Action: Nov. 15, 2013

TMA Action Nov. 15, 2013   News and Insights from Texas Medical Association 

INSIDE: New SGR Replacement Plan Unveiled

New SGR Replacement Plan Unveiled
TMA Webcast Explains Health Insurance Exchanges
Delegating and Supervising Prescribing Privileges for APRNs/PAs
Medicine Protests Medicare Advantage Terminations
Help Your Patients Achieve a Healthy Weight 

The Digital Practice: Building a Stronger Online Presence
Preparing Your EHR for 2014
Anson Jones, MD, Awards Honor Physicians
TMA Offers Updated Procedures Manual
This Month in Texas Medicine

New SGR Replacement Plan Unveiled

Once again, Texans in Congress are playing key roles in fixing our broken Medicare payment system. The latest joint proposal comes from the House Ways and Means Committee and Senate Finance Committee. Rep. Kevin Brady chairs the Ways and Means Committee's Subcommittee on Health, and Sen. John Cornyn sits on the Senate Finance Committee and its Subcommittee on Health Care. 

Another bill, sponsored by Rep. Michael Burgess, MD (R-Texas), has already passed the House Energy and Commerce Committee with bipartisan support. TMA will work with all three of them, and the rest of the Texas delegation to Congress, to come up with the best bill to replace Medicare's Sustainable Growth Rate (SGR) formula. 

TMA leaders will meet with these Texas leaders before, during, and after the upcoming American Medical Association House of Delegates meeting.   

TMA Webcast Explains Health Insurance Exchanges

A one-hour live webcast, Health Insurance Exchange: Business Impact, at noon CST on Dec. 5, will help answer many of the questions you probably have about the health insurance exchanges created by the Affordable Care Act. Lee Spangler, TMA vice president for medical economics, will examine the details of the exchanges and what they mean to your practice.  

 As the December issue of Texas Medicine will report, you need to figure out if you are participating in the plan(s) offered in your area and if they will affect your current payer contracts. You'll need to learn how to identify patients on the exchange plans and what happens if these patients don't pay their premiums. The Texas Health and Human Services Commission estimates 40 percent of the state's 6 million uninsured are eligible for exchange subsidies.  But, only 2,991 Texans successfully picked a plan during the first month of the exchange's open enrollment period, U.S. Department of Health and Human Services reported.

 You will earn 1 hour of continuing medical education credit by joining the live webcast.

Delegating and Supervising Prescribing Privileges for APRNs/PAs

With the rules being finalized by the Texas Medical Board, the new law governing the delegation and supervision of prescribing privileges for advanced practice registered nurses (APRNs) and physician assistants went into effect Nov. 1.

The new law — passed as Senate Bill 406 by Sen. Jane Nelson (R-Flower Mound) and Rep. Lois Kolkhorst (R-Brenham) — replaces the site-based regulatory structure with a more collaborative model based on periodic quality assurance reviews and a new prescription authority agreement (PAA).

The law does not stipulate a specific form for the PAA, but TMA has developed a sample template for physicians to use. Accompanying the sample PAA is a fact sheet summarizing the details of the law.

SB 406 was passed with support from TMA, the Texas Academy of Family Physicians, the Texas Association of Physician Assistants, and the various groups representing APRNs. The new law reinforces the importance of physician-led medical care teams, recognizes the skills all practitioners bring to patient care, and allows the delegating/supervising physician greater flexibility in tailoring the PAA to his or her practice.   


Medicine Protests Medicare Advantage Terminations

Physicians across the country are being kicked out of Medicare Advantage (MA) plans, undermining patients' rights and denying them access to care, TMA, the American Medical Association, and numerous national specialty societies and state medical associations say in a letter to the Centers for Medicare & Medicaid Services (CMS). 

They asked CMS "to take immediate action" to make sure Medicare beneficiaries participating in MA plans "have accurate and reliable information to make health insurance elections during the 2014 Open Enrollment period …"

The letter says hundreds of physicians hare reported they were terminated from MA networks. "The terminations are 'without cause' and have been timed in a manner that undermines the accuracy and reliability of the information Medicare beneficiaries are relying upon in order to make important health care decisions for 2014 health insurance coverage. The timing and process used to communicate the terminations and modifications to the networks are not consistent with CMS guidance and regulations," the letter says. 

They added that the terminations "will disrupt long-established patient-physician relationships, interfere with existing physician referral networks, and undermine emergency department coverage in many hospitals. Both the continuity and coordination of care will be negatively affected, and treatment for certain types of care commonly provided by a very limited number of sub-specialists may no longer be available within the network."

TMA and the others urged CMS to extend the MA open enrollment period and require MA plan sponsors that have reduced their networks to immediately:  

  • Provide and document that patients received actual and accurate notice of whether their current physicians will be in the 2014 network;  
  • Ensure that patients know they can retain their physician by choosing fee-for-service or by choosing a product with an out-of-network benefit if their plan provides one; 
  • Give physicians information needed to challenge network adequacy based on CMS regulations and extend the appeals deadline until physicians receive such information;  
  • Tell AMA and the state medical societies how many patients are impacted and which physicians were terminated; and
  • Direct plans to hold all terminations initiated just prior to or during Open Enrollment in abeyance for 2014.     

Help Your Patients Achieve a Healthy Weight

Do you advise your patients to lose weight? If so, check out American Medical Association Healthier Life Steps® program, which offers hands-on tools to help patients establish and achieve their goals. You’ll even find tips to start a discussion about weight loss with your patients. 

The Healthier Life Steps program, offered by TMA, provides these practical resources to help you encourage your patients to exercise, quit smoking, eat healthier, and reduce risky alcohol use:  

  • Patient lifestyle questionnaires, 
  • Action plans, 
  • Progress-tracking calendars, and 
  • Continuing medical education opportunities.  

