Action: May 15, 2015

TMA Action May 15, 2015   News and Insights from Texas Medical Association

TMA Elects New Leaders
Passionate Professor Wins Distinguished Service Award
Lawmakers Pass Pair of TMA's Priority Immunization Bills
AMA Provides SGR Repeal Bill Summary, Timeline
ICD-10 July End-to-End Testing Deadline Extended to May 22
Physicians: Reenroll in Medicaid by March 24, 2016
Start the PQRS GPRO Registration Process Now
Bill Aims to Attract Mental Health Professionals to Underserved Texas Counties
Preparing for EHR Divorce
Latest CDC Texas HPV Vaccination Report Focuses on New 9-Valent Vaccine
Earn up to 16 CME Credits at Leadership Academy
DSHS Office of Women’s Health Hiring for Physician II
TMA Foundation Elects New Officers
TMA Awards Scholarships to Minority Medical Students
TMA Physicians Award Outstanding Science Teachers
Register for the Texas Primary Care and Health Home Summit
This Month in Texas Medicine    

TMA Elects New Leaders

Alfredo Tomas Garcia III, MD, took the oath of office as TMA's 150th president, pledging to defend the patient-physician relationship. "We are not 'providers,'" the Houston cardiologist told the House of Delegates. "We are healers. We are physicians."

Patty Loose, of Austin, became the 98th president of the TMA Alliance. "The alliance is an army of volunteers who are dedicated to helping the family of medicine," she said. "We married it. In one form or another, we committed ourselves to you and to the practice of medicine." 

The house gave rousing rounds of farewell applause to outgoing TMA President Austin I. King, MD, and departing Alliance President Angela Donahue.

The TMA House voted Don Read, MD — a colorectal surgeon from Dallas — to be TMA president-elect in the only contested election at TexMed 2015. He will take office as TMA's 151st president at TexMed 2016 in Dallas. 

In other election results: 

  • With the retirement of House Speaker Clifford Moy, MD, the house elevated Vice Speaker Susan Strate, MD, to the top spot at the podium. Delegates chose Houston emergency medicine physician Arlo Weltge, MD, as the new vice speaker.
  • The House reelected David Henkes, MD, to the Board of Trustees. New trustees are Dallas cardiologist Rick Snyder, MD, and Houston ophthalmologist Keith Bourgeois, MD. Board members chose Doug Curran, MD, as the new board chair, Dr. Henkes as vice chair, Dr. Snyder as secretary, and Drs. David Fleeger and Linda Villarreal as at-large members of the executive committee. The new resident physician member of the board is Laura Faye Gephart, MD, an obstetrician-gynecologist in Temple; and the new medical student member is Justin Bishop from the Texas Tech University Health Sciences Center School of Medicine in Lubbock.
  • Three new members won election to the Texas Delegation to the American Medical Association: John Carlo, MD, a public health physician from Dallas; Denton internist John Flores, MD; and Bret Beavers, MD, an orthopedic surgeon from Fort Worth.   

Passionate Professor Wins Distinguished Service Award

A real giant of American medicine received TMA's Distinguished Service Award, a well-deserved crown for a lifetime of leadership. "I regard this award not only as a tribute to my own contributions, but also as a recognition of the achievements and performance of my students, house staff, and fellows," said Donald W. Seldin, MD, who helped build The University of Texas Southwestern Medical School from a ramshackle cluster of buildings to an institution that has spawned six Nobel Prize winners. 

In testimony to the long reach of his 60-year teaching career, half the members of the TMA House of Delegates stood to indicate that Dr. Seldin had been an influence in their medical education. 

Other awards presented at TexMed 2015 included these: 

  • Jose Manuel de la Rosa, MD, of El Paso, received the Platinum Award, the top honor in the TMA Award for Excellence in Academic Medicine program.
  • The Young Physician Section presented its Young at Heart Award to Arlo Weltge, MD, of Houston.
  • The Resident and Fellow Section presented its J.T. "Lamar" McNew, MD, Award for outstanding mentoring and service to young physicians to San Antonio neurosurgeon David Jimenez, MD.
  • The Medical Student Section gave its Chapter of the Year Award to The University of Texas Medical School at Houston (UTHealth Medical School) chapter; its Student of the Year Award to Kayla Riggs, a UTHealth Medical School student; and the C. Frank Webber, MD, Award to Russell Kridel, MD, of Houston, for his commitment to mentoring medical students. 

