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TMA Tackles Legal Issues
Law Sheds Light on Industry Payments to Physicians
Later this year under the Physician Payments Sunshine Act, the Centers for Medicare & Medicaid Services (CMS) will make public physician payments reported by manufacturers of drugs, medical devices, and biologicals that participate in federal health care programs.
Tax Fraud Scheme
Comptroller Mails Business Transaction Forfeiture Notices
Physician practices subject to the franchise tax should be aware that if the Texas Comptroller of Public Accounts hasn't received their franchise tax returns or approved their extension requests, they may receive a "Texas Notice of Intent to Forfeit Right to Transact Business."
A nationwide identity theft scheme is targeting physicians and leaving the Internal Revenue Service liable for hundreds of thousands of dollars in fraudulent tax refunds. As of June, more than 100 Texas Medical Association members notified the association someone had stolen their Social Security numbers and attempted to claim their tax refunds. The association has learned the crime's victims also include physician assistants, advanced practice registered nurses, dentists, podiatrists, and pharmacists. Texas is one of 49 states and the District of Columbia affected by this con.
Secret Service Expects to Make Arrests in Tax Refund Fraud Case
Last month, the Texas Medical Association first reported Texas physicians are victims of a tax refund/identity theft fraud scheme making waves across the nation. The association has since learned the crime's victims also include physician assistants, advanced practice registered nurses, dentists, podiatrists, and pharmacists. Texas is one of 49 states and the District of Columbia affected by this con.
Tax Refund Fraud Scheme Affects Texas Physicians
Physicians are the latest victims in a tax refund fraud scheme making waves across the nation. The American Medical Association reports it's working with federal officials in the investigation, headed by the Internal Revenue Service and the Secret Service. While the exact source of the identity theft hasn't been detected, several theories exist.
Scope of Practice
Appeals Court Rules Marriage and Family Therapists Can't Diagnose
The Texas Third District Court of Appeals handed down a favorable decision in TMA's lawsuit against the Texas State Board of Examiners of Marriage and Family Therapists (TSBMFT). The court decided marriage and family therapists cannot diagnose.
TMA Opposes Bill to Expand Audiologists' Scope
TMA and more than 110 national organizations, state and local medical associations, and state and local specialty societies delivered a clear message to members of the U.S. Congress: Oppose any efforts to give audiologists direct, unlimited access to Medicare patients without a physician referral and to include audiologists in the definition of physician. The groups outlined their opposition to House Resolution 5304 in a letter to Congress last month.
Patient Safety First
Thanks to opposition from the Texas Medical Association and other organizations, the Texas Board of Nursing (TBON) has withdrawn proposed rules that would have allowed advanced practice registered nurses to make medical diagnoses. TBON announced its proposal on the heels of another scope-of-practice debate involving dentists. In June, a new State Board of Dental Examiners rule took effect, allowing dentists to screen for and treat sleep disorders. The board adopted the rule even though TMA and the Texas Neurological Society testified against the change, pointing out its potential to harm patients with severe obstructive sleep apnea.
TMA Opposes Nurse Practitioner Plan
Proposed new rules regulating the scope of practice of advanced practice registered nurses (APRNs) would illegally allow APRNs to make medical diagnoses, and they ignore key tenets of a new state law, the Texas Medical Association and nine other state medical societies wrote in a formal comment letter to the Texas State Board of Nursing.
Licensure Should Stay Intact
What we really need are standardized processes for licensing similar to medical, dental, and nursing boards for ALL health care providers. Otherwise the burden of proof falls on facilities which employ or contract with these providers and many of those facilities do not have the infrastructure to carry out such investigations.
DPS Begins to Synch Controlled Substance Permit Renewals
Following a three-month delay, the Texas Department of Public Safety (DPS) reports it is beginning to synchronize physicians' controlled substances registration (CSR) expiration dates with their Texas Medical Board (TMB) license expiration dates.
