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Volume 17, No 9

March 2, 2015


Medicine Lobbies Congress for SGR Repeal, Regulatory Relief 

TMA leaders and members of the Coalition of State Medical Societies met with key members of Congress and staff to the Senate Finance Committee and the House Ways and Means and House Energy and Commerce committees to push our federal agenda. The Capitol Hill consensus is that we’re looking at another short-term patch for Medicare’s Sustainable Growth Rate (SGR) formula next month — rather than repeal — to avoid a 24-percent cut in physicians’ Medicare payments on April 1. However, the outlook is better for some relief from onerous and bureaucratic federal regulations of physicians’ practices. To further our campaign, please send me stories of how Medicare rules and audits are interfering with patient care. The Texans included David Henkes, MD, chair of the Texas Delegation to the American Medical Association; AMA Vice Speaker Sue Bailey, MD; AMA Trustee Russ Kridel, MD; Texas Delegation Vice Chair Asa Lockhart, MD; TMA Trustee Gary Floyd, MD; ophthalmologist Lyle Thorstenson, MD; Dallas medical student John Corker; TMA’s chief lobbyist Darren Whitehurst; and me. The coalition includes medical societies from Texas, California, Arizona, Oklahoma, Louisiana, Florida, South Carolina, North Carolina, New Jersey, and New York. 

The Truth About Balance Billing

A pair of newly developed TMA resources examine how insurance plans’ network designs and payment decisions are leaving many Texans with “surprise bills” for health care services. Inadequate and limited physician networks that insurers sell today are leaving patients with unpaid bills and making the news. A new TMA white paper, “Network Inadequacy and Unfair Discrimination in Insurance,” explains how insurers limit their losses at the expense of the consumer. TMA staff also have prepared a detailed spreadsheet of network information gathered from Blue Cross and Blue Shield of Texas (BCBSTX), Humana, and United Healthcare health plans as of December 2014. To use the spreadsheet, click on the tab for the insurer at the bottom of the spreadsheet for the information for that carrier. You may sort by hospital/facility, city, county, or provider(s) in anesthesiology, pathology, radiology, and/or emergency medicine.

First Tuesdays Returns to the Capitol Tomorrow

Tomorrow is our second First Tuesdays at the Capitol for the 2015 Texas Legislature. We expect several hundred physicians, students, and TMA Alliance members to walk the halls in support of our 2015 legislative agenda. Scope of practice will be a hot topic, with 10 bills already filed that would expand nonphysician practitioners’ scope beyond what is safely permitted by their education, skills, and training. We’ll be lobbying in support of House Bill 1514 by Rep. J.D. Sheffield, DO (R-Gatesville), and Senate Bill 644 by Sen. Brandon Creighton (R-Conroe), which would require health insurers to uniformly designate on patients’ insurance ID cards whether they are covered by Affordable Care Act (ACA) insurance exchange products and whether they have a federal tax subsidy to help pay for it. Those patients have the 90-day grace period for paying premiums, which is creating havoc in some physicians’ offices. We’ll also be talking to senators and representatives about Medicaid reform, the state budget, and immunizations and other important public health topics. If you can’t make it tomorrow, come to First Tuesdays on April 7 and May 5.

Dr. Burgess Receives AMA Government Service Award

The Texans who traveled to Washington, D.C., last week, gave a standing ovation for a long-overdue honor given to U.S. Rep. Michael Burgess, MD (R-Lewisville), the only TMA member in Congress. As the outstanding U.S. representative, Dr. Burgess received a 2015 Dr. Nathan Davis Award for Outstanding Government Service — AMA’s highest award for elected officials and government employees. The award, named for the founding father of AMA, recognizes elected and career officials in federal, state, or municipal service whose outstanding contributions have promoted the art and science of medicine and the betterment of public health. TMA nominated Dr. Burgess for the award.

Tax Relief in Sight

This week’s Legislative News Hotline video brings you news on the Senate’s tax relief package, a bill that would eliminate your $200 annual occupation tax, and why e-cigarettes are a danger to Texas’ children. TMA Lobbyist Troy Alexander explains what repealing the occupation tax means for you. Joel Dunnington, MD, past chair of TMA’s Council on Science and Public Health, stopped by the studio this week before testifying at the Capitol to explain why e-cigarettes must be banned from public schools


Appeals Court Says "No," Again, to Chiropractic Board

Sometimes you have to fight in court just for the right to fight in court. The Texas Third Court of Appeals denied the Board of Chiropractic Examiners’ request for a rehearing. That action left standing the Third Court’s earlier decision that the trial court has jurisdiction to hear TMA’s challenge to the chiropractic board’s rules. Those rules would allow chiropractors to diagnose and treat vestibulo-ocular nystagmus cases. The case will now proceed to a trial on the merits.

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