Action: Jan. 5, 2017

TMA Action Jan. 5, 2017   News and Insights from Texas Medical Association

The 85th Texas Legislature Is Coming to Town
DEA Reverses Course on Registration Renewals
Practice Websites Targeted in ADA Shakedown
Paxton: DOs Are Physicians
Our Biggest CME Sale: 20 Percent Off in January
Don't Miss First Tuesdays at the Capitol in 2017
Court Blocks ACA Rule on Transgender Services

It's Official: Keynote Speakers Selected for TexMed 2017
MD Students: Get Hands-On Training This Summer With GIMSPP
Only Nine Days Left to Become an Accountable Care Leader
TMA's Outreach Programs Funded for 2017
This Month in Texas Medicine

The 85th Texas Legislature Is Coming to Town

Veteran and rookie lawmakers, hundreds of lobbyists, and thousands of private citizens will descend onto Austin beginning Jan. 10 for the start of the 2017 Texas legislative session. Medicine will be well represented.

As always, the TMA professional staff will complement the relationships that physician leaders have built with their senators and representatives as they work to promote TMA's 2017 agenda. Tops on the list are the state budget, insurance reform, scope of practice, telemedicine, the Texas Medical Board, and public health priorities. Specifically, TMA will be fighting for:

  • Improved Medicaid payments, fewer administrative hassles, and better coverage for low-income Texans;
  • Preserving physicians' right to bill for their services and reducing the likelihood that patients will receive surprise bills;
  • Better funding for the Texas Medical Board (TMB), and improvements to TMB's physician disciplinary processes; and
  • Support for "Telemedicine Done Right."  

For more details on TMA's legislative agenda, see "Building on Success" in the January issue of Texas Medicine.

When the legislature convenes Jan. 10, Lt. Gov. Dan Patrick will begin his second session as presiding officer in the Senate, and Rep. Joe Straus (R-San Antonio) is expected to be reelected to his fifth term as speaker of the House.

Seven physicians, all TMA members, will serve in the 85th Texas Legislature: 

  • Sen.-Elect Dawn Buckingham, MD (R-Lakeway),
  • Sen. Donna Campbell, MD (R-New Braunfels),
  • Sen. Charles Schwertner, MD (R-Georgetown),
  • Rep. Greg Bonnen, MD (R-Friendswood),
  • Rep.-Elect Tom Oliverson, MD (R-Houston),
  • Rep. J.D. Sheffield, DO (R-Gatesville), and
  • Rep. John Zerwas, MD (R-Simonton). 

Senator Schwertner, an orthopedic surgeon, will chair the Senate Health and Human Services Committee. Sen. Jane Nelson (R-Flower Mound), another longtime friend of medicine, will chair the budget-writing Senate Finance Committee. House committee members and chairs will be appointed later this month.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine's priorities at the Capitol. Here are five ways you can help: 

  1. Come to First Tuesdays at the Capitol,
  2. Subscribe to the TMA Legislative News Hotline,
  3. Lobby your legislators,
  4. Testify before a House or Senate committee, and
  5. Learn more about TEXPAC

DEA Reverses Course on Registration Renewals

In quick succession, the U.S. Drug Enforcement Administration (DEA) announced and then rescinded significant changes to its registration renewal process. The DEA initially said it would eliminate the informal grace period the agency has previously allowed for registrants to renew their registrations.

After the American Medical Association and others criticized the move, the agency reversed course and announced it would maintain its current policy: 

  • If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.
  • DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required.
  • Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration. 

DEA also initially said it would send only one renewal notice to each registrant's "mail to" address approximately 65 days before the expiration date and no other reminders. The revised plan now includes sending an electronic reminder to renew to the email address associated with the DEA registration. 

To check your registration expiration date, contact the DEA Registration Service Center at (800) 882-9539 or by email, and include your DEA registration number in your email.

AMA has asked DEA some additional questions about the details of the registration process. We will provide those answers in upcoming issues of Action.

