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Appeals Court Backs TMA in Chiro Lawsuit
Judge Upholds Prop 12 Tort Reform Caps
TMA Tackles Legal Issues
No Longer an Option: Feds Now Require Antifraud Complaince Plan
The U.S. Department of Health and Human Services Office of Inspector General (OIG) used to encourage physicians in Medicare and Medicaid to adopt voluntary compliance programs. But now it's the law.
Latest TMA Courtroom Action
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.
Aetna to Pay Up
In December, Aetna became the latest insurer to agree to a proposed settlement to pay physicians and patients $120 million because it used Ingenix databases that deflated payments for out-of-network physician services. The decision stems from settlement of a 2009 lawsuit against Aetna by the Texas Medical Association, the American Medical Association, and state medical societies in California, Connecticut, Florida, Georgia, New Jersey, New York, North Carolina, Tennessee, and Washington. They alleged Aetna used databases created by Ingenix, Inc., a subsidiary of UnitedHealthcare, to set usual, customary, and reasonable (UCR) rates for out-of-network services. They said Ingenix was inherently flawed and unable to establish proper UCR rates.
Aetna Deal Creates Physician Payment Funds
Aetna has agreed to pay physicians and patients $120 million because it used databases that deflated rates for out-of-network services.
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.
TMA Opposes New Chiropractic Board Rules
The Texas Board of Chiropractic Examiners (TBCE) is at it again. The board has lost numerous court battles with physicians over its attempts to expand chiropractors' scope of practice by passing a rule. This time, TBCE proposed a new definition of biomechanics, one of the keys to that profession’s statutorily prescribed scope.
Doctors Targeted: FTC Aims at Scope Limits
The Federal Trade Commission (FTC) has decided to get involved in scope-of-practice issues. South Carolina dental regulators have already felt the FTC's wrath. That worries organized medicine and state licensing boards. They fear the powerful agency may place a higher value on competition than on patient safety.
Wrongfully Accused: Physician Innocent of Billing Fraud Charge
Despite being embroiled in a nightmarish lawsuit that jeopardized his professional future and personal freedom, Khaled Jabboury, MD, describes his ordeal as "a message of love." The oncologist's devoted cancer survivors packed a Houston courtroom daily to support their embattled physician during his 10-day criminal trial on fraud charges last fall.
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.
Scope of Practice
Alternative to Scope Fight is Almost Law
TMA reached a landmark agreement with advance practice nurses and physician assistants on legislation to improve patients' access to care through an improved delegated-model for team-based health care. The bill helps establish a more flexible and collaborative practice model that improves on current site-based restrictions.. (From May's
TMLT Cuts Premiums Again
For the ninth consecutive year since tort reform, the Texas Medical Liability Trust (TMLT) is cutting its liability insurance premiums. This time, the TMLT Board of Governors approved an average 6.9-percent cut in liability premiums and an 18.5-percent dividend for renewing policyholders.
Here is guidance on appropriate standards of conduct for the physician, as well as links to ethics continuing medical education courses, and tools such as a “do not resuscitate” form, medical power of attorney and more.
Board of Councilors Issues Ethics Opinions
The Board of Councilors serves as the ethical policy making body of the Texas Medical Association. The Current Opinions of the Board of Councilors covers a wide range of topics from abortion to withdrawing life-prolonging medical treatment, and represents a collective judgment in these matters that are intended to aid physicians in their decision making.
Warning: Know What You Sign
Physicians who sign employment arrangements, listen up. A majority of employment contracts have provisions known as covenants not to compete, or noncompete clauses, which prevent you from competing with your former employer if you decide to leave and open a practice somewhere else.
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