Table of Contents: April 2008

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Vol. 104 No. 4

 

COVER STORY

Promises, Promises
It has been five years since TMA joined the federal class-action lawsuit filed under the Racketeer Influenced and Corrupt Organizations Act (RICO) against some of the nation's largest for-profit HMOs. Since then, most of the defendants have settled out of court and agreed to change the way they do business. Texas physicians benefited by collecting previously unpaid claims, and they stand to benefit further from the new business practices. The trick, however, is making sure the insurance companies live up to their promises.

By Crystal Conde

 

LEGISLATIVE AFFAIRS

It's the Care That Counts
The renewal of the fight in Congress over fair Medicare payments to physicians this summer is expected to include another round in the battle over physician ownership of hospitals and other health care facilities. Critics claim physician-owned specialty hospitals skim off the paying patients. Physicians argue it's the care that counts, not who owns the facility.

By Ken Ortolon

 

PUBLIC HEALTH

Are We Ready?
A hearing by two state legislative committees in February is causing concern over the state's level of preparedness to handle a disaster such as a Katrina-like hurricane or pandemic influenza. Among the concerns are funding and a shortage of physicians.

By Crystal Conde

 

MEDICAL ECONOMICS

Free Sometimes Costs
Physicians across Texas report numerous problems filing Blue Cross claims through the Availity clearinghouse. The situation has been so bad for some that they have opted to pay to use a different clearinghouse even though Availity's services are free.

By Ken Ortolon

 

MEDICAL EDUCATION

Can't We All Just Get Along?
Texas Tech medical school officials learned a lesson from the bitter fight between Galveston physicians and The University of Texas Medical Branch in the 1990s. They've worked hard to get along with West Texas physicians, and their efforts appear to be successful.

By Ken Ortolon

 

ROUNDS

Texas Physicians Sue to Protect Liability Reforms
TMA President Demands Congress Fix Medicare Payment System
Summit Charts Medical Education's 2009 Legislative Agenda
Renew Your Passion for Medicine at TexMed 2008
Escape to the Mexican Riviera
Don't Lose Your Patients
The Changing Image of Radiology
United Changes Reimbursement Policy
Feds Finally Release Patient Safety Rule
TMLT Offers Medical Student Scholarships
Greetings From TMB
Donor Screening Helps Predict Infection Risk in Corneal Transplant
UTSA Team Reports Antibiotic Resistance
Minority Kids' Health Care Lacking
Are You Losing Revenue by Undercoding?

 

MANAGING YOUR PRACTICE

Negotiating a Contract
To evaluate a contract, first assess the plan itself.

FLMA and You
The Family Leave and Medical Act applies to any medical practice that employs 50 or more people for 20 or more calendar work weeks.

PAR for the Course
To change your Medicare participation status ,  you need to complete a few extra steps. 

DSHS Offers New Cancer Treatment Resource
A new resource for treating qualified low-income women with certain breast or cervical cancer diagnoses is available.

Complaining to TDI
To complain about an insurance company's practices to the Texas Department of Insurance, you need to complete certain forms.

Use the NDC
Medicare officials are seeing professional Medicaid claims be denied because physicians are not including the national drug code on claims for physician-administered prescription drug codes.

Immunization Liability
Texas' Health and Safety Code doesn't protect a physician who vaccinates a Medicare patient in a hospital if the patient is harmed by the shot.

 

DEPARTMENTS

Commentary
Deaths
Classifieds
MedBytes

 

 

 

 

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