Action: May 1, 2017

TMA Action May 1, 2017   News and Insights from Texas Medical Association

Feds Give Texas Millions to Fight Opioid Addiction
Training to Focus on Opioid Prescribing Guidelines
Are You MIPS Exempt? Word Coming Soon
State Issues Meningococcal Disease Alert
Federal Tort Reform Bill Should Mirror Texas Law, Groups Say

Tips for Your Best TexMed Experience
Get Social Savvy at TexMed With KevinMD
Empower Future Physicians in Three to Four Weeks
Beware of Buying, Prescribing Illegal and Unlicensed Drugs
This Month in Texas Medicine

Feds Give Texas Millions to Fight Opioid Addiction

Texas is set to receive an injection of federal dollars as part of a nationwide effort to fight opioid addiction.

The U.S. Department of Health and Human Services (HHS) announced it will issue $485 million in grants to states and territories to combat the evolving epidemic, which was responsible for more than 33,000 deaths in 2015. Texas will receive $27.4 million, the second-largest allocation behind California. The funds were awarded based on overdose death rates and unmet need for treatment.

Of the states receiving the five largest amounts, Texas' 2015 opioid death rate of 9.4 per 100,000 population was by far the lowest, according to statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics.

In a letter to governors, HHS Secretary Tom Price, MD, said the money will support prevention, treatment, and recovery services, depending on recipients' specific needs.

"As I begin my tenure as secretary of the Department of Health and Human Services, I do so with a profound commitment to addressing this public health crisis as one of our top three departmental priorities," Secretary Price said. "Through a sustained focus on people, patients, and partnerships, I am confident that together we can turn the tide on this public health crisis."

Although funding this year was disbursed immediately, Secretary Price asked governors to work with HHS to identify best practices, lessons learned, and key strategies so that funds disbursed in 2018 can be used more effectively.

"My intention for the second year is to develop funding allocations and policies that are the most clinically sound, effective, and efficient," Secretary Price said. 

For more information about the grants and the nationwide effort to combat opioid addiction, see the HHS website

Training to Focus on Opioid Prescribing Guidelines

The U.S. Centers for Disease Control and Prevention (CDC) has launched an online training series to help clinicians apply its opioid prescribing guidelines for adults with chronic pain.

The eight-part series is designed to help physicians better understand the recommendations as well as the risks and benefits of prescription opioids, nonopioid options, risk management, and more.

"More than 40 people die every day from prescription opioid-involved overdose," CDC said. "The CDC Guideline for Prescribing Opioids for Chronic Pain provides recommendations for safer and more effective prescribing of opioids for chronic pain in patients 18 and older in outpatient settings outside of active cancer treatment, palliative care, and end-of-life care."

The interactive modules include patient scenarios, videos, tips, resources, and more. The series starts with an overview of the CDC guidelines. Future modules will cover communicating with patients, treating chronic pain without opioids, reducing the risks of opioids, and assessing and addressing opioid use disorder. 

For more information and to see modules that are available and proposed throughout the year, visit the CDC website.

Are You MIPS Exempt? Word Coming Soon

Physicians, check your mailboxes to find out whether you are eligible or exempt from the Merit-Based Incentive Payment System (MIPS) for the 2017 performance period and what that may mean for your 2019 Medicare payment rates.

The Centers for Medicare & Medicaid Services (CMS) has begun sending letters to individual and group practices that say which clinicians associated with a taxpayer identification number are eligible for the program and which are exempt. The 2017 performance period began Jan. 1.

MIPS is one of two payment paths under the new CMS Quality Payment Program, which is part of the Medicare Access and CHIP Reauthorization Act (MACRA). It replaces the Sustainable Growth Rate formula and consolidates the Physician Quality Reporting System, the Value-Based Payment Modifier program, and Medicare's electronic health records incentive (meaningful use) program into one single program this year. 

In 2017, CMS will exempt physicians from MIPS if they: 

  • Are in their first year of Medicare Part B participation;
  • Are part of an advanced alternative payment model; or 
  • Care for 100 or fewer Medicare Part B patients or bill Medicare less than $30,000 in Part B-allowed charges each year.  

CMS estimates that about 41 percent of clinicians will be exempt from participating in MIPS in 2017. "Eligible clinicians in small practices are much more likely to be excluded from MIPS than those in larger practices," CMS says. "For example, more than half (51.6 percent) of eligible clinicians in practices of one to nine clinicians will be excluded from MIPS, whereas about one-fourth (27.3 percent) of eligible clinicians in practices of 100 or more clinicians will be excluded."

