcast, how do I get it, and what do I with it once I have it? (See the short tutorial on the iTunes Web site.)

Get Your Fair Share: United Claims-Filing Deadline Approaches

The countdown has begun for physicians to take action in the settlement of a lawsuit against UnitedHealthcare over its system for determining "usual, customary, and reasonable" charges for out-of-network services. About $300 million is available to physicians who want to file a claim, but they must submit a claim form and any required documentation by Oct. 5.

From the July issue of Texas Medicine.

Get the Right People: TMA Can Make Sure You Do

TMA Practice Consulting can help physicians determine their clinical and business staffing needs to recruit skilled, appropriate candidates. TMA Practice Consulting staff recruitment services include recommending salaries and benefits, placing employment advertisements, conducting telephone screening, scheduling and participating in interviews, checking references, and initiating background checks for qualified candidates.

From the July issue of Texas Medicine.

Bleeding Money: Texas Trauma Center Funding Is in Jeopardy

Funds from the Driver Responsibility Program (DRP) help make it possible for trauma centers to treat every trauma patient who comes through their doors, regardless of insurance status. But the Texas Legislature has held in reserve almost as much money as it has doled out since it approved the DRP in 2003. And, a potential multibillion-dollar budget deficit facing legislators, plus growing opposition from some local judges, lawmakers, and upset residents, has placed the program in jeopardy.

From the July issue of Texas Medicine.

Jul 7, 2010

Reform Law Promises Big Changes in Health Care System

Some people may love it; others definitely hate it. And still more are just trying to figure out what's in it.

Download the show now.

Regardless of how you feel about the health system reform bill signed in March by President Barack Obama, it is now the law of the land. And experts say it is likely to be the biggest change in the health care landscape in America since the enactment of Medicare in the 1960s.

Few people truly know exactly what is in the measure or what its consequences might be, intended or otherwise. And stakeholders in the health care industry are scrambling to determine how to deal with it.

The cover story in the June issue of Texas Medicine magazine takes an in-depth look at process that produced the health care reform bill and what its likely impact will be.

In this installment of Podcast TMA, TMA President Susan Rudd Bailey, MD, of Fort Worth and TMA Board of Trustees member Douglas Curran, MD, a family physician from Athens, discuss how the health system reform law was enacted and what it portends for patients and their physicians.

This installment covers:

  • Whether the reform law will be good for patients and physicians.
  • How elements of the reform law stack up against a set of guiding principles TMA developed for evaluating health care reform proposals.
  • How the legislative process played out in a highly partisan atmosphere.
  • What TMA is doing assist physicians understand the new law and maintain the viability of their practices in the new environment.

Want to Subscribe to Podcast TMA through iTunes?

  • Here's the link. It takes you to the iTunes store. Subscription is free.
  • Catch up on all the old Podcast TMA episodes on the TMA Web site.
  • What's a Podcast, how do I get it, and what do I with it once I have it? (See the short tutorial on the iTunes Web site.)

Jun 29, 2010

PCV 13 Replaces PCV7 for Children

The PCV13 vaccine against pneumococcal disease is now available and replaces the PCV7 vaccine for children.

Workers' Comp Grades Physicians

If you treat workers' compensation patients, you may soon get a letter telling you that you have been selected for the workers' compensation system's Performance-Based Oversight Regulatory System.

Medicaid Cuts Compound Budget Problems

Even modest cuts to physicians for treating patients on Medicaid or in the Children's Health Insurance Program 'will actually jeopardize the state's efforts to trim Medicaid costs,' the leaders of organized medicine in Texas warn in a letter to state officials.

High Court Gives Podiatry the Boot

Physicians prevailed in the courts once again in mid–June when the Texas Supreme Court sided with TMA and the Texas Orthopaedic Association in their 10-year battle with podiatrists over the definition of the foot.

Jun 25, 2010

House Approves Medicare Fee Increase

The U.S. House of Representatives finally acted today, June 24, and reversed the 21.3-percent cut in Medicare payments to physicians. The House approved Senate-passed legislation that raises fees by 2.2 percent through Nov. 30. The bill goes to President Obama for his signature.

TMB Seeks New Medical Director

The Texas Medical Board is looking for a new medical director to replace Alan Moore, MD. Dr. Moore resigned July 1 to return to the private sector.

Jun 23, 2010

Texas Physicians Host 5th Annual Border Health Conference in DC

Physicians representing the Texas Medical Association and TMA’s Border Health Caucus continue their work in Wshington, D.C., today as they host the Fifth Annual Border Health Conference. The purpose of the conference is to raise awareness of health care disparities existing along the border and the impact on border patients and their physicians. These include:

  • Strengthening the border’s public health infrastructure,
  • Preventing chronic disease,
  • Improving patients’ access to a physician by shoring up the health care workforce, and
  • Stopping the Medicare Meltdown.

"What happens on the border does not stay at the border," Lawrence Kline, DO, of California, a member of the US-Mexico Border Health Commission, told the conference.

For example, tuberculosis is a global threat, killing momre than 2 million persons each year. "This is a time bomb in the world, Dr. Kline said.

