Action: March 1, 2011

TMA Action March 1, 2011
News and Insights from Texas Medical Association


INSIDE: CMS to Shelve Physician Lab Signature Rule


CMS to Shelve Physician Lab Signature Rule
Stay Clear of Medicare Fraud Charges
Update Your Medicaid Information
Workers' Comp Has New Forms
Get Kids Moving; Give Away Bike Helmets
EHR Incentive Program Resources
CDC Issues Pertussis Guidance  

TMA Mobile App Reaches Blackberry, Android
Head to Houston May 13-14 for TexMed 2011
TMA Offers New Policy & Procedure Guide
This Month in Texas Medicine
Do You Twitter? Follow TMA

CMS to Shelve Physician Lab Signature Rule

Thanks to the efforts of TMA member U.S Rep. Michael Burgess, MD (R-Texas), the Centers for Medicare & Medicaid Services (CMS) plans to withdraw its rule requiring physicians to sign laboratory requisition forms, the American Medical Association says. The requirement was included in the 2011 Medicare fee schedule and was supposed to go into effect April 1.

"Congressman Burgess put in a lot of hard work to get the support needed to get the rule revoked," according to AMA.

Long-term care facilities were especially upset with the requirement because physicians often order lab tests for their patients in the facilities over the telephone. They argued the requirement would slow the process.

"One of the reasons we made this proposal is because we believed that it would be less confusing for a physician's signature to be required for all requisitions and orders, eliminating uncertainty over whether the documentation is a requisition or an order, whether the type of test being ordered requires a signature, or which payment system does or does not require a physician signature," CMS said when it proposed the requirement.

In early February, Representative Burgess and several other members of Congress wrote CMS Administrator Donald Berwick, MD, [PDF] that the requirement could harm Medicare patients because care might be delayed. "Under this new policy, laboratories will face a difficult decision when they receive a patient specimen with an unsigned requisition," the letter said. "Laboratories will have to decide not to provide their needed services and therefore be unable to provide a physician the information necessary to make health care decisions, or to provide the services without guarantee of payment, then work to obtain signatures in order to submit claims to Medicare."

The letter asked for additional time for CMS "to work with the laboratory, physician, hospital, and long-term care communities to put in place safeguards to ensure patient care is not negatively affected, allay concerns on possible payment complication stemming from this new requirement, and ensure a streamlined process for health care providers."  


Stay Clear of Medicare Fraud Charges

Cracking down on fraud, waste, and abuse in government health care programs has taken a front seat in the U.S. government's drive to control health care costs. To wit: The Medicare Fraud Strike Force, a joint effort of the U.S. Health and Human Services and Justice departments, indicted 111 people for $225 million in Medicare fraud, including seven from Texas, in February. While none are physicians, doctors are on federal auditors' radar.

Here are the top six things they are looking for as indications of possible fraud:

    1. High number of claims for one procedure,  
    2. Consistent billing at the same level or code,  
    3. An unusually large volume of claims,  
    4. Routine procedures outside of your specialty,  
    5. Questionable referral patterns, including accepting something of value in return for referrals, and  
    6. Routine waiver of patient copays without determining financial need.  

You can avoid being at risk for refunds, fines, or penalties in government health care programs by more fully understanding how to steer clear of inappropriate practices and what's at stake if you don't. TMA can help. TMA's on-demand webinar, Fraud and Abuse, looks at the definitions of fraud and abuse, how to steer clear of kickbacks, how auditors root out the problem, and fines and penalties.

Update Your Medicaid Information

As of March 24, physicians in the state Medicaid program must update and verify key demographic information in the Provider Information Management System every six months to make sure their information is correct in the Online Provider Lookup, the Texas Medicaid & Healthcare Partnership(TMHP) advises.

They will not be able to use any applications from your accounts on the TMHP secure portal, including TexMedConnect Acute Care, if they do not update the information.

The information that must be updated includes primary or alternate physical address, telephone numbers, e-mail addresses, office hours, counties served, and patient age and gender limitations.

For more information, call TMHP at (800) 925-9126 or (800) 568-2413, or visit the TMHP website.



e-MDs Ad  


Workers' Comp Has New Forms

Starting March 1, physicians in the Workers' Compensation program must begin using the new DWC Form-069 [PDF] and DWC Form-073 [PDF], and fax them to the Texas Department of Insurance Division of Workers' Compensation (TDI-DWC) at (512) 490-1047. Do not send the reports and narratives to the TDI-DWC field offices or other agency fax numbers.

If you have additional questions regarding the submission of designated doctor reports and narratives to TDI-DWC, call Comp Connection for Health Care Providers at (800) 372-7713 (804-4000 in the Austin area) and select option 3.