Practice Websites Targeted in ADA Shakedown

An Austin attorney is sending demand letters to physicians and providers across the state alleging that their websites are not accessible to people with visual disabilities and that he will personally sue them unless they pay him $2,000 plus attorney fees.

Omar Weaver Rosales already faces sanctions and a $176,000 fine imposed by U.S. Magistrate Judge Mark Lane, of Austin, over his actions against defense attorney Jim Harrington, of Austin, in hundreds of lawsuits he filed alleging violations of the Americans with Disabilities Act (ADA). In those cases, Mr. Rosales sued small businesses over parking lot violations.

Mr. Harrington, a veteran civil rights attorney who himself spent decades fighting for ADA enforcement, says he know of at least 20 instances around the state where Mr. Morales has threatened lawsuits over physicians' and providers' websites. That number includes two inquiries that have come to the TMA Knowledge Center.

"This is about as close to a shakedown as you can get," Mr. Harrington said. "Rosales sends a draft of a suit, with himself as plaintiff, to scare people into paying him $2,000. This is a perverted use of the ADA. The law was designed to help the disability community, not make lawyers rich."

Mr. Harrington says ADA does not allow private citizens to collect damages in ADA cases; it only allows them to win a court order directing a plaintiff to correct any accessibility problems. He adds that "the law is not clear on ADA website access," particularly in states such as Texas that fall under the U.S. 5th Circuit. He also says that attorneys who represent themselves as plaintiffs in ADA cases are not entitled to attorney's fees.

"I have great respect for the ADA and its noble purpose, and I have brought many suits under the ADA in my career on behalf of the disability community," Mr. Harrington said. "But all of us agree that abuse of the ADA undermines its goals and creates friction between the disability community and the larger community, and thwarts integrating those communities together in a common society."

TMA's Office of General Counsel has identified several resources for medical practices concerning websites and ADA compliance. These include information from the U.S. Department of Justice, the Employer Law Report, and eMedia Law Insider. TMA staff use online checking services, such as, to check for potential ADA problems on the TMA website.

Legal articles in Action or on the TMA website are intended to help physicians understand the law by providing legal information on selected topics. These articles are published with the understanding that TMA is not engaged in providing legal advice. When dealing with specific legal matters, readers should seek assistance from their attorneys.

TMAIT Action Ad 6.15    

Paxton: DOs Are Physicians

Texas Attorney General Ken Paxton flatly rejected a Houston probate judge's assertion that Texas law did not allow doctors of osteopathy (DOs) to file certificates of medical examination needed for mental health commitments.

"Refusing to accept a certificate of examination for mental illness from a physician solely on the basis that the physician holds a degree designation of doctor of osteopathy rather than a degree of medicine appears to constitute the type of discrimination that the Legislature specifically sought to avoid," General Paxton wrote in an official opinion. "We find no authority to reject a certificate of medical examination for mental illness solely on the degree designation distinction."

The issue landed in the attorney general's lap late last year at the request of State Senate Health and Human Services Committee Chair Charles Schwertner, MD (R-Georgetown). Senator Schwertner was outraged at Probate Judge Rory Olsen's decision.

"As a physician, I find Judge Olsen's attempt to singlehandedly redefine the practice of medicine both reckless and profoundly misguided," he wrote in a letter asking General Paxton to affirm that MDs and DOs enjoy the same legal rights.

At that point, Judge Olsen announced he would accept commitment requests signed by DOs, pending the decision from General Paxton. 

Before Senator Schwertner's intervention, TMA, the Harris County Medical Society, the Texas Osteopathic Medical Association, the Federation of Texas Psychiatry, and the American Osteopathic Association had all written to Judge Olsen explaining the legal equivalence in Texas of allopathic and osteopathic physicians. "Eliminating DOs' authority in the most populous county in Texas could have disastrous consequences for the health and safety of persons who physicians have determined need protective psychiatric care," they wrote.

Our Biggest CME Sale: 20 Percent Off in January

Don't miss out on TMA's biggest, once-a-year continuing medical education (CME) sale. For the entire month of January, TMA is offering members 20 percent off all CME courses (excluding live programming). This means an additional 20 percent off the already discounted TMA member pricing.