In addition, the Weigh What Matters app helps patients track their weight, diet, and exercise — and even calculate their body mass index score — as they work toward their goals. The app also allows patients to view and email progress reports to their doctor. 

Healthier Life Steps program materials are free for physicians and patients, courtesy of TMA and AMA. Physicians can download the materials for use in their practices. For more information, email the TMA outreach coordinator or call (800) 888-1300, ext. 1470, or (512) 370-1470.  

TMLT Action Ad 4.13     

The Digital Practice: Building a Stronger Online Presence

The latest consumer statistics suggest that more than 90 percent of potential patients will research your practice online before deciding where to go for their health care. So what does your online presence say about your practice?

Is your website properly structured and designed? Do you offer online appointment scheduling and digital forms? Are you getting good patient reviews and positive social media talk? Creating and managing a top-notch Internet presence and positive reputation is imperative to building your practice and maintaining relationships with current patients.

TMA is offering a new live webinar on Nov. 19 from noon to 1 pm to address these issues and help you evaluate your current online credibility. This webinar, The Digital Practice: Building a Stronger Online Presence, is the final installment of the Tech Tuesday series, which covered a variety of technology topics from HIPAA security to electronic health record concerns. 

Aimee Ostrander, creative director of Akaro Graphics, and Kim Mallinger, who handles marketing and patient relations for Cedar Park Pediatric & Family Medicine, will teach the course.

The series' June-October webinars are available to view on-demand through the TMA Education Center.    

Preparing Your EHR for 2014

Physicians participating in the electronic health record (EHR) incentive program must upgrade their EHR system to the 2014 certified version before attesting in 2014. Check the Certified Health IT Product List to see if your vendor has updated the product you use. If you do not see your EHR listed, you should ask your vendor about its timeline so that you can adequately prepare and perform testing before going live with the upgrade product.  

Because of the EHR upgrade in 2014, participants of the EHR incentive program are allowed a 90-day reporting period. Unlike the any-90-day period of your first year of participation, the 2014 90-day reporting period is by quarter:   

  • Jan.1 to March 31, 
  • April 1 to June 30,  
  • July 1 to Sept. 30, and  
  • Oct. 1 to Dec. 31. 

If 2014 is your first year to report on meaningful use, you may select any 90-day reporting period.

Physicians needing assistance with the EHR incentive program may receive consulting help from one of four Texas regional extension centers (RECs). The RECs are qualified to help physicians navigate the complexities of the program. Check out TMA's REC Resource Center to find out which REC serves your area. 

For more information about EHRs or other health information technology issues, email TMA's HIT Department or call (800) 880-5720.  

Anson Jones, MD, Awards Honor Physicians

Do you write a medical column for your local newspaper? Host a radio health show or a weekly medical segment on the local TV news? If so, enter your work in the TMA Anson Jones, MD, Awards contest. 

For more than 50 years, TMA has honored award-winning Texas journalists with the Anson Jones, MD, Awards for excellent medical news reporting. TMA opened the competition to physician-reporters in 2007 with the Physician Excellence in Reporting category.  

Enter today. Here is the entry form and more information. Entries are accepted until Jan. 15, 2014. If you have questions, email ansonjones[at]texmed[dot]org or call TMA Outreach Coordinator Tammy Wishard at (800) 880-1300 ext. 1470, or (512) 370-1470.  

 PC Action Ad Nov 13    

TMA Offers Updated Procedures Manual

TMA’s updated Policies and Procedures: A Guide for Medical Practices is now available for purchase though the TMA Education Center. Simply add the product to your cart and purchase this updated manual. Everything you need to comply with new rules and regulations is included. 

While you are there, check out TMA's new, fully customizable Employee Handbook for Medical Practices. Use it to create your practice's employee policies on attendance and punctuality, benefits, compensation, and much more. Take advantage of this handbook at a discounted price when you purchase your Policies and Procedures: A Guide for Medical Practices.

For more information, email the TMA Knowledge Center or call (800) 880-7955.

This Month in Texas Medicine

The November issue of Texas Medicine  tells you why physicians are glad the legislature restored funding for women's health but say problems still exist. You'll also learn about plans for expanding graduate medical education, why TMA is challenging a CIGNA policy, what physicians say needs to be done about the state's antiquated mental health hold law, and what state and federal laws say about communicating with patients.

Check out our digital edition.

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.    

This Just In ...

Want the latest and hottest news from TMA in a hurry? Then log on to  Blogged Arteries.    

TMA Deadlines for Doctors

TMA's Deadlines for Doctors alerts you and your staff to upcoming state and federal compliance timelines and offers information on key health policy issues that impact your practice. 

 Federal Agency: New OSHA Deadline: Training About Hazardous Materials

 2013 E-Prescribing Incentives. End-of-year reporting deadline to claim a 0.5-percent bonus  

 EHR Incentive Program Reporting Period Ends for 2013 Payment Year  

 E-Prescribing Deadline for 2013 Incentive

TMA Education Center

The TMA Education Center offers convenient, one-stop access to the continuing medical education Texas physicians need. TMA's practice management, cancer, and physician health courses are now easier than ever to find online. 

Live Seminars  

Medicare 2014  
11/19    McAllen 
11/21    San Antonio 
12/3      Houston 
12/4      Houston 


The Digital Practice: Building a Stronger Online Presence
noon-1 pm CST

OSHA Annual Training Webinar
Training on new requirements must be completed by December

Hard Knocks: An Update on Concussion and Texas Law  


TMA Winter Conference
1/31-2/1    Austin

5/2-3    Fort Worth  

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Last Updated On

January 27, 2016