Delegates Vote to Preserve Billing Rights, Fight MOC Coercion

The Texas Medical Association "has the green light to fight for state legislation that will address two crucial issues for Texas physicians," thanks to the TMA House of Delegates, Council on Legislation Chair Ray Callas, MD, wrote in a letter to all TMA member physicians.

Meeting in Dallas at TexMed 2016, the house on April 30 unanimously approved what Dr. Callas called:

  • "The TMA Board of Trustees multi-faceted plan to preserve physicians' right to bill for services provided to our patients; and
  • A Harris County Medical Society proposal that would free us from the pressure of the American Board of Medical Specialties' maintenance of certification [MOC] requirements."

"As chair of the TMA Council on Legislation, I am tremendously excited by these actions, and I pledge to you that your TMA leadership will follow through," Dr. Callas wrote.

He pointed out that lawmakers in other states have enacted laws to ban physicians from billing for services provided to patients out of network. These laws fall short of helping patients hold the very insurers who sell policies with narrow networks accountable for the lack of access to in-network physicians and health care providers. The Obama administration and several presidential candidates have proposed similar nationwide measures.

"We will not let it happen here in Texas," Dr. Callas said.

"The plan the House of Delegates approved calls on TMA to push for legislation that holds insurance companies accountable for their inadequate and narrow networks. It extends the applicability of Texas' exemplary mediation program for $500-or-more balance bills to all out-of-network physicians and providers and facilities. It keeps physicians aligned with patients' needs and best interests."

Read more about the plan and the extensive research that supports it in the cover story of the May issue of Texas Medicine.

The MOC proposal grew out of a new law that Oklahoma Gov. Mary Fallin signed last month. It would ban the use of MOC "as a condition of licensure, reimbursement, employment, or admitting privileges at a hospital" in Oklahoma.

Dr. Callas said "several key Texas legislators … are quite interested in pursuing a similar measure here. The TMA house followed through perfectly."

The resolution delegates adopted calls on TMA to "pursue legislation that eliminates discrimination by the State of Texas, employers, hospitals, and payers based on the American Board of Medical Specialties' proprietary MOC program as a requirement for licensure, employment, hospital staff membership, and payments for medical care in Texas."

Other highlights from TMA's 2016 annual meeting include:

Look for more detailed coverage of TexMed 2016 and the House of Delegates activities in coming issues of Action and Texas Medicine.

Action, May 2, 2016