Choose from more than 100 on-sale courses, including popular programs covering ethics, risk management, compliance, and practice operations. The discount applies to online and print publications, on-demand webinars, and podcasts.

Start your New Year with the lowest prices on TMA's hottest 2016 CME programs, including MACRA and Medicare: Get Clarity and Direction! (recorded on Nov. 30) and the revised Policies and Procedures: A Guide for Medical Practices, updated in October.

Visit the TMA Education Center and enter coupon code NEWYEAR20 at checkout to start saving. 

Don't Miss First Tuesdays at the Capitol in 2017

Your patients and your profession need you to be a lobbyist for a day. Mark your calendar now to join the Party of Medicine in Austin for First Tuesdays at the Capitol during the 85th Texas Legislature on Feb. 7, March 7, April 4, and/or May 2, 2017. The March 7 event is designated the official TMA Alliance First Tuesday, as well the young and newly licensed physician event. The April 4 event is dedicated to medical students and residents. Registration is now open.

TMA's comprehensive 2017 legislative agenda advocates what's best for patients and their physicians, from preserving physicians' right to bill for services to improving Medicaid payment rates and reducing red tape and hassles.

If you're traveling to Austin from out of town for First Tuesdays, reserve your room for the Monday before each event at the Doubletree Suites by Hilton Hotel by calling (800) 445-8667. Don't forget to mention you are attending TMA's First Tuesdays at the Capitol event for the special room block rate of $219 for February, March, and April and $209 for May. Hotel rooms in Austin are in demand during legislative sessions, so make your reservations now.

You also can reserve a room online, but make sure to enter the correct group code for your stay (February: FTC, reserve by Jan. 16; March: TAT, reserve by Feb. 13; April: CAP, reserve by March 13; and May: TUE, reserve by April 10). For more information or to register, visit the TMA website, or call (800) 880-1300, ext. 1363.

Court Blocks ACA Rule on Transgender Services

A federal district court judge in Texas has blocked the Obama administration from enforcing antidiscrimination protections related to gender transition and pregnancy termination-related services, a victory for Texas and seven other states involved in a lawsuit against the federal government.

The states and three health care organizations sued over U.S. Department of Health and Human Services (HHS) rule language that prohibits discriminating on the basis of "gender identity" and "termination of pregnancy," part of a rule attempting to align the nondiscrimination portions of the Affordable Care Act. The rule did not define termination of pregnancy but did define gender identity as "an individual's internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual's sex assigned at birth."

The lawsuit in U.S. District Court for the Northern District of Texas claimed the rule was redefining the word "sex" and would require the plaintiffs to perform and provide insurance coverage for procedures related to gender transition and abortion. That requirement would force practitioners to "violate their deeply held religious beliefs," the plaintiffs claimed.

One day before the rule's Jan. 1 effective date, District Judge Reed O'Connor issued a 46-page order saying the regulation violates the Administrative Procedure Act and also "likely violates" the Religious Freedom Restoration Act. Judge O'Connor's order said Title IX of the Education Amendments of 1972 and "Congress's incorporation of it in the ACA unambiguously adopted the binary definition of sex." The would-be rule exceeded the definition of sex discrimination in ACA and also did not incorporate the religious or abortion exemption in Title IX, the order said.

Following the order, Texas Attorney General Ken Paxton said in a news release the blocked rule would "force the Employees Retirement System of Texas to amend its coverage for all 500,000 participants to provide for gender reassignment and abortion" and would force health care practitioners to "participate in sex-reassignment surgeries and treatments, even if it violates their best medical judgment or their religious beliefs." It called the rule a "striking example of federal overreach" under ACA.

White House spokesperson Katie Hill called the decision "a setback, but hopefully a temporary one, since all Americans ― regardless of their sex, gender identity, or sexual orientation ― should have access to quality, affordable health care free from discrimination," according to multiple reports. Reuters reported it wasn't immediately clear whether the outgoing Obama administration would appeal the decision.


