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COVER (LEGISLATIVE AFFAIRS)While balance billing legislation represented one of TMA's biggest victories of the 2017 legislative session, it also created a host of new considerations for doctors. Senate Bill 507 by Sen. Kelly Hancock expands balance billing mediation to all physicians and other practitioners who provide out-of-network services at certain in-network facilities, and also expands mediation to out-of-network emergency care. This story will get physicians ready for Jan. 1, 2018, the date on which the law begins applying to health claims.
LAWA Harris County judge rejected a constitutional challenge to the state's Advance Directives Act in September, siding with the arguments of TMA and other organizations. The district judge threw out the lawsuit Evelyn Kelly filed against Houston Methodist Hospital after the death of her son, Chris Dunn. Ms. Kelly was challenging the part of the Advance Directives Act that allows a treating physician to consult an ethics committee if he or she believes life-sustaining treatment of a patient would exacerbate or extend that patient's suffering. If the ethics committee agrees and the physician causes the treatment to be withdrawn, the law provides a qualified immunity from liability. Although Methodist continued life-sustaining treatment on Mr. Dunn until his death, his care team believed the treatment was medically inappropriate and had previously taken the case to the hospital's ethics committee.
ECONOMICSAlthough it has yet to proliferate as a practice, reference pricing has emerged as a potential strategy for health plans to keep premiums low and address the problems that managed care plans are facing, such as increasing costs and narrow networks. In reference pricing, health plans simply set a maximum payable amount for specific procedures or services, regardless of what physician performs them. That can eliminate the need for network participation, can reduce overhead costs, and allows physicians who aren't contracted with a plan to make their own decisions about accepting procedures, patient collection, and claims filing.
PRACTICE MANAGEMENTPreparing for the unexpected – Hurricane Harvey showed many Texas physicians just how vulnerable their practices can be to natural disasters and other sudden calamities. Recovering from these setbacks can be difficult. But there are steps physicians can take to prepare for recovery, making it simpler and less painful. We'll explore a variety of issues, including insurance coverage, legal issues, and challenges in rebuilding infrastructure.
PUBLIC HEALTH How to get rid of old prescriptions – For generations, people have been flushing their old prescriptions down the toilet. These drugs then get fed into the water supply, where they can harm wildlife. In other cases, people simply hang on to old unused prescriptions, creating a potentially dangerous situation. In 2007, there were more than 250,000 cases of improper medicine use reported to Poison Control Centers in the U.S. But the issue can be confusing. In fact, the FDA in some cases actually recommends flushing old prescriptions.
EDUCATIONDoes Texas have too many medical schools? – By 2020, Texas will be opening four new medical schools. This comes after the 2016 opening of two other medical schools, Dell and UTRGV. Many argue that all these new schools are needed. Medical school enrollment remained flat during the 1990s and early 2000s while the state grew at a breathtaking rate. Unfortunately, it's unlikely that there will be enough residencies positions for all these new med students. That means Texas will be expensively educating them only to ship them out of state, where they are likely to remain. Also, state funding for medical schools is unlikely to grow soon, meaning these new schools will be competing with existing schools for scarce state dollars.
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