Much of the conversation, however, continued to focus on Congress' refusal to stop the 21-percent cut in physicians' Medicare payments that took effect June 1.

David Palafox, MD, of El Paso (left), visits with Rep. Charlie Gonzalez (D-San Antonio).

"This is a terrible way of doing business," Representative Gonzalez said. "If you are hurt disappointed and angry you should be."

Rep. Sylvestre Reyes (D-El Paso) speaks at the Border Health Conference.

Congressman Reyes told Texas physicians to continue to pressure the Senate for a permanent fix for Medicare's sustainable growth rate (SGR) formula. "To continue to keep kicking the SGR fix down the road is the most irresponsible thing [Congress] can do," he said.

Rep. Henry Cuellar (D-Laredo) addresses the Border Health Conference. Talking about fixing the Medicare payment problem from year to year is not fair to anyone, he said.

Representative Cuellar described the dilemma the House is in. "Do we pass something to get the Senate past their elections or do we look long term for a permanent fix?" he asked.

Get It Over With: Join PECOS

There's a lot of confusion about when physicians have to enroll in the Medicare’s Provider Enrollment, Chain, and Ownership System. Some reports say July 6. Others say next Jan. 1.

Give Kids Bike Helmets in October

Help children in your community realize the importance of safety and exercise with a helmet giveaway during Brain Injury Awareness Month in October.

HHSC Hearing on Medicaid Cuts June 29

The Texas Health and Human Services Commission (HHSC) will hold a public hearing on June 29 on the proposed 1-percent across-the-board cut in payments to physicians in Medicaid and the Children's Health Insurance Program.

TMB to Certify Pain Clinics

Starting Sept. 1, most pain management clinics in Texas must have Texas Medical Board (TMB) certification.

Jun 22, 2010

Texas Physicians Take to Capitol Hill

Physician leaders from the U.S.-Mexico border and San Antonio this week are bringing their concerns directly to Washington, D.C., to urge the nation’s leaders to permanently fix the Medicare Meltdown.

Physicians representing the Texas Medical Association (TMA) and TMA’s Border Health Caucus (BHC) are meeting one-on-one with U.S. representatives and senators to encourage them to take action to stop the 21.2-percent Medicare cut that took effect Friday, June 18, so patients will have access to a doctor when they need one.

One prominent theme we've heard so far is that Republicans are blaming the Democrats and the House is blaming the Senate for holding Medicare legislation hostage.

Kristina Culley (left), legislative aide for U.S. Rep. Louis Gohmert (R-Tyler), visiting with Drs. Victor Gonzales of McAllen and Manuel Acosta of El Paso on border health issues and Medicare payment meltdown.

TMA President Susan Rudd Bailey, MD, along with El Paso physicians David Palafox, MD (center), and Andres Enriques, MD, explain to Kwamme Anderson, staff person for U.S. Rep Eddie Bernice Johnson (D-Dallas), the many challenges facing physicians resulting from Medicare cuts and Medicaid. Anderson says Congress has physicians' livelihood in their hands.

U.S. Rep. Ruben Hinojosa (D-Merceds) center, with (left to right) Drs. Gilberto Handal of El Paso, Chevy Lee of McAllen, Linda Villarreal of Edinburg, Victor Gonzalez of McAllen, and medical student David Espinoza from UT Health Science Center at Houston.

Congressman Hinojosa tells us we will know more about the status of the Medicare legislation after the Democratic caucus this evening. His staff predicts that ultimately, maybe next week, it will pass.

"My patients tell me that they don't want to lose their Medicare, but if I can't see them, then they've essentially lost their Medicare," Dr. Lee said.

Added Dr. Gonzalez, "Medical education is tied to Medicare. If you want more physicians in the workforce, you need a secure Medicare system. It's bigger picture than just doctor payment."

Dr. Bailey and TMA Vice President for Advocacy Darren Whitehurst meet with staff for Rep. John Carter (R-Round Rock).

Dr. Bailey and others have a frank and very enlightening discussion with Jenifer Healy, a staff person for Sen. Kay Bailey Hutchison. Main takeaway is that physicians and patients are in a political soccer game with no points being scored.

Sarah Whiting from Rep. Joe Barton's tells Drs. Villarreal and Lee that the congressman supports a short-term Medicare fix today and then a real long term fix. She says Mr. Barton is a supporter of tort reform and sees the need for liability protections in health care reform.