Get Kids Moving; Give Away Bike Helmets

It's alarming: Obesity rates among U.S. children and adolescents have tripled since 1980. Even more frightening, obese kids have an 80-percent chance of lifelong obesity, putting them at risk for heart disease, diabetes, and other serious health problems.

You can take steps right now to reverse this statistic. How? By encouraging kids to get more exercise, such as riding their bikes. Bike riding can be good exercise. And to keep them safe while biking, they need a good helmet. TMA's Hard Hats for Little Heads program makes it easy to give kids a free helmet. Plus, we have the tools you need to encourage your young patients to ride their bikes.

Here are three ideas to get you on your way:

  1. Give a free helmet to children at their well-check appointment to encourage them to exercise.  
  2. Hold a weekly and/or monthly drawing for free bicycle helmets. Excellent months to hold a drawing are Bike Month in May or Brain Injury Awareness Month in October.  
  3. Plan a larger-scale giveaway in your community, at a health fair, or community/sports event that children will attend.  

For each event, TMA provides free helmets with a matching purchase based on the amount you buy. We also provide educational materials in English and Spanish, including a video showing how to properly fit a helmet.

To find out more, e-mail Tammy Wishard, TMA's outreach coordinator, or call her at (800) 880-1300, ext. 1470, or (512) 370-1470.   

EHR Incentive Program Resources

Unsure which electronic health record (EHR) incentive program is right for you? TMA has resources to help you make this important decision. Registration opened in January for both EHR incentive programs. If you are one of the many Texas physicians planning to enroll in either program, we recommend you start as soon as possible.

 TMA's resources include:


If you wait to participate until after 2011, you have that much less time to meet the stage one EHR criteria. Medicare incentives are largest in 2011-12. In addition, physicians who cannot demonstrate meaningful use of a certified EHR system by 2015 will receive smaller Medicare payments. Starting the program early could give you an advantage on incentive payments and meaningful use requirements.

Federal subsidies are available for technical consulting through the Texas regional extension centers (RECs). Subsidies lower the cost of consulting, valued at $5,000, to $300 for primary care physicians. If you already use an EHR system or if you are ready to adopt one, the RECs can help you meet the criteria necessary to earn EHR incentives. 

Visit the TMA REC Resource Center for more information.   

What can I do now?
Step 1:  Call the Texas REC in your area for guidance.
Step 2: 
Select and adopt a certified EHR

Step 3:  Meet the meaningful use criteria (
quick glance criteria [PDF] and in-depth criteria [PDF]).
Step 4:  Register for Medicare's Provider Enrollment, Chain, and Ownership System.  
Step 5:  Register at the CMS Registration and Attestation Portal.

What can I do later?
Step 6:  Obtain EHR certification code (instructions).
Step 7:  Complete 
reporting and attestation
Step 8:  Receive incentive payment.

CDC Issues Pertussis Guidance

The Centers for Disease Control and Prevention (CDC) says the continuing resurgence of pertussis likely will cause physicians to see more patients with the illness. It issued an advisory to help physicians make sure they use the proper procedures to correctly diagnose and treat pertussis.

"Proper testing criteria, timing of testing, specimen collection techniques, protocols for avoiding specimen contamination, and appropriate interpretation of test results are all necessary" for an accurate diagnosis through  polymerase chain reaction (PCR), CDC said. "PCR is an important tool for timely diagnosis of pertussis and is increasingly available to clinicians. PCR is a molecular technique used to detect DNA sequences of the Bordetella pertussis bacterium and, unlike culture, does not require viable (live) bacteria present in the specimen. Despite this advantage, PCR can give results that are falsely negative or falsely positive."

Call CDC's 24-hour information line at (800) 232-4636 if you need more information.



TMA Mobile App Reaches Blackberry, Android

The TMA Mobile App is now available for Blackberry and Android phones.

The smartphone application, which TMA launched last fall for the iPhone and iPad, offers 24/7 access with up-to-the-minute data on 45,000 of your Texas colleagues. Plus, the app gives you TMA news, events, and alerts to keep you informed. You can locate specialists across the state and also follow TMA in the media, plan your TexMed schedule, and respond to legislative action alerts. It's all right there in your hand.

To get this free, members-only mobile application, go to from your iPhone, iPad, Blackberry, or Android phone and download it. You will need your TMA website user name and password to log in and use the app features.

This TMA member benefit is made possible by the sponsorship of the Texas Medical Liability Trust and the Texas Medical Association Insurance Trust.

Call the TMA Knowledge Center at (800) 880-7955 or e-mail TMA Knowledge Center if you have questions or need help downloading or using the app.


Head to Houston May 13-14 for TexMed 2011

Take advantage of your TMA membership by attending TexMed 2011 May 13-14 at the George R. Brown Convention Center and Hyatt Regency Houston. 