Lawmakers Pass Pair of TMA's Priority Immunization Bills

Last week, the Texas House of Representatives gave initial approval to two of TMA's priority immunization bills, both authored by Rep. J.D. Sheffield, DO (R-Gatesville). 

House Bill 2171 prevents the automatic deletion of an 18-year-old's immunization records from the ImmTrac state registry, preserving them instead until the person reaches age 26. House Bill 2474 would require the state to provide vaccine exemption counts down to the school campus level. Thanks to all the physicians and alliance members who attended our special Last Thursday at the Capitol white-coat lobby day. 

These physician-witnesses testified before the Texas Legislature recently: 

  • Austin ophthalmologist Jack Pierce, MD, testified before the Senate Health and Human Services Committee in favor of Senate Bill 1718 by Sen. Donna Campbell, MD (R-New Braunfels), which would direct the Texas Medical Board to maintain a registry of physicians and therapeutic optometrists who comanage glaucoma patients. He also spoke against Senate Bill 577 by Sen. Charles Perry (R-Lubbock). The bill would allow optometrists to perform certain surgeries.
  • Austin neurologist Sara Austin, MD, testified before the House Public Health Committee, expressing TMA's concern with three medical marijuana bills.
  • Ryan Van Ramshorst, MD, a San Antonio pediatrician, testified against two bills by Rep. Allen Fletcher (R-Tomball) that would expand the scope of practice of chiropractors.
  • Louis P. Appel, MD, an Austin pediatrician, testified on House Bill 2304 by Rep. Four Price (R-Amarillo), the Health and Human Services Commission (HHSC) sunset bill. He asked the House Human Services Committee to delay merging the Texas Department of State Health Services and Texas Department of Family and Protective Services into HHSC until 2019, to streamline Medicaid credentialing, and to cut Medicaid red tape.
  • Houston neurologist Kim Monday, MD, testified before the House Public Health Committee in support of House Bill 2978 by Rep. Greg Bonnen, MD (R-Friendswood), about the role of neurodiagnostic technicians as part of the medical care team. 

AMA Provides SGR Repeal Bill Summary, Timeline

The American Medical Association's Legislative Counsel has prepared documents on the recently enacted Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), also known as HR 2.  

The detailed section-by-section summary of the new law offers a breakdown of physician and provider payment, the Medicare program, the Children’s Health Insurance Program, offsets, and other information. The timeline is a chronological list that shows when some of the major provisions will take effect, including the new Merit-Based Incentive Payment System (MIPS) and the new "Measure Development Plan," which sets priorities for new quality measures for MIPS and alternative payment model quality reporting.

ICD-10 July End-to-End Testing Deadline Extended to May 22

Medicare has extended the deadline for July participation in ICD-10 end-to-end testing. If you'd like to volunteer, you may apply now through May 22 to take part in July 20-24 testing. Volunteer forms are available on your Medicare Administrative Contractor (MAC) website

Selected health professionals will have a chance to test sample claims using ICD-10 codes with MACs and the Common Electronic Data Interchange contractor. The Centers for Medicare & Medicaid Services will review applications and select additional July testers, who will be notified of their selection by June 12.

Physicians who submit claims directly to Medicare can participate in end-to-end testing. Clearinghouses also may apply to conduct testing. 

Selected testers will need to submit future-dated claims and provide valid National Provider Identifiers, Provider Transaction Access Numbers, and beneficiary Health Insurance Claim Numbers that will be used for test claims. MACs require this information for setup purposes by the deadline on your acceptance notice. 

TMAIT Action Ad Sept 14

Physicians: Reenroll in Medicaid by March 24, 2016

The Affordable Care Act requires all Medicaid health professionals to reenroll in the program at least once every five years (some professionals must reenroll more frequently). Physicians are next on the list and must reenroll by March 24, 2016.  However, if you initially enrolled or reenrolled on or after Jan. 1, 2013, you will be required to reenroll by the date indicated on your enrollment letter.