Medicare Payment Problems Hurting Texas Patients

Medicare payment checks to physicians are flowing again — but they’re 21.3 percent smaller than they were this time last week as Medicare officials could no longer wait for Congress to figure out how to apply the latest Band-Aid. A TMA flash survey that accompanied our news reports of the latest Medicare Meltdown finds that Texas physicians will take or are considering some very drastic action in response. The chart below shows the preliminary responses to the question, “Regardless of the outcome of the current Medicare payment cut, the ongoing cash flow problems and constant uncertainty over Medicare payments has led my practice to take, or consider, the following steps:”

  • Reduce my total Medicare caseload: 252 (68%)
  • Refuse all new Medicare patients: 210 (57%)
  • Lay off staff: 197 (53%)
  • Refer Medicare patients to the emergency room: 120 (33%)
  • Drop out of Medicare altogether: 117 (32%)
  • Stop seeing existing Medicare patients: 91 (25%)
  • It doesn't matter, I don't take Medicare anyway: 2 (1%)

U.S. Senate on Friday approved a deal stopping the cuts and raising fees 2.2 percent until Nov. 30. But the House of Representatives had already gone home for the weekend and was not scheduled to resume voting until tomorrow. That led the Centers for Medicare & Medicaid Services, which had held Medicare payments since the first of the month, to direct Medicare contractors to begin processing claims dated June 1 and later under the new rates on a first-in, first-out basis. “Washington obviously doesn’t realize the damage they’re doing to our practices and our patients,” said TMA President Sue Bailey, MD.

Jun 17, 2010

The Average Doctor Makes $28 an Hour - VIDEO

A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.

Jun 16, 2010

AMA House Concludes its Business

CHICAGO -- The AMA House of Delegates finished its work early Tuesday. Here are some Texas photos from the closing day, including the installation of new AMA Alliance President Susan Todd of Fort Worth and the AMA Board of Trustees reelection victory for Joe Annis, MD, of Austin.

Jun 15, 2010

Joe Wins!

CHICAGO -- Congratulations to Austin anesthesiologist Joe Annis, MD, who was just reelected for another term on the AMA Board of Trustees.

"I'm so proud to be a member of a group of this caliber," Dr. Annis told the Texas Delegation to the AMA this morning before the election results were announced.

Dr. Annis was the only incumbent among a group of eight physicians seeking four positions on the board.

Jun 14, 2010

Fort Worth's Susan Todd Takes Helm of AMA Alliance

CHICAGO -- If organized medicine in Texas were a corporation, our most valuable assets would be our human resources. We are blessed with fantastic physician and alliance leaders who make us great.

In the past decade, few have shined more brightly than former TMA Alliance President Susan Todd of Fort Worth. She also has led our TMA Foundation and is the driving force behind TMA’s First Tuesdays at the Capitol. Tomorrow, she takes her starring role to the national stage when she takes office as president of the AMA Alliance.

Monday night, TMA and the TMA Alliance threw a Texas-style celebration of Susan's achievement. Her colleagues from Texas and around the country came by to pay tribute.

"To do something better, you must work an extra bit harder," said TMA EVP Lou Goodman, PhD. "For Susan Todd, that’s a constant state of mind, a disposition. Congratulations, Susan!"

AMA Votes for New Medicare Payment Option

Photo by Ted Grudzinski / AMA

CHICAGO -- Had enough of choosing between participating, non-par, or opt-out status for Medicare? Find that none of them are right for you and your patients? The American Medical Association House of Delegates wants to give you a different choice.

In an emtional and often confusing debate, the house Monday voted to ask Congress to institute a new Medicare payment option for physicians and patients. The new status choice would allow physicians to privately contract with Medicare patients for health care services, at a mutually agreed-upon price, with no penalty to either party.

After a long debate, delegates voted better than 2-to-1 for the new option.

Here's the exact language of what the house passed:

RESOLVED: That our American Medical Association immediately formulate legislation for an additional payment option in Medicare fee for service that allows patients and physicians to freely contract, without penalty to either party, for a fee that differs from the Medicare payment schedule in a manner that does not forfeit benefits otherwise available to the patient. This legislative language shall be available to our AMA members no later than September 30, 2010.

Medicare Extends Claims Hold

Congress still hasn't done anything to reverse the 21-percent cut in Medicare payments to physicians, so the Centers for Medicare & Medicaid Services (CMS) ordered TrailBlazer Health Enterprises and other Medicare carriers through Thursday, June 17. The hold will be lifted on June 18. Claims previously were on hold through June 14.

Jun 13, 2010

Texans Make Their Points at AMA Reference Committees

CHICAGO -- Sunday, June 13, is reference committee day at the AMA House of Delegates. The house splits up into eight committees to gather member testimony on reports and resolutions before the house. The reference committees' recommendations form the starting point for full house action later in the week.

The members of the Texas Delegation to the AMA have work groups for each reference committee. Based on TMA and AMA policy, they devise a Texas position for each report and resolution, monitor the reference committee debate, and add their own testimony.

Go to Health Reform School and Earn CME

As part of its campaign to help Texas physicians survive and thrive in the new health care environment, TMA offers Health Reform School.

Rohack Promotes Healthier Life Steps

CHICAGO -- AMA President Jim Rohack, MD, the former TMA president, included a plug for a program TMA is promoting to help physicians keep their patients healthy, Healthier Life Steps is an AMA program that TMA has endorsed and is distributing free of charge to Texas physicians.

"Our AMA us quietly influencing the shape of health care in America through efforts such as the Healthier Life Steps program," Dr. Rohack said in his presidential address to the AMA House of Delegates Saturday. "This patient-physician partnership helps physicians help patients eat better, be more physically active, avoid tobacco use and alcohol misuse.

