Remember Eight, at Eight, on the Eighth
Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8 at 8 pm, you can learn what actions legislators took on medicine's top eight issues.
TMA President C. Bruce Malone, MD, will call you at your home telephone number and invite you to stay on the line for TMA's Tele-2011 Legislative Victory Update. For the next 45 minutes, Dr. Malone and TMA's lobby team will discuss these eight issues:
- 2012-13 state budget;
- Employment protections;
- Texas Medical Board reform;
- Scope of practice expansions;
- Health system reform;
- Public health; and
- Health insurance reform.
You may ask questions after each topic and use your phone to participate in a survey. And, the best part, you will earn 1 AMA PRA Category 1 Credit™ for your time (providing you stay on the line for the entire program).
If you prefer that we call you on your cell or office telephone, please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by e-mail by Friday, June 3, and let us know. We hope to talk to you on June 8.
You also can learn more about the 2011 legislative session on TMA's website.
TMA for Medicare Private Contracting Bill
TMA joined the American Medical Association, 42 state medical associations, and 33 national specialty societies in asking House Speaker John Boehner to support and cosponsor the "Medicare Patient Empowerment Act" [PDF] (HR 1700) by U.S. Rep. Tom Price, MD (R-Ga.).
Texas Reps. Michael Burgess, MD, Pete Sessions, and Sam Johnson are cosponsors. Sen. Lisa Murkowski (R-Ark.) introduced a similar bill (S 1042) in the Senate.
"This legislation will help to preserve the patient-physician relationship by allowing seniors to continue to use their Medicare benefit, even with physicians who do not accept Medicare patients," the groups said in a letter to the speaker.
The letter says poor reimbursement and growing administrative burdens are forcing many physicians to leave the Medicare program or limit the number of patients they see.
"Unfortunately, for most Medicare beneficiaries, this also means the end of a relationship with a physician whom they have come to trust," the physicians wrote Speaker Boehner. "Currently, seniors who wish to see a doctor who does not accept Medicare must pay for all services by that physician out of their own pocket. The physician may not seek reimbursement from Medicare for the care provided, nor will Medicare reimburse the beneficiary. This despite the fact that seniors have paid into the program in the form of payroll taxes throughout their working lives.”
Passage of the Medicare Patient Empowerment Act, they wrote, "means Medicare would continue to pay the amount it typically covers today, with the patient paying the doctor directly for the difference between what Medicare pays and what the doctor charges. It would also enable physicians to help patients in financial need by permitting them to charge a lower amount than Medicare currently allows, something they are legally forbidden from doing today."
Allowing patients and physicians to independently and voluntarily contract for care "puts control back into their hands and preserves the relationship with their physician," they concluded.
The AMA will host a webinar explaining the details of the bill at 6 pm June 8. Hosted by AMA President Cecil B. Wilson, MD, the webinar will outline the major provisions of the bill, review the history of federal and state policy on Medicare fee limits, and discuss steps that physicians can take to build support for the bill. It is free for AMA members and $39 for nonmembers.
TMA Explains Medicare/Medicaid Coding
TMA's Payment Advocacy staff have prepared a free presentation to refresh physicians' understanding of how the Medicare National Correct Coding Edits (NCCI) process works. It explains the importance of billing according to the NCCI edits, includes tips for ensuring that your practice stays current with NCCI changes, outlines the differences among the Medicare, Medicaid, and commercial edits, and provides other helpful billing tips.
The Centers for Medicare & Medicaid Services requires all Medicare claims to be processed against the NCCI to promote accurate coding. The health system reform law required Medicaid to implement the NCCI edits, as well. Texas Medicaid did so last fall. All Medicaid claims submitted on or after Oct. 1, 2010, are subject to NCCI edits.
The edits tell you when two procedures can be reported together and when they cannot. For example, cutting through lesions during surgery is part of the surgery and not a separate payable service.
TMB to Resume Death Registration Fines
On June 1, the Texas Medical Board (TMB) will resume disciplining physicians who do not use the Texas Electronic Registrar (TER) Death Registration system to register patient deaths, TMB Executive Director Mari Robinson, JD, told the TMA Patient-Physician Advocacy Committee at TexMed 2011. The fine is $500.
Last November, TMB refunded money to more than 100 physicians who had already been fined and suspended pending cases because of physicians' complaints about the registration system. TMB said the delay in disciplining physicians would last until the 2011 session of the Texas Legislature ends this month.
If you haven't registered and aren't using the system, now is a good time to do so. Here's what TMB said in the January TMB Bulletin: "It's important to note that electronic death certification is here to stay. The health department adopted this system because it is faster for all parties involved, and it's less susceptible to fraud than paper."