The Texas Health and Human Services Commission and the Texas Medicaid and Healthcare Partnership (TMHP) have improved the electronic enrollment portal to make it easier for doctors to complete the reenrollment process. (Physicians newly enrolling in Medicaid can also use the portal.) The enhancements apply to applications submitted through the TMHP website on or after April 26, 2015.

The improved electronic application process allows you to:

  • Upload supporting documentation;
  • Sign the enrollment agreement electronically (e-sign);
  • Receive guidance as you work on the application and see more accurate error messages to avoid mistakes;
  • Receive instruction on how to upload documents and submit the application using an e-signature; and 
  • Expedite processing of your application by reducing the need for printing and mailing documents. 

For physicians currently enrolled in Medicaid, the portal will pre-populate the application with demographic data pulled from the physician’s current account.

To be considered fully reenrolled by the March 24, 2016, deadline, physicians must receive verification from TMHP that the application has been approved before that date. It currently takes about 32 days for applications to be processed. Thus, physicians should reenroll early to avoid gaps in enrollment. The reenrollment requirement also applies to physician assistants and advanced practice registered nurses.

To use the online application, you must have a TMHP user account and a user name (portal user ID). Refer to the TMHP Portal Security Provider Training Manual for instructions on activating a TMHP user account. For more information about Medicaid provider reenrollment, visit the TMHP provider reenrollment page.

Start the PQRS GPRO Registration Process Now

The Physician Value-Physician Quality Reporting System (PV-PQRS) registration system is open through June 30. This registration applies to group practices with two or more eligible professionals (EPs) interested in participating in the 2015 PQRS program year under the group practice reporting option (GPRO). 

According to the Centers for Medicare & Medicaid Services (CMS), physician groups of all sizes and physician solo practitioners will be subject to payment adjustments in 2017 based on quality and cost performance in 2015. Failure to report data on quality measures to Medicare for the 2015 PQRS program year will result in an automatic 2-percent pay cut under PQRS, plus another automatic 2-percent to 4-percent pay cut under Medicare's Value-Based Payment Modifier program, all in 2017. The payment adjustments will apply to all Part B covered professional services under the Medicare physician fee schedule.

To access the PV-PQRS registration system, you will need to obtain an Individuals Authorized Access to the CMS Computer Services (IACS) account. It takes at least 24 hours for CMS to process an IACS account request. This step should be completed now or as soon as possible to avoid last-minute delays before the deadline.

To determine if the GPRO is right for your practice, visit the GPRO webpage. To learn about the registration process, review the 2015 PQRS GPRO Registration Guide or visit the PQRS GPRO Registration webpage. Group practices that previously reported under the GPRO and plan on reporting PQRS data again via GPRO must register every year. If you plan to report your data on quality measures as an individual EP and not under the GPRO, you do not need to sign up or register anywhere to participate in the 2015 PQRS program year. 

If you are not sure where to begin for the 2015 PQRS program year or do not know which reporting mechanism to select, visit the CMS How To Get Started webpage

For free consulting services on Medicare's quality reporting programs, turn to the TMF Quality Innovation Network Quality Improvement Organization, an offshoot of the TMF Health Quality Institute. Under contract with Medicare, TMF has created several educational networks you can join:   

Stay informed about the latest PQRS news by subscribing to the PQRS listserv. For questions, contact the CMS QualityNet Help Desk, Monday through Friday, 7 am to 7 pm CT by phone, (866) 288-8912, or email. You also can contact the TMA Knowledge Center by phone, (800) 880-7955, or email

Bill Aims to Attract Mental Health Professionals to Underserved Texas Counties 

It's no surprise Texas is lacking in mental health professionals. A statewide survey sheds light on just how dire the situation is: 185 of Texas' 254 counties are without a psychiatrist. Overall, the state is home to just 4.1 psychiatrists per 1,000 patients, only slightly better than Nevada, Mississippi, and Idaho, nationally. Legislative efforts are in the works to try to attract more psychiatrists and other mental health professionals to underserved Texas communities.