"We all know these behaviors are the leading causes of preventable illness and mortality among our patients. They also contribute heavily to the problem of spiraling health care costs. The Healthier Life Steps is available online, free of charge, to both health care practitioners and patients.

"I was delighted to see our Medical Student Section choose it as their National Service Project. And last month, I was able to help kick off the co-branded program at the Texas Medical Association's annual meeting.

"Take advantage of it. It might help save the life of someone you love."

It's the "Write Coat Rally"


Join your colleagues in telling Congress enough is enough. Repeal the Medicare SGR!

"Protect access to care."

CHICAGO -- At the Annual Meeting of the AMA, delegates from every state and specialty society are staging a "Write Coat Rally" by writing messages urging Congress to repeal the Medicare SGR on white coats that will be delivered to Capitol Hill.

"Help me help patients." You can join the rally today by delivering a message to your representatives in Congress through the AMA Physicians' Grassroots Network toll-free hotline at (800) 833-6354.

"Save my practice." Tell Congress that unless they act now, more physicians will be forced out of the Medicare and TRICARE programs and seniors and military families will lose access to the doctors they trust and the care they need.

Call (800) 833-6354 today and tell Congress enough is enough. Repeal the Medicare SGR!

Jun 12, 2010

Larger Than Life Texan

CHICAGO -- San Antonio internist Jayesh Shah, MD, is one of a half-dozen physicians featured in huge posters outside the hall of the American Medical Association House of Delegates. The posters are part of the AMA's "Mo>ing Medicine Forward" campaign.

Dr Shah is the chair of the AMA International Medical Graduate Section.

Live blog cancelled: AMA Forum on Health System Reform

Update: CHICAGO -- Live blog cancelled. Am told the "open forum" is actually a "closed forum."

From 4-5 pm, Saturday, June 12, the American Medical Association will conduct an open forum on health system reform at the AMA House of Delegates meeting. Please join us for a live blog of that event.

Three Seek Top AMA Post

CHICAGO -- Three physicians are asking the AMA House of Delegates to make them AMA president-elect when the house votes on Tuesday. All three of them -- Drs. Peter Carmel of New Jersey, Joseph Heyman of Massachusetts, and Edward Langston of Indiana -- asked the Texas Delegation for their votes Saturday.

Dr. Carmel

Dr. Heyman

Dr. Langston

Texans Win Medical Student Section Regional Elections

CHICAGO -- Elliot Richards (below, right) a first-year student at Baylor College of Medicine was elected chair of AMA Medical Student Section Region 3. Andrew Harrell another first-year student at Baylor was elected Secretary/Treasurer.

Congratulations, gentlemen!

Jun 9, 2010

TMA Backs Truthful Ad Bill

TMA joined the American Medical Association, American Osteopathic Association, and several national specialty societies in supporting H.R. 5295, the Healthcare Truth and Transparency Act of 2010, that outlaws any health care professional from misleading patients about their level of training in advertising and marketing.

Monitor Blue Cross Compliance

It's too late to file a claim, but physicians still need to make sureBlue Cross and Blue Shield (BCBS) continues to honor the terms of its settlement of a 2003 federal class action lawsuit that claimed numerous BCBS plans were involved in a scheme to defraud doctors in violation of the federal Racketeer Influenced and Corrupt Organizations Act (RICO).

Jun 8, 2010

Medicaid Limits Ultrasounds

Starting July 1, the Texas Medicaid PCCM and fee-for-service programs will allow physicians to perform only three obstetrical ultrasounds during a pregnancy without prior authorization.

Reminder: TEXPAC Endorses Sibley

The Texas Medical Association Political Action Committee(TEXPAC) has endorsed Republican former State Sen. David Sibley to fill the unexpired term of Sen. Kip Averitt (R-Waco), who stepped down due to health concerns.

Be Prepared: It Could Happen to You

Thanks to hurricanes Ike and Rita, Texas physicians along the Gulf Coast know all too well the devastation a storm can wreak on their practices. Hurricane season has started and the National Oceanic and Atmospheric Administration expects a busy season.

Here are some tips to make sure you and your practice are ready.

The New Normal: Lengthy Bill Changes Health Care System

Some people may love it, while others definitely hate it. Still more are just trying to figure out what's in it. But health system reform is now law, and it's likely to the biggest change in American health care since Congress created Medicare in 1965. Physicians, patients, insurers, and others are scrambling to determine how to deal with it. From the June issue of Texas Medicine magazine.

Jun 7, 2010

Medicare HSAs and Billing Privileges Focus of TMA Resolutions in AMA House

Following up on actions last month by the TMA House of Delegates, the Texas delegation is bringing a pair of resolutions to Saturday’s AMA house meeting.
  • Resolution 115 calls on AMA to support legislation in Congress to allow Medicare beneficiaries to make tax-free contributions to health savings accounts.
  • Resolution 116 would change AMA policy to prevent paperwork delays at CMS from penalizing physicians who provide care for Medicare patients.

Check out Blogged Arteries for progress on these two items.