FTC Calls for APRN Independent Practice
In a new report, the Federal Trade Commission (FTC) encourages states to allow a wider scope of practice for nurses with postgraduate education and urges state lawmakers to loosen regulations on advanced practice registered nurses (APRNs), allowing them to deliver care independently of physicians. The FTC claims more independent APRNs will increase competition in the primary health care marketplace.
TMA Opposes Audiology Scope Expansion
Audiologists lack the "medical training necessary to perform the same duties as physicians" and aren't able to "provide patients with the medical diagnosis and treatment options they require." That's the message TMA, the American Academy of Otolaryngology – Head and Neck Surgery, 38 state and local medical associations, and dozens of specialty societies and national organizations sent in a letter to House and Senate leaders.
A Bitter Pill: Physicians Seek Justice for Network Terminations
When insurance companies make business decisions that could have negative implications for Medicare patients' access to care and treatment continuity, it's a bitter pill for physicians.
Good Form: TMA Form Helps Keep You Out of Trouble
As more physicians adopt electronic health records (EHRs) and increasingly share patient information electronically, complying with state and federal privacy and security laws becomes more important than ever. TMA wants physicians to have the tools they need to comply while alleviating the administrative hassles that often accompany compliance, so it has created a patient authorization form to help physicians adhere to the law.
Specifics, Please: Tell DSHS What Killed a Patient
Just listing "cardiac arrest" as a cause of death in the Texas Electronic Registrar (TER) death registration system doesn't cut it anymore. That's because the Texas Department of State Health Services (DSHS) wants physicians to be more specific when listing the cause of a patient's death in the system.>
Proposition 12 Produces Healthy Benefits
Proposition 12 continues to produces healthy benefits. Improving access to medical care is critically important to all Texans. This is especially true for children, pregnant women, the aged, the poor, those in an emergent condition and those in rural Texas. Charity care has greatly increased since the passage of the 2003 reforms.
Here is guidance on appropriate standards of conduct for the physician, as well as links to ethics continuing medical education courses.
State Mental Health Hold Law "Antiquated"
When Temple emergency physician Robert Daniel Greenberg, MD, encounters suicidal or homicidal patients, he doesn't have the legal authority to temporarily hold them. For example, if the parents of an unresponsive 19-year-old patient fear he'll commit suicide once he wakes up, Dr. Greenberg says he's powerless to temporarily detain him. He has to wait for a judge to issue an emergency detention order.
Latest TMA Courtroom Action
Court Keeps Injunction in United Medicare Advantage Case
A federal appeals court has refused to allow UnitedHealthcare to continue kicking physicians out of its Medicare Advantage plans. On Dec. 12, the court declined United's request to lift an injunction against the insurer and referred the case to a three-judge panel. The appeals court ordered the parties in the lawsuit to file briefs later this month.
Abortion Ruling Supports Physician Judgment
An Austin federal judge enforcement of a provision of the state's new antiabortion law that requires physicians performing abortions to have admitting privileges at a hospital within 30 miles of their facility. On Oct. 28, the day before the law was to take effect, U.S. District Judge Lee Yeakel also upheld a physician's judgment in the use of RU-486 by women seeking an abortion. The state immediately appealed the ruling to the U.S. 5th Circuit Court of Appeals, and on Oct. 31, the court lifted Judge Yeakel's injunction, allowing the state to enforce the regulations. The legal battle is expected to continue.
Aetna to Pay $120 Million in Claims Dispute
Aetna's creation of a $120 million fund to pay physicians for out-of-network claims moved closer to reality last month when a New Jersey federal judge tentatively approved a settlement of the class action lawsuit by the Texas Medical Association and its organized medicine partners. Final approval is scheduled for March.
Appeals Court Backs TMA on Workplace Breastfeeding
The Fifth Circuit U.S. Court of Appeals agrees with TMA and the Texas Pediatric Society that a Houston federal judge wrongfully ruled against a woman who says her employer fired her because she wanted to pump breast milk. The court said "discriminating against a woman who is lactating or expressing breast milk" violates federal law. It overturned the decision and sent the case back to the trial court for further proceedings.
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