It's Official: Keynote Speakers Selected for TexMed 2017

This year, TexMed 2017 will bring top medical talent to Houston, starting with the doctors in attendance and including both keynote speakers: Kevin Pho, MD, of, and Pete Blair, PhD, executive director of ALERRT

Dr. Pho is the founder of the wildly popular blog He is a practicing board-certified internist and a social media leader in health care since 2004. Dr. Pho's presentation on Friday, May 5, "Connect and Be Heard," will take you through his decade-long social media journey and explain how social media can make a profound difference in health care.

Dr. Blair will deliver the closing keynote presentation on Saturday, May 6. A professor of criminal justice at Texas State University and the executive director of the Advanced Law Enforcement Rapid Response Training (ALERRT) Center, Dr. Blair researches and delivers nationwide training on active shooter events. By developing dynamic scenarios for first responders, the ALERRT program builds a comprehensive response team of police, fire, and Emergency Medical Services personnel to establish preparedness on local, regional, and state levels. 

To help conference attendees discover the newest best practices and the latest research in the field, TMA has opened a call for poster abstracts. A total of three submission categories are available, including Quality Research, Quality Improvements, and Clinical — with a focus this year on Disaster Medicine and Emergency Preparedness and Enhanced Perioperative Recovery. For complete details, visit the TMA website.

TexMed 2017 will renew your passion for medicine. Registration is now open and is free to all TMA members and their practice staff.

MD Students: Get Hands-On Training This Summer With GIMSPP

Your spring semester is starting, which means it's already time to plan for summer. First- and second-year medical students looking to get a leg up on your peers, take note: Applications for the 2017 General Internal Medicine Statewide Preceptorship Program (GIMSPP) are being accepted. 

Get hands-on training and personal instruction from an internist in primary care. Students are matched with a physician preceptor and spend two to four weeks (between May and August) receiving personalized supervision. By following rounds and interacting with patients, you'll receive hands-on guidance and an early clinical advantage before the start of residency.

Applicant matches are being assigned and will be completed no later than April. GIMSPP is an excellent opportunity for practical exposure in connecting the science of medicine with actual patients. Selected students receive a stipend for participation, with larger payments for students who work in a rural or underserved part of Texas. 

Last year, 163 medical students completed GIMSPP. This year, the Texas Chapter of the American College of Physicians (TXACP) is working to match even more students — in communities both large and small — across the Lone Star State. Because student preceptorships are available on a first-come, first-served basis, TXACP encourages all students to apply early. Students must be currently enrolled in a Texas medical school to participate. 

Only Nine Days Left to Become an Accountable Care Leader


You still have time to make 2017 your year for mastering the Medicare Access and CHIP Reauthorization Act (MACRA) and accountable care. The application deadline has been extended to Jan. 13 for TMA's comprehensive 2017 Accountable Care Leadership Program.

Over the course of 10 months, program participants will explore risk-based payment initiatives, clinic-based balanced scorecards, the development of accountable care organizations (ACOs), and patient-centered medical homes. Earn more than 95 hours of continuing medical education while addressing strategies for effective negotiation, conflict management, and stakeholder reliance.

Recent graduates from the 2016 Accountable Care Leadership class describe the program as "the clearest information I've ever received on MACRA and MIPS [Merit-based Incentive Payment System]" with "great insight into where health care is headed and how it will likely get there."

The 2017 leadership class will be limited to 30 participants, so submit your application as soon as possible. 

Since 2012, ACOs across the nation have served nearly 9 million seniors and have saved Medicaid more than $1.2 billion. Learn how you can expand these savings, and influence how value-based care will affect your practice and your patients by joining TMA's Accountable Care Leadership Program.

For complete coursework details, program requirements, and participation fees, visit the TMA website. 

