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.