May 31, 2010

AMA Mimics TMA Insurance Conduct Code

Taking a cue from TMA, the American Medical Association released its own Health Insurer Code of Conduct Principles and called on all health insurers to adopt consistent corporate practices that will bring transparency and accountability to the health insurance industry.

Congress Leaves, Medicare Fees Cut

Oh, so now they’re worried about spending too much money?

Medicare payments to physicians dropped 21.2 percent June 1 because Congress opted to go on vacation without doing anything to stop it. The Senate recessed for Memorial Day without acting after attempts to approve a House-passed bill delaying the cut – part of legislation extending unemployment benefits – failed because some Senators balked at the cost of the approximately $143 billion bill.

FTC Delays “Red Flag Rule” Until December

The Federal Trade Commission (FTC) has delayed until Dec. 31 enforcement of the 'red flag rule' that was scheduled to take effect June 1.

HSR Tele-Town Hall Meeting a Success

As part of its campaign to help Texas physicians survive and thrive in the new health care environment, TMA educated 4,200 Texas physicians and medical students on the details of the new health system reform law in a statewide telephone town hall meeting May 27.

May 24, 2010

2003 Redux? Physicians Fear Medical Training Funding Cuts

Texas faces shortages in virtually every recognized medical specialty, but experts say the need for primary care doctors is particularly critical. The Senate Health and Human Services Committee began a study of the current and long-range need for physicians and other health professionals in the state. TMA officials say that study is definitely timely, but fear there may be little opportunity to expand training for physicians due to the state's projected budget shortfall. From May's Texas Medicine

Lawsuit Challenges Red Flag Rule

The American Medical Association (AMA), American Osteopathic Association, and the Medical Society of the District of Columbia sued the Federal Trade Commission (FTC) May 21 to keep it from forcing physicians to comply with the FTC's 'red flag rule' that takes effect June 1.

Medicaid Fee Cut Impact Lessened

State officials released their spending cuts May 18, and it appears there's a little bit of good news for some physicians in the state Medicaid program.

Balance Bill Mediation Required by Law

State law requires facility based physicians to notify patients that they have the right to mediate balanced bill disputes for services are provided at a network facility by a facility-based physician who is out-of-network.

May 19, 2010

A Guide to Medical Software for Apple Computers

The Latest from Chris Thorman at Software Advice

Is it possible that the next time you go in for a checkup you and your doctor will be lamenting over Microsoft while updating your medical records on Safari?

We’re hearing more and more questions about Mac compatibility from physicians interested in electronic medical records (EMR systems). Many providers, notably smaller offices, are choosing Apple computers over PC-based systems to run their practice. Their reasons are the same reasons consumers choose Mac products: stability, simplicity and “coolness.”

On the surface, it appears that Apple’s popularity in the consumer market is starting to creep into the medical practice market. Physicians like their home Macs and their iPhones, so they want the same hardware in the office.

May 17, 2010

TDI Examines Pharmacy Benefits Managers

The Texas Department of Insurance (TDI) is asking physicians for information on their experiences with pharmacy benefits managers.

May 15, 2010

United Ends H1N1 Special Payments

Saying that Centers for Disease Control and Prevention data show that H1N1 cases have steadily declined since last fall, UnitedHealthcare is ending emergency reimbursement measures it instituted in October 2009.

How Are We Doing?

We want to know if we're meeting your communications needs through Action, Texas Medicine, and the TMA website.

Doctor Who Promotes Bike Helmet Use Was Saved By One

TMA physician Ernest Neal Charlesworth, MD, is helping to promote TMA's Hard Hats for Little Heads program, which urges children to wear bike helmets, and to exercise. After suffering a serious bike crash, he credits his own helmet with saving his life. “I simply would not be alive today if I had not had a helmet on,” Dr. Charlesworth said.

May 14, 2010

Law Requires Electronic Death Registration

Texas law requires all cause-of-death information and medical certifications to the Texas Department of State Health Services to be submitted electronically through the state's online death registration system, the Texas Electronic Registrar.

Health Reform Answers a Phone Call Away

Because it's hard to know exactly what's in the unbelievably complex and lengthy health system reform bill, chances are you're asking, 'What does it mean to me? What does it mean to my patients?'

Stick by your phone the evening of May 27 to find out.

Reform Bill Slightly Raises Medicare Fees

Although the health system reform law did not fix the Sustainable Growth Rate's impact on the Medicare conversion factor, it does mean physicians in most areas of the state will receive small fee increases retroactive to Jan. 1.

May 11, 2010

What It Means: TMA Analyzes Pros and Cons of Health System Reform Law

Congressional passage of the health system reform bill, the Patient Protection and Affordable Care Act, sent physicians and patients scrambling to examine the fine print to determine how the new law will impact health care for all Americans. TMA launched a massive new education campaign to help Texas physicians and their practices survive and thrive in the new health care environment. From this month's Texas Medicine.

Medicare Melting Down: Congress Still Avoiding Permanent Fix

Texas Medical Association leaders say there is no doubt members of Congress understand the importance of fixing the broken Medicare physician payment system. They understand it. They just haven't done anything about it. From this month's Texas Medicine.

