Blogged Arteries

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.

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.

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.

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.

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.

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.

• Kenedy, 49.5%
• Hudspeth, 48.5%
• Jeff Davis, 44.2%
• Culberson, 42.6%
• Presidio, 40.8%

• Collin, 16.6%
• Duval, 16.7%
• Carson, 17.3%
• Brooks, 17.8%
• Orange, 17.9%

• Kenedy, 40.2%
• Glasscock, 38.9%
• Reagan, 36.7%
• Sherman, 36.1%
• Hudspeth, 36.0%

• Brooks, 8.8%
• Duval, 9.4%
• La Salle, 9.6%
• Collin, 10.3%
• Jim Hogg, 10.4%

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.

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.

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

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.

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

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.

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 http://www.foxbusiness.com/on-air/money-rocks/

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

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.

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.

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.)

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.

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.

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.