Senate Bill 239 by Sen. Charles Schwertner, MD (R-Georgetown), recently passed the Senate. The bill would offer a loan remittance program to medical graduates choosing to practice as mental health professionals in an underserved Texas county. Specifically, the state would cover 10 percent of their loans after their first year in practice and 5 percent more each of the next four years they are in practice in a health professional shortage area. Texas would pay up to $160,000 total. The bill is pending in the House Committee on Public Health.

The North Texas Regional Extension Center commissioned recruiting firm Merritt Hawkins to conduct the survey, titled "The Physician Workforce in Texas: An Examination of Physician Distribution." According to the survey, Texas would need 12,819 additional physicians to meet the national average of 22.6 physicians per 100,000 residents.

Preparing for EHR Divorce

It's said that choosing an electronic health record (EHR) system is like choosing a spouse. While the majority of EHR unions seem destined for happily ever after, that is not the case with all. Physicians should have an exit strategy as they enter the EHR vendor relationship. The best way to do this is to seek mutually agreeable contract terms. 

TMA recognized the need for this and developed EHR Buyer Beware:  Issues to Consider When Contracting with EHR Vendors. This eight-page document encompasses eight must-haves for physicians, including the transferability of patient data. The Office of the National Coordinator for Health Information Technology also covers this topic in its paper EHR Contracts:  Key Contract Terms for Users to Understand. The 25-page document is more inclusive and covers key information such as details about a "meaningful use" warranty.  

A number of EHR vendors recently banded together to create an EHR Developer Code of Conduct. Ask your EHR vendor if it is part of the code of conduct. If not, it should be. TMA will add that criteria to the current list of questions for the EHR Comparison Tool

If you need assistance with EHR selection, implementation, or meaningful use, the federally established regional extension centers can help. For more information, visit the Texas Regional Extension Center Resource Center on the TMA website.  

You can email questions related to EHRs and other office technologies to TMA's Health Information Technology Department, or call (800) 880-5720.   

TMLT Action Ad 4.13    

Latest CDC Texas HPV Vaccination Report Focuses on New 9-Valent Vaccine

Did you know that at its February meeting, the Advisory Committee on Immunization Practices recommended the 9-valent human papillomavirus (HPV) vaccine as one of three HPV vaccines that can be used for females and one of two vaccines that can be used for males? 

You'll find details on the new vaccine, along with Texas-specific information, in the Centers for Disease Control and Prevention's (CDC's) third quarter HPV vaccination report.

CDC hopes that highlighting Texas-specific data will help immunization stakeholders and physicians develop strategies that increase HPV vaccination rates. The first quarter report focused on key recommendations for preventing missed HPV vaccination opportunities in Texas. The second quarter report focused on the importance of the clinician recommendation for HPV vaccination. 

Earn up to 16 CME Credits at Leadership Academy

TMA is a cosponsor of the 2015 Western Health Care Leadership Academy, which takes place May 29-31 in Hollywood. The event features keynote speaker Malcolm Gladwell, author of New York Times bestseller The Tipping Point, and special guest Siddhartha Mukherjee, MD, an oncologist, cancer researcher, and Pulitzer Prize-winning science writer.  

Attendees will hear from the experts and leaders of change. The conference will examine the most significant challenges facing health care today and present proven models and innovative approaches to transform an organization's care delivery and business practices.

The California Medical Association (CMA) and the California Medical Group Management Association will host the event, which is designated for a maximum of 16 AMA PRA Category 1 Credits™.

CMA has added to its block of rooms at Loews Hollywood Hotel, available at a special rate of $219 per night. Rates are guaranteed until the room block is filled. To make a reservation, call (855) 563-9749, or book online.

DSHS Office of Women’s Health Hiring for Physician II

The Texas Department of State Health Services (DSHS) Office of Women's Health is hiring for the Physician II position to assist the women's health programs. View the job description for more information and to apply.

The Physician II serves as the principle medical resource and principle subject matter expert for medical direction and consultation, specifically to the Family Planning, Breast and Cervical Cancer Services, Primary Health Care, Expanded Primary Health Care, and Title V programs, and in general to the Office of Women's Health Section's initiatives.