TMA Wins Four IABC Bronze Quill Awards

TMA won four Bronze Quill awards from the International Association of Business Communicators.

Medicaid Webinar May 19

Texas Medicaid program officials will conduct a free Webinar from noon to 1 pm CDT May 19 to educate physician about Medicaid initiatives.

Sign the Petition, Get 10 More

Have you signed the Stop the Medicare Meltdown petition yet? Have you asked your friends, family, and neighbors to sign it? If not, please do so today.

May 4, 2010

Maximum Overdrive: Increasing Patient Satisfaction with Automated Messaging

Submitted by an exhibitor at the recently concluded TexMed 2010.

By James F. Wilson, B.S., EMT

Senior Account Executive
Personal Communications, Inc.
1918 Vestavia Court
Arlington, TX 76018


With the explosion of electronic and technologic devices and systems aimed at healthcare, it becomes increasingly difficult to decide not only which ones to invest in, but also how to maximize their full potential. Automated Messaging Systems are rather inexpensive investments that truly increase revenue and efficiency. However, the majority of practices with these systems are not utilizing the full potential of their Automated Messaging Systems.

As the Medical Home concept comes back to the forefront, the need to efficiently provide personal superior patient care with the utmost of customer satisfaction. If used to their full potential, Automated Messaging Systems can assist you in providing exemplary patient satisfaction.

Key Words:

Automated Messaging Systems, Patient Reminders, Medical Home, Patient Satisfaction, Efficiency, Quality, Increased Revenue


  1. Implementing automated appointment reminders will reduce no-shows dramatically while freeing up valuable clinic staff time.
  2. The reduction of no-shows recovers lost revenue that can save your practice several thousand dollars per year.
  3. The purpose of this article is to address the “additional” applications that many are unaware of and that can greatly enhance your patients’ satisfaction, knowledge and safety.
  4. If all additional applications of Automated Messaging Systems are used to their full potential they can assist in providing the best patient care possible.
  5. Automated Messaging Systems can be used to follow up with patients that have a new diagnosis or care plan.
  6. Imagine being able to send a personal message to all of your patients concerning a current event health crisis!

Maximum Overdrive

May 3, 2010

Bitter Budget Ahead - Podcast TMA

Texas' next legislative session might prove to be more bitter than sweet. The state will confront a potential budget deficit of at least $11 billion next January. Gov. Rick Perry, Lt. Gov. David Dewhurst, and House Speaker Joe Straus have asked all state agencies to reduce their current budgets by up to 5 percent to cover the monetary shortfall. The funding reduction proposal for the Texas Department of State Health Services (DSHS) slashes about $100 million in state general revenue funds to the department.

This installment of Podcast TMA features commentary from Jeffrey Levin, MD, chair of the Texas Medical Association Council on Public Health, and Vince Fonseca, MD, MPH, former state epidemiologist, on the long-term effect reductions in public health funding could have on the state's residents. The cover story of the May 2010 issue of Texas Medicine magazine delves into the DSHS budget-cut proposal and examines the state's current public health funding levels.

This installment covers:

  • Proposed reductions in Medicaid and Children's Health Insurance Plan physicians' payments;
  • Money-generating alternatives; and
  • Reasons public health funding is particularly vulnerable during economic downturns.

Please note that unless stated otherwise, the opinions expressed in this podcast are the individual physicians' and not the official position of the Texas Medical Association.

Want to Subscribe to Podcast TMA through iTunes?

  • Here's the link. It takes you to the iTunes store. Subscription is free.
  • Catch up on all the old Podcast TMA episodes on the TMA Web site.
  • What's a Podcast, how do I get it, and what do I with it once I have it? (See the short tutorial on the iTunes Web site.)

Apr 28, 2010

DSHS Issues Newborn Screening Advisory

The Texas Department of State Health Services (DSHS) is sending physicians and other health care professionals an advisory outlining their responsibilities in collecting blood specimens from newborns.

CMS Lifts Fraud Training Requirement

Responding to complaints from organized medicine, the Centers for Medicare & Medicaid Services (CMS) no longer requires physicians and suppliers in the Medicare Advantage program to obtain training in preventing fraud, waste, and abuse.

BCBSTX Begins Care Improvement Project

Blue Cross and Blue Shield of Texas (BCBSTX) says it wants to work with physicians to make sure patients with chronic conditions, such as diabetes and high blood pressure, get regular follow-up care.

Save Medicare Petition Gains Momentum

Another dozen national and state specialty societies have joined TMA's petition drive to "Stop the Medicare Meltdown."

Apr 26, 2010

Helping Haiti - Podcast TMA

As Austin orthopedic surgeon Scott Smith watched the news coverage of the Jan. 12 earthquake that virtually destroyed the Haitian capital Port-au-Prince he decided he had to do something to help the thousands of people left injured.

Similarly, Joanna Gibbons, a second-year medical student at the Texas College of Osteopathic Medicine, saw the devastation and the suffering and felt the same. As she put it, “I couldn’t not go.”

Dozens of Texas physicians, medical students, nurses, physician assistants, and other health professionals flocked to Haiti in the days and weeks following the earthquake. Their efforts saved countless lives and eased the suffering of many.

