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Volume 16, No 29

Sept. 15, 2014


REVISED HEALTHY VISION SETS TMA ADVOCACY COURSE: The fields of engagement — the Texas Legislature, U.S. Congress, courts, state and federal bureaucracies — are many. The issues are all-encompassing. But TMA’s approach, as outlined in the new second edition of our Healthy Vision 2020 document, is clear. As TMA President Austin King, MD, writes in his welcome message, “Our government must make it easier — not more difficult — for us to care for our patients.” I encourage you to study the document, and share our healthy vision with lawmakers, business leaders, and your colleagues. You can order print copies from the TMA Knowledge Center at (800) 880-7955. Here’s our Top Ten List:

  1. Reverse recent cuts in physicians’ Medicare, Medicaid, and Children’s Health Insurance Program payments, particularly those that hurt access to care.
  2. Devise and enact a system for providing health care to low-income Texans with realistic payment to physicians, less stifling state bureaucracy, and no fraud-and-abuse witch hunts.
  3. Repeal the broken Sustainable Growth Rate formula. Enact a rational Medicare physician payment system that works and is backed by a fair, stable funding formula.
  4. Increase funding for graduate medical education.
  5. Protect Texas’ landmark medical liability reforms.
  6. Stop any efforts to expand scope of practice beyond that safely permitted by nonphysician practitioners’ education, training, and skills.
  7. Standardize Medicaid managed care administrative processes.
  8. Ensure criteria used to measure physicians’ performance are evidence-based, fair and accurate, and truly evaluate quality and efficient care, not just cost.
  9. Stop Recovery Audit Program (RAC) bounty hunters.
  10. Eliminate adoption of the ICD-10-coding system.  

SPEAKERS IGNITE TMA FALL CONFERENCE AUDIENCE: TMA and physicians have become political targets in Texas, and it’s time to fight back. That’s one of many key messages delivered at 2014 TMA Fall Conference. Dr. King used a multimedia display to illustrate the degree and intensity of the attacks. We need to grow TEXPAC’s treasury and membership so we can have the resources we need to counter what he called Orwellian doublespeak being used against us. Among the other conference speakers: 

  • State Sen. Jane Nelson (R-Flower Mound), the newly appointed (and first women to hold that post) chair of the Senate Finance Committee, said the huge turnover in the Texas Legislature over the past three years creates a challenge for medicine to educate the newcomers on the nuances of our complex issues. But looking back to her first election to the Senate in 1992, she told the crowd, “I wouldn’t be here today without TEXPAC.”
  • TMA Council on Legislation Chair Dawn Buckingham, MD, of Austin walked through TMA’s Healthy Vision priorities for the 2015 Texas Legislature and urged the audience members to build relationships now with their state representatives and senators.
  • Dallas nephrologist Donald Wesson, MD, past chair of the ABIM Foundation, explained how physicians can gain the upper hand in the quality-of-care debate by embracing the Choosing Wisely® program. “Texas can be, and should be, a vanguard state,” he said.
  • Despite some strong candidates running good campaigns, 2014 won’t be the year a Democrat wins a statewide elected office in Texas, predicted Evan Smith, CEO and president of The Texas Tribune. “An asteroid could fall on all the Republican candidates this cycle, and they would all win,” he said, pointing to the GOP’s strong advantage among Texans who actually vote.
  • Pat Evans, retiring after 48 great years as executive director of the Big Country County Medical Society in Abilene, told the physicians, “God put you here to heal people. Remember, no government or hospital administrator or big insurance company can take that away from you.” 

IS THIS ANY WAY TO TREAT A DOCTOR? Our Facebook page is exploding with likes, shares, and comments on our new Doctors Are Under Siege by the Federal Regulatory Barrage flyer. It has garnered rave reviews from physicians around Texas and around the country for accurately portraying the weight of federal demands on a practice today. Please download it, print it out, and share it with your patients and friends in high places. TMA’s lobby team will distribute it on Capitol Hill next week.

POST TORT REFORM, TEXAS STILL ATTRACTING RECORD NUMBERS OF NEW PHYSICIANS: The Texas Medical Board (TMB) licensed a record 3,994 new physicians for the fiscal year that ended last month. The number of new physicians applying for a Texas license also reached an all-time high of 5,149. Texas has averaged licensing 3,254 new physicians each year since the passage of our medical liability reforms 11 years ago. “The state medical board is now licensing twice as many doctors per year than in the medical crisis years before lawsuit reforms were enacted,” said Howard Marcus, MD, chair of Texas Alliance For Patient Access.

TMA DECIPHERING HYDROCODONE CHANGE CHALLENGES: The U.S. Drug Enforcement Administration’s decision to reclassify drugs that contain hydrocodone combinations from Schedule III to Schedule II continues to elicit questions and a good bit of anger from Texas physicians. TMA is working to get some solid answers from the maze of state and federal agencies with jurisdiction, and we’ll update our online Q&A document as we get them. I’ve also asked our lobby team to see what legislative remedies are available.

GOVERNOR NAMES NEW MEDICAL BOARD CHAIR: Gov. Rick Perry appointed Michael Arambula, MD, the new chair of TMB. Dr. Arambula, a TMA member, is a psychiatrist in private practice and an adjunct associate professor in the Department of Psychiatry at The University of Texas Health Science Center at San Antonio. The governor also appointed John Guerra, DO, an OB-Gyn from Mission, to TMB.

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