TMA Foundation Elects New Officers

The TMA Foundation (TMAF) elected officers at its April 30 meeting in Austin. Officers, who will serve a two-year term, include: 

  • Deborah A. Fuller, MD, TMAF president and an obstetrician-gynecologist in private practice in Dallas; 
  • Carl O. Trusler, MD, TMAF vice president and a retired family physician in Abilene;
  • Mary Love "Bitsy" Henderson, of Austin, TMAF secretary; and
  • James A. Prentice, MD, TMAF treasurer and a retired anesthesiologist from Austin. 

D’Anna Wick, of Tyler, was elected Executive Committee member-at-large and will serve a one-year term. 

Read more about these TMAF leaders.

PC Action Ad Oct 13

TMA Awards Scholarships to Minority Medical Students

Nine minority students entering Texas medical schools this fall each will receive $5,000 scholarships from TMA. Students were recognized at TexMed, the association's annual conference, in Austin for their academic achievement, commitment to community service, and deep desire to care for Texas' increasingly diverse population. 

The TMA Educational Scholarship, Loan, and Awards Committee chose winners from a competitive field of promising future physicians.

TMA created the Minority Scholarship Program to help diversify the physician workforce to fulfill the needs of Texas' diverse population. The scholarship encourages minority students to enter medicine by lightening their medical school financial burden. Since 1999, TMA has awarded 101 scholarships totaling $505,000 thanks to generous gifts from donors to the TMA Foundation.

The 2015 TMA Minority Scholarship Recipients are: 

  • Lillian Ene, of Rockwall, graduated from the University of North Carolina, Wilmington. She will attend Texas Tech University Health Sciences Center-Lubbock to become a pediatrician or emergency physician in rural Texas. Her scholarship is funded by the Nueces County Medical Society (CMS); the Travis CMS; Rose D. Jackson, Palestine; Jaime D. Sandoval, MD, Corpus Christi; and Andrew and Sukie Desire, Wichita Falls.
  • Jennifer Espinales, of Harlingen, graduated from The University of Texas at Brownsville and will attend The University of Texas Medical Branch at Galveston. She plans to become an internal medicine physician. C. Enrique Batres, MD, Sugar Land; and Mark J. Kubala, MD, Beaumont, funded Ms. Espinales' scholarship.
  • Hillary Evans, of Buda, is a graduate of Saint Edward's University in Austin. She will attend The University of Texas Southwestern Medical Center in Dallas to become an internal medicine physician. Dallas CMS; Diane and Clifford Moy, MD, Frisco; and physicians and their families funded Ms. Evans' scholarship.
  • Kimberly Farias, of Waco, graduated from The University of Texas at San Antonio and will attend the University of North Texas Health Science Center at Fort Worth. She plans to become a pediatrician. Her scholarship was made possible by the Tarrant CMS; E. Thomas Wightman, MD, Arlington; Irvin Robinson, MD, Fort Worth; Roberto and Aguiela Bayardo, Houston; and physicians and their families.
  • Samuel Garcia, of Horizon City, graduated from The University of Texas at El Paso and will attend Texas Tech University Health Sciences Center Paul L. Foster School of Medicine in El Paso. He plans to become a cardiologist. Mr. Garcia's scholarship was funded by the Hidalgo-Starr CMS; the El Paso CMS; Roberto and Aguiela Bayardo, Houston; and physicians and their families.
  • Peris June Nganga, of Irving, graduated from The University of Texas at Dallas and will attend The University of Texas Health Science Center at San Antonio to become a primary care physician. Her scholarship is funded with gifts from H-E-B and Rajam Ramamurthy, MD, and Somayaji Ramamurthy, MD, both of San Antonio.
  • Efrain Rodriguez, of Mission, graduated from The University of Texas Pan American in Edinburg and will attend The University of Texas Health Science Center at Houston. He will study to become a family physician. H-E-B and Gregory R. Johnson, MD, Houston, funded Mr. Rodriguez's scholarship.
  • Ruth Woldemichael, of Amarillo, graduated from Rice University in Houston and will attend Texas A&M Health Science Center in College Station. She plans to specialize in family or internal medicine. Ms. Woldemichael’s scholarship was made possible by the McLennan CMS; Libby and Bruce Malone, MD, Austin; Charli and Jim Rohack, MD, Galveston; Roberto and Aguiela Bayardo, Houston; and physicians and their families. 