Download the show now.

The cover story in the April issue of Texas Medicine tells the story of a few of the Texas physicians and medical students who responded to the tremendous need for medical care in Haiti and what they found there.

In this installment of Podcast TMA, Dr. Smith and Fort Worth trauma surgeon Robert Sloane discuss their experiences helping Haitian quake victims.

This installment covers:

  • Why Texas physicians such as Drs. Sloane and Smith felt compelled to volunteer in Haiti.
  • The devastation and traumatic injuries they encountered there, as well as the conditions under which they had to work.
  • Experiences with patients that touched them personally.
  • The continuing need that the Haitian people will have for ongoing medical care from volunteer physicians and others.

Want to Subscribe to Podcast TMA through iTunes?

Here's the link. It takes you to the iTunes store. Subscription is free.
  • Catch up on all the old Podcast TMA episodes on the TMA Web site.
  • What's a Podcast, how do I get it, and what do I with it once I have it? (See the short tutorial on the iTunes Web site.)

Apr 19, 2010

Surprise! Congress Delays Medicare Cut

Stop us if you’ve heard this one before.

Congress put fresh lipstick on the Medicare physician fee pig late Thursday (April 15) when it once again postponed a 21.3-percent reduction – this time until June 1 – rather than find a real solution to the payment problem.

Apr 15, 2010

Gala Supports the TMA Foundation

You may win a superb bottle of wine or a first-class trip to a luxury destination when you attend "Texas Legends: Celebrating Lone Star Trailblazers," the TMA Foundation's 17th annual benefit from 6 to 11 pm, Friday, April 30, at the Omni Fort Worth Hotel during TexMed 2010.

Vaccinate During Infant Immunization Week

National Infant Immunization Week, April 24-May 1, is a great time to step up vaccinations in your office.

Loan Application Deadline Extended

The Department of State Health Services is giving some physicians more time to apply for help in repaying their medical school loans under the Physician Education Loan Repayment Program.

Lehrmann Wins Supreme Court Nomination

Endorsed by the Texas Medical Association Political Action Committee (TEXPAC), Judge Debra Lehrmann, of Fort Worth, posted a convincing win over Rick Green of Dripping Springs in the April 13 runoff election to gain the Republican nomination for the Texas Supreme Court.

Medicare Cuts Kick In; Take Action Today

The April 14 deadline came and went with no action from the U.S. Congress, so the 21.3-percent cut in physicians' Medicare payments officially took effect today (April 15).

"It is absolutely unacceptable for the United States Congress to inflict this kind of perpetual uncertainty on Medicare patients and their physicians," said Texas Medical Association President William H. Fleming III, MD. "This is an all-too-real reason why Congress needs to quit dithering and get to work on a permanent new Medicare payment formula today.

We need every physician, every patient, every nurse, every spouse, and every health care professional in Texas to join our million-signature petition drive now.

Apr 9, 2010

Texas RECS Funded

Four Texas regional extensions centers (RECs) received $35.4 million from the Office of the National Coordinator to help physicians implement and 'meaningfully use' electronic health records (EHRs).

HHSC Seeks Medicaid Home Proposals

The Texas Health and Human Services Commission (HHSC) is requesting proposals for a children's Medicaid 'health home' pilot.

Medicare Fees Affect Medicaid Patients

Responses to TMA's March survey thus far so far show that ongoing problems with the Medicare fees are affecting physicians' acceptance of Medicaid patients.

Blue Cross Ranking Physicians' Performance, Again

Blue Cross and Blue Shield of Texas (BCBSTX) is notifying physicians of their rankings under its BlueCompare Evidence Based Measures system, and doctors have until May 15 to respond or face possible termination from the Blue Cross networks.

Apr 1, 2010

Support Medicine's Candidates: Vote

The Texas Medical Association Political Action Committee (TEXPAC), TMA's political arm, urges you to support medicine-friendly candidates in the April 13 Republican and Democratic primary runoff elections.

Blue Cross Ranks Physicians' Performance -- Again

Physicians who don't practice medicine the way Blue Cross and Blue Shield of Texas thinks they should have until May 15 to explain their performance or face possible termination from the Blue Cross networks.

Mar 31, 2010

Dispelling the Lies: What Health Reform "Actually" Means for Seniors

This is a reply to a March 30, 2010, article on the Huffington Post. What good is health system reform if patients on Medicare have no doctor to see? Since 1992, a fundamental problem has existed in the program. It has become a huge gaping wound that jeopardizes physicians’ ability to care for their Medicare patients. Without a permanent solution, fewer and fewer Medicare patients will have access to the care they need. Care that has been promised to them. Without a permanent solution, many provisions in the reform law won’t work. Why are doctors being forced out of Medicare? Medicare uses a faulty formula to calculate physicians’ payments. The formula has mandated physician fee cuts almost every year for the past decade. Only short-term congressional fixes … Band-Aids … have stopped the cuts each year. Without a permanent solution, the cuts grow deeper each year.. Tomorrow, Medicare cuts physician payments more than 21 percent. It’s almost ironic the cut happens on April Fools’ Day, because it won’t stick. Within the next two weeks, Congress will do what it has done for the past 10 years: put another a Band-Aid on the wound. This is the fourth time Congress has frozen the cuts this year. How can doctors stay in a program with so much uncertainty? Some doctors are opting out of the Medicare program, some are taking fewer Medicare patients, some are not taking any new Medicare patients, and some doctors are leaving the profession and retiring early. Steve Levine, VP for Communication, Texas Medical Association Read the Article at HuffingtonPost