"Caring for Patients in a Time of Change" is the theme of the conference, which offers more than 100 hours of clinical and business continuing medical education (CME), an exhibit hall with some 100 exhibits, and a chance to learn how to enhance patient care, stay abreast of clinical updates, discuss key issues with experts in the field, and help set TMA policy on issues that are important to you and your patients. Attendance at TexMed is free for TMA members.

Here are some highlights:

  • See into The Future of Medicine Under the New Health System with Jeff Goldsmith, PhD, at the General Session. Sponsored by Texas Medical Liability Trust.  
  • Spend some quality time with colleagues and friends at the Networking Luncheon in the Expo Hall. After lunch, stroll through the Expo Hall and preview the latest technology, products, and services for your practice. Boxed lunch tickets are $15. Sponsored by Blue Cross and Blue Shield of Texas.  
  • Check out the breakout session on accountable care organizations and how they affect your practice at 1:30 pm May 13; the Public Health CME track on new incentives and tools that allow physicians to track and benchmark preventive services; and the Quality track, which will help physicians meet the demands of public and private payers as they push forward value-based purchasing programs that offer rewards for efficiency and quality outcomes.  
  • Join us at a new event – a reception honoring 2011-12 TMA President C. Bruce Malone, MD, Austin, and TMAA President Bridget McKeever, Corpus Christi. Sponsored by the Texas Medical Association Insurance Trust.  
  • Get your photo taken for TMA's database and the new TMA Mobile App by RCL Portrait Design, a professional photographer who will be set up in the Expo Hall. You may purchase a portrait if you like, but there is no obligation or pressure. Call (800) 951-8712 to reserve your spot.
  • Eat, drink, and be merry at the TMA Foundation's 18th annual gala, Picture of Good Health. This annual fundraiser is a chance to have fun with friends while supporting TMA's health improvement programs.  

Register for the conference and make your housing reservations online. Or contact TMA Knowledge Center by telephone at (800) 880-7955 or by e-mail.  

TMA Offers New Policy & Procedure Guide

TMA's new Policy and Procedure Guide contains more than 200 up-to-date policies and procedures, tools, sample letters, and forms you can customize for your office. The practical and easy-to-use guide is specific to Texas medical practices and Texas law. Based on "best practices," it is vital to running an efficient practice – from solo physicians to large groups.

Written by practice management and health law experts, this guide includes new policies on these topics and more:

  • Human resources,  
  • Front desk,  
  • Business office,  
  • Management responsibilities,
  • Clinical,  
  • Medical records,  
  • Safety, and  
  •  The Health Insurance Portability and Accountability Act.

Each guide contains a customizable CD. Call 800-880-7955 or e-mail the TMA Knowledge Center  to order a copy.



This Month in Texas Medicine

The March issue of Texas Medicine explains why the Affordable care Act may have some good news for patients and physicians, details the grim financial news coming out of Austin, and tells you about the devastating impact of a now discredited vaccine "safety" study. You'll also learn how TMA helped kill an unfair insurance policy provision and why you need a policy and procedure manual in your practice.


Texas Medicine RSS Feed

Don't want to wait for Texas Medicine to land in your mailbox? You can access it as an RSS feed, the same way you get the TMA Practice E-Tips RSS feed.  


E-Tips RSS Feed

TMA Practice E-Tips, a valuable source of hands-on, use-it-now advice on coding, billing, payment, HIPAA compliance, office policies and procedures, and practice marketing, is available as an RSS feed on the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases and for Blogged Arteries, the feed for Action


Do You Twitter? Follow TMA

As part of its work to explore new communications technologies, TMA regularly publishes on Twitter, the hot, 140-character "micro-blogging" service.

If you Twitter, follow TMA to get practice management tips, news bits, and political chatter – and we'll follow you, too. If you don't know what we're talking about, click here to check it out.


What Can Practice Production Numbers Tell You?

Consider these factors if your production isn't consistent.

A practice management tip from
TMA Practice Consulting


This Just In ...

Want the latest and hottest news from TMA in a hurry? Then log on to Blogged Arteries. You can hear the latest Podcast TMA episodes and read the most recent news from Action and Texas Medicine

TMA Seminars

Practice Management, Ext. 1421

Billing and Compliance
4/12     San Antonio
4/14     Austin
4/26     Houston
4/28     McAllen
5/4       Dallas
5/5       Fort Worth

Recorded Web Seminars

Avoiding RAC Audits
Communication Skills: Why Bother?
Evaluating Your Medicare Options
Meaningful Use
Medical Records-Consent for Treatment of Minors
Patient-Physician Relationship
Patient Satisfaction
Professional Courtesy: Waiving Copays, and Charity Care Requirements
 Revenue Cycle Management  

Physician Health and Rehabilitation, Ext. 1342

Family Systems: The Impact of Marriage and Family on Physicians
4/2       Tyler
4/16      Galveston
9/10      Amarillo
10/20    El Paso

About Action

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