REPORT OF COUNCIL ON MEDICAL EDUCATION
CME Report 1-A-07
Subject: Update of 1992, 1993, and 1997 TMA Policy
Presented by: Dennis B. Dove, MD, Chair
Referred to: Reference Committee on Science and Education
House of Delegates policies included in the association's Policy Compendium are reviewed periodically for relevance and appropriateness. At meetings held over the past 12 months, the Council on Medical Education reviewed policy statements originally adopted in 1992, 1993, and 1997. The council's analysis and recommendations for retention, deletion, or amendments are summarized in this report.
The following policy is recommended for retention as it is current, valid, and relevant:
205.014 Medical Education Funding Through All Payer Approach. The Texas Medical Association supports the funding of medical education through an all payer approach and enhanced funding of medical research through existing mechanisms (Council on Medical Education, p 67, A-97).
Recommendation 1: Retain.
200.032 Teaching Physicians Audit Process . The Texas Medical Association endorses and supports the American Medical Association, American Association of Medical Colleges, Association of American Medical Colleges, Association of Academic Health Centers, American Hospital Association, and Medical Group Management Association in efforts to achieve an audit process which is based on logic and reason (Council on Medical Education, p 66, A-97).
Background: The council discussed the nature of the Physicians at Teaching Hospitals (PATH) audits conducted by Medicare in 1997 that precipitated the initial adoption of this policy statement and determined that the threat of future audits of this nature remained valid. On this basis, the council recommends the policy be retained with the exception of deleting references to the six individual national organizations that took action on this topic in 1997. These references refer to past activity that may not necessarily be repeated in the future.
The council recommends adoption of the following amended language:
200.032 Teaching Physicians Audit Process. The Texas Medical Association endorses and supports the American Medical Association, American Association of Medical Colleges, Association of American Medical Colleges, Association of Academic Health Centers, American Hospital Association, and Medical Group Management Association in efforts to achieve a Medicare audit process which is based on logic and reason (Council on Medical Education, p 66, A-97).
235.020 Billing by Fellows . The Texas Medical Association supports enabling fellows or their supervisors to bill for services rendered to Medicare patients when those fellows are the teaching physicians for residents (Council on Medical Education, p 66, A-97).
Background: After consulting staff of the TMA Office of General Counsel and Payment Advocacy, the council determined that a fellow could directly bill for services provided to Medicare patients while supervising residents in cases where the fellow has a full medical license and meets Medicare credentialing requirements. Accordingly, the council recommends the following changes:
235.020 Billing by Fellows. The Texas Medical Association supports enabling fellows or their supervisors to bill for services rendered to Medicare patients in cases where when those fellows who are the teaching physicians for residents have a full medical license and are Medicare credentialed (Council on Medical Education, p 66, A-97)
The council proposes combining the following policy statements into a single policy statement:
175.006 Physician Licensure by Individual StateMedical Boards . Individual state medical boards should judge the competency and qualifications of physicians. The Texas Medical Association will monitor and respond to changes in federal law (including but not limited to NAFTA) which would supersede state physician licensure law. TMA opposes proposals for post-licensure assessment as a condition for physician participation in the Medicare program (Council on Medical Education, pp 98-99, I-93).
235.010 Board Certification as a Requirement for Reimbursement or Licensure . Further, the Texas Medical Association opposes the use of board certification as a requirement for reimbursement or licensure (Council on Medical Education, p 98, A-92).
Background: Support was expressed for the sovereign right of states to regulate physicians within their respective borders and disapproval for any effort by federal authorities to usurp these rights as defined in Policy 175.006. For updating purposes, it was recommended that the reference to the North American Free Trade Agreement (NAFTA) be deleted and the remainder of the policy be retained as written. Additionally, the council determined that 235.010 was closely related and voted for the two policies to be combined, as follows:
175.006 Physician Licensure by Individual State Medical Boards. Individual state medical boards should judge the competency and qualifications of physicians. The Texas Medical Association will monitor and respond to changes in federal law ( including but not limited to NAFTA) which would supersede state physician licensure law. TMA opposes proposals for post-licensure assessment as a condition for physician participation in the Medicare program. Further, the Texas Medical Association opposes the use of board certification as a requirement for reimbursement or licensure (Council on Medical Education, pp 98-99, I-93 and p 98, A-92).
Recommendation 2: Retain as amended.
TMA House of Delegates: TexMed 2007