PC Action Ad Sept 13

TMA's Outreach Programs Funded for 2017

More Texans will be affected by TMA's five signature outreach programs thanks to grants recently approved by the TMA Foundation totaling $514,000. Donations from individual and institutional donors make these grants possible. Thousands of physician, TMA Alliance, and medical student member volunteers join with community members and local organizations to make the programs possible.

Be Wise — ImmunizeSM helps improve vaccination rates and educates the public on why vaccinations are safe, important, and effective. TMA and alliance members protect Texans from serious diseases through education and hands-on immunization clinics. In 2017, Be Wise will provide 31,000 shots to uninsured and underinsured Texans, an increase of 1,000 shots over the 2016 target. Top 2017 donors to the Be Wise program are H-E-B and TMF Health Quality Institute.

Hard Hats for Little Heads enables physicians, students, and alliance members to take a proactive and visible role in preventing head injury by providing bicycle helmets to children. Hard Hats encourages Texas children to exercise safely by wearing a properly fitted helmet when bicycling, skateboarding, inline-skating, or riding a scooter. Funding for 2017 supports giving away at least 30,500 helmets, 1,500 more than the 2016 target. The program is made possible in 2017 thanks to major support from Blue Cross and Blue Shield of Texas.

The Minority Scholarship Program annually awards a $10,000 scholarship at each Texas medical school to a first-year African-American, Hispanic, or Native American student whose experience includes health care volunteerism, community service, and high academic standing. With the addition of The University of the Incarnate Word's School of Osteopathic Medicine in San Antonio, the number of scholarships increases to 12 in 2017. Major supporters of the Minority Scholarship Program in 2017 include the TMAF Trust Fund of Dr. Roberto J. Bayardo and Agniela (Annie) M. Bayardo, H-E-B, and the TMAF Patrick Y. Leung, MD, Minority Scholarship Endowment.

Walk With a Doc Texas aligns two TMA priorities: fighting the obesity epidemic among adults and children and reducing health disparities in minority and medically underserved communities. TMA physician, resident, and student members volunteer to establish a walk site and invite patients, along with family and friends, to join them for weekly or monthly walks throughout the year. In 2017, the number of sites will increase from 36 to 39 and attract nearly 12,000 participants. Top support in 2017 is generously provided by the TMA Insurance Trust and Prudential. 

The Ernest and Sarah Butler Awards for Excellence in Science Teaching promote the understanding and role of science in our modern society by recognizing a first-place elementary, middle, and high school science teacher and their schools with cash awards. Starting in 2017, second-place teachers will receive a cash award, in addition to the grant their school receives for science curriculum enhancements. The TMAF Ernest and Sarah Butler Endowment for the Recognition of Excellence in Science Teaching provides major support for the 2017 program.

Be Wise—Immunize is a service mark of the Texas Medical Association.

This Month in Texas Medicine

The January issue of Texas Medicine features a preview of the 2017 Texas legislative session, which delves into TMA’s plan to build on significant successes medicine achieved over the past two sessions, including reforming the state’s Medicaid program and expanding graduate medical education opportunities. In the issue, you’ll also find coverage of TMA’s scope-of-practice court victory against the Texas Board of Chiropractic Examiners, an explanation of the final rule to implement the Medicare Access and CHIP Reauthorization Act, and what’s involved in achieving patient-centered medical home status.

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 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

HIPAA Training for Staff and Compliance Officers

MACRA and Medicare: Get Clarity and Direction!

Conferences and Events

2017 TMA Winter Conference
Jan. 27–28, 2017
Hyatt Regency Austin

About Action       

 Action, the TMA newsletter, is emailed twice a month to bring you timely news and information that affects your practice

To change the email address where you receive Action, go to Member Log-In on the TMA website, then click on "Update Your TMA Demographic Information (including newsletter subscriptions and preferences)."

To unsubscribe from Action, email TMA's Communication Division at tmainfo[at]texmed[dot]org.

If you have any technical difficulties in reading or receiving this message, please notify our managing editor, Shari Henson. Please send any other comments or suggestions you may have about the newsletter to Crystal Zuzek, Action

Last Updated On

September 26, 2018