The ninth scholarship recipient, who will attend Baylor College of Medicine, will be determined soon. This scholarship is made possible through donations from Harris County CMS and Houston Academy of Medicine; Pamela and Art Klawitter, MD, Needville; Gregory R. Johnson, MD, Houston; and physicians and their families.

The TMA Minority Scholarship program is supported by the TMA Foundation, the philanthropic arm of TMA, thanks to generous major supporters and gifts from physicians and their families.

TMA Physicians Award Outstanding Science Teachers

TMA named six Texas science teachers winners of the 2015 TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching. Three first-place prizes were awarded at TexMed 2015. Three second-place awards will be presented in upcoming local ceremonies. These educators help create tomorrow's physicians by inspiring students in the field of science.

Patricia Kassir of The Bendwood School in Houston, Joseph Morris of All Saints’ Episcopal School in Fort Worth, and Anna Loonam of Bellaire Senior High School in Bellaire are this year's elementary, middle, and high school first-place winners, respectively. TMA awards each top recipient a $5,000 cash prize, and each winner's school receives a $2,000 resource grant toward its science programs.

Ms. Kassir teaches the gifted and talented program for medical science to grades 3-5; Mr. Morris teaches seventh-grade life science; and Mrs. Loonam teaches advanced placement biology.

Second-place winners are Laura Wilbanks of Whiteface Elementary School in Whiteface, Carol Raymond of E.A. Young Academy in North Richland Hills, and Theresa Lawrence of Friendswood High School in Friendswood. Second-place winners' schools each receive a $1,000 resource grant to enhance science classroom learning.

TMA believes encouraging excellent science teaching is important, as only 32 percent of Texas eighth-graders have achieved proficiency in science, according to the National Science Foundation's Science and Engineering Indicators 2014 report. 

Science professionals from The University of Texas Charles A. Dana Center chose finalists from all the nominees, and physicians from TMA's Educational Scholarship, Loan, and Awards Committee selected the winners. 

The TMA Ernest and Sarah Butler Awards for Excellence in Science Teaching are supported by the TMA Foundation, the philanthropic arm of TMA, thanks to an endowment established by Dr. and Mrs. Butler, of Austin, and additional gifts from physicians and their families.

Register for the Texas Primary Care and Health Home Summit

The third annual Texas Primary Care and Health Home Summit will take place June 18-19 at the Marriott Plaza in San Antonio.

Presented by the Texas Medical Home Initiative and Texas Health Institute and cosponsored by TMA, the event will challenge attendees to build stronger and more effective teams, improve transitions of care, and continue to advance the principles of the patient-centered medical home in Texas. Continuing medical education credits will be offered.

Register by May 29, and review the draft agenda for more details.

This Month in Texas Medicine

The May issue of Texas Medicine features a cover story on TMA PracticeEdge, TMA’s practice management and accountable care tool for primary care and multispecialty practices. It also features articles on legislation that would expand the scope of practice for nonphysician practitioners; the American Board of Internal Medicine’s changes to maintenance-of-certification criteria; legislative efforts to clamp down on balance billing; and an update on graduate medical education (GME) legislation and the 2013 GME grant programs.

Click to launch the full edition in a new window.     

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 This Just In ...

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

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.  

ICD-10 Implementation Compliance   

First-Year Participants' Last Day to Begin 90-day Reporting Period of Meaningful Use for the 2015 Medicare and Medicaid EHR Incentive Programs  

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.  

On-Demand Webinars

Achieving ICD-10 Implementation Success    
ICD-10 Documentation and Auditing: Success Is in the Details
ICD-10 Starts With Physicians 

Conferences and Events

TMA Fall Conference
Sept. 25-26

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Last Updated On

December 19, 2016