Mar 29, 2010

Medicare Fees Drop Again; Claims on Hold

Medicare payments to physicians will decrease 21.3 percent April 1 because Congress went on a two-week Easter recess March 26 without doing anything to stop the cut.

Mar 26, 2010

Ban Discretionary Clauses, TMA Says

TMA 'strongly supports' a Texas Department of Insurance (TDI) proposal to ban discretionary clauses in insurance policies, TMA President William H. Fleming III, MD, says in a letter to TDI.

Physicians Make Millions for Hospitals

Physicians are not only the primary providers of medical care at the nation's hospitals, but a new survey suggests they also are key drivers of hospital revenue.

Physician Cost Profiles Often Wrong

Insurance companies that rate physicians on the cost of the care they provide are wrong almost a fourth of the time, says a RAND Corp. study published in the March 18 issue of the New England Journal of Medicine.

Is the Web-enabled House Call Legal? (Podcast TMA)

The old-fashioned house call may be a thing of the past, but it hasn't disappeared completely; it has simply taken on a new shape. To keep pace with technology, physicians are constantly changing the way they communicate with patients. Physicians can now use the Internet to see patients from their homes, offices, or anywhere a Web cam is available. This method of practice is known as telemedicine. The Texas Medical Board (TMB) is examining the best way new communication tools can be used to deliver safe, quality patient care.

Download the show now.

This installment of Podcast TMA includes information on TMB regulations pertaining to the practice of telemedicine. The cover story of the March 2010 issue of Texas Medicine magazine explores a new telemedicine company that has launched its online diagnosis and treatment service in Texas and examines state law that applies to physicians who participate in telemedicine. Today, TMB Medical Director Alan T. Moore, MD, shares his insight on telemedicine practice in Texas.

This installment covers:

  • TMB's concerns with the practice of telemedicine;
  • Optimal use of telemedicine;
  • Proposed changes to TMB telemedicine rules; and
  • Guiding principles the board uses when making rules determinations.

Want to Subscribe to Podcast TMA through iTunes?

Here's the link. It takes you to the iTunes store. Subscription is free.
  • Catch up on all the old Podcast TMA episodes on the TMA Web site.
  • What's a Podcast, how do I get it, and what do I with it once I have it? (See the short tutorial on the iTunes Web site.)

Mar 18, 2010

TMA Fights for Patients and Physicians as House Prepares to Vote

First, do no harm. With the U.S. House of Representatives likely to take a historic vote on health system reform this weekend, your Texas Medical Association is engaged on multiple fronts to make sure the end result doesn’t violate the Hippocratic Oath.

Five Things You Can Do Right Now

  1. Use the TMA Grassroots Action Center today to send a strong message to Sens. John Cornyn and Kay Bailey Hutchison and your U.S. representative. Tell them to oppose the health system reform bill in the House and begin work immediately on a permanent replacement of the Medicare payment formula.
  2. Sign TMA’s online Stop the Medicare Meltdown petition and encourage your colleagues, friends, family, and neighbors to do the same.
  3. Sign TMA’s open letter to Congress (PDF) and fax it to the TMA Public Affairs Division at (512) 370-1633.
  4. Post the Stop the Medicare Meltdown petition (PDF) in your waiting areas and exam rooms for your patients to sign. Fax completed petitions to the TMA Public Affairs Division at (512) 370-1633.
  5. Write a letter to the editor of your local paper.

Mar 16, 2010

Sign the Stop the Medicare Meltdown Petition

A confluence of events in Washington is pushing TMA to increase the volume of our work to enact a permanent fix to the Medicare payment formula. Despite their professed support for a new Medicare payment system for physicians, senators and representatives from both parties have done nothing to fix the formula that threatens to bankrupt physicians and leave Medicare patients without a doctor. For 10 years, they’ve done nothing to fix the single largest government health program. How can they build a new system on a broken foundation?

To educate patients on Medicare’s problems and engage all Texans in the drive to fix them, we are embarking on a campaign to gather 1 million signatures to stop the Medicare Meltdown. We begin with an open letter to Congress (PDF), which we will deliver to members of the Texas congressional delegation the last week of March at news conferences across the state. (Please see — and sign — the open letter to Congress, below.) The petition drive will include online petitions (PDF) posted on the TMA (PDF) and MeAndMyDoctor Web sites, social media petitions for Facebook and Twitter, and other tactics. We will use all of our communication vehicles and our county medical society partners to send campaign materials and the petitions to physicians and patients. We will work with community partners such as senior citizen groups, disability rights organizations, and others.