Apr 4, 2011

New Protections for Physicians in Nonprofit Health Corporations?

TMA Legislative News Hotline

Monday, April 4, 2011

The Nueces County Delegation
March 2011 First Tuesday

More than 350 physicians and medical students from across the state are headed to Austin for First Tuesdays at the Capitol tomorrow. TMA and alliance leaders and medical students will visit one-on-one with their state legislators, asking lawmakers to find the money needed to preserve basic health care services for Texas’ seniors, children, persons with disabilities and mental illnesses. They also will urge lawmakers to support a statewide smoking ban, prevent efforts by nonphysician practitioners to expand their scope of practice, and support funding for graduate medical education and the physician loan repayment program.

Sara Austin, MD
Physician Employment: Today, Sara Austin, MD, an Austin neurologist and a member of TMA’s Council on Legislation, is testifying in support of Senate Bill 1661, by Sen. Robert Duncan (R-Lubbock). This bill establishes protections for physicians’ clinical autonomy and gives to the physician board of directors of nonprofit health care corporations [501(a)s] the responsibility for all policies related to clinical care. It also strengthens the role of the Texas Medical Board (TMB) in supervising the activities of nonprofit health care corporations.

After almost three days of debate, the Texas House passed its proposed two-year budget, House Bill 1, Sunday evening. The bare-bones budget of $164.5 billion passed with a vote of 98 to 49. The 2012-13 budget continues to call for deep cuts to health and human services. The budget is short of what it would take to maintain current health services, especially given population growth and inflation. HB 1 would slash Medicaid and Children’s Health Insurance Program (CHIP) physician payments by 10 percent, expand Medicaid HMOs statewide, and dramatically reduce mental health services. The budget now heads to the Senate for consideration.

Meanwhile, the Senate Finance Committee is working on its own budget scenario. Right now, its budget bill spends $10 billion more than the House to prevent huge cuts to Medicaid and education. It includes no cuts in physicians’ Medicaid or CHIP payments.

Physician Employment: SB 894 by Senator Duncan is on the Senate Calendar today, which means the bill could be taken up as soon as tomorrow by the full Senate. SB 894 would allow critical access hospitals, sole community hospitals, and hospitals in counties of 50,000 or fewer to employ physicians. Most of these hospitals are run by local governments. The bill contains many features that protect the physician’s clinical autonomy against the corporate practice of medicine. The bill:
  • Places the responsibility for all clinical matters — bylaws, credentialing, utilization review, and peer review — under the medical staff;
  • Guarantees physicians’ independent medical judgment;
  • States that all physicians — employed or independent — are subject to the same rights and responsibilities;
  • Allows employed physicians to participate in the selection of their liability insurance and have the right to consent to settle in a liability action; and
  • Requires the medical staff to designate a chief medical officer (CMO) who must be approved by the hospital board. The CMO has the duty to report to TMB that the hospital is hiring physicians under this bill and that the CMO is the contact for TMB. The CMO has a duty to report instances of interference to TMB.
Physician Liability: The Senate State Affairs Committee will take up SB 1245 by Sen. Dan Patrick (R-Houston). The measure would provide immunity to physicians when they perform a student athlete physical examination or medical screening.

The physicians of the day at the capitol are Chris Casso, MD, of McAllen and Melva Palacios, MD, of Edinburg. Dr. Casso has practiced family medicine for five years. She graduated from The University of Texas Medical Branch in 2004. Dr. Palacios has practiced family medicine for seven years. She graduated from The University of Texas Health Science Center at San Antonio in 2002. Dr. Palacios and Casso are members of TMA and the Hidalgo-Starr County Medical Society.

Tell us your story. TMA wants to capture your story on video. Tell us why you decided to become a physician. What day did you leave your office or hospital and say to yourself, “Now, that’s why I became a physician”? Tell us what your profession means to you. Check out “physician moments” from some of your colleagues.

House Budget Shrinks Spending, Slashes Services (Texas Tribune)
House GOP budget to call for big changes to Medicare, Medicaid
(CNN Politics)
Medicaid cuts stir fears in Texas
(Abilene Reporter-News)
WT may soon drive rural health care
(Amarillo Globe-News)
New ACO Rules Outline Gains And Risks For Doctors, Hospitals
(Kaiser Health News)

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