For questions about your eligibility and exemption status or other information in your letter, contact the CMS Quality Payment Program Service Center by phone at (866) 288-8292 or by email. If you are not exempt from MIPS, you can turn to TMA and the TMF Health Quality Institute for help.  

  • For information about your participation options and simplest ways to avoid the 2019 MIPS penalty, refer to this Action article
  • For MACRA education, attend the education tracks on Quality Payment Programs in Today's Practice, May 5-6 at TexMed 2017, hosted by the TMA Councils on Health Care Quality and Practice Management Services. Registration is free for TMA members. 
  • For a MACRA readiness assessment and customized on-site assistance to help you with your practice's specific needs, contact TMA Practice Consulting by phone at (800) 523-8776 or by email. The assessment will focus on clinical processes, electronic health record optimization, and workflow improvement opportunities to help increase your MIPS scoring. TMA is dedicated to working with you and your practice to earn an incentive payment, not just avoid the penalty.  
  • For MIPS education and technical assistance, join the TMF Quality Payment Program Network or contact TMF by email.  

For more information, visit the TMA MACRA Resource Center

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State Issues Meningococcal Disease Alert

The Texas Department of State Health Services (DSHS) is investigating a case of possible exposure to meningococcal disease at a Houston event in mid-April that had thousands of attendees, DSHS announced in an alert through the Texas Public Health Information Network.

DSHS announced a laboratory-confirmed case of invasive Neisseria meningitidis in a person who attended the Bunnies on the Bayou social event on April 16. N. meningitidis is the bacteria that causes meningococcal disease. Event organizers say the event's attendees came from multiple states.

Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the meninges that affects the brain membrane, according to the World Health Organization. Symptoms include a stiff neck, high fever, sensitivity to light, confusion, headache, and vomiting. 

The patient's high-risk close contacts have been identified, and the patient has received postexposure prophylaxis, according to the alert. But other people who attended the event could be at risk. People who can report cases of possible exposure are asked to contact DSHS via the state's all-hours Disease Reporting Line at (800) 705-8868.

Federal Tort Reform Bill Should Mirror Texas Law, Groups Say

Physicians, hospitals, and other health care providers throughout Texas would lose substantial protections against frivolous medical lawsuits if a bill working its way through the nation's capital becomes law, two Texas medical groups say.

In a letter to U.S. Rep. Michael Burgess, MD, (R-Texas), the heads of TMA and the Texas Alliance for Patient Access (TAPA) urge that HR 1215, the Protecting Access to Care Act of 2017, be as closely aligned to Texas standards, which are "considered by many to be the 'gold standard' in state medical liability law."

The organizations are concerned that state flexibility language in HR 1215 would be too easy to amend or delete and that many of the protections that have been upheld by Texas courts could be relitigated outside of the state.

Further, the organizations ask that health care liability claims covered by the legislation be directly related to health care and that the statute of limitations for the start of a lawsuit be defined in more specific terms.

The organizations seek to protect a sweeping package of medical lawsuit reforms that became Texas law in 2003. 

Those reforms have contributed substantially to the health and well-being of Texas residents by reducing frivolous lawsuits, attracting large numbers of physicians to the state, and allowing hospitals and nursing homes to expand their services. 

"As HR 1215 makes its way through the legislative process, we will be requesting your help in improving the bill," said TMA President Don R. Read, MD, and TAPA Board Chair Howard Marcus, MD. "We offer our organizations as resources as to how medical malpractice reforms in Texas have benefited patients and doctors, and look forward to working with you and your staff on this important legislation."

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Tips for Your Best TexMed Experience

TexMed takes place this week (May 5-6 in Houston). To help attendees make the most of this conference, TMA has compiled a few essential tips and resources. If you haven't registered, you can do so on site. TexMed is free to TMA members and offers more than 80 hours of free continuing medical education (CME) programming. If you're still on the fence, check out these Top Three Reasons to Attend

What to Do? There's an App for that! Download the TexMed 2017 Meeting App or the Onsite Program Book to plan your itinerary and view all TexMed events and meetings. Staying in Houston? For the latest attractions this weekend, check out Visit Houston

There's More Than One Reason to Attend. Some attend TexMed primarily for business meetings, others for CME and EXPO. Regardless of your interests, don't leave until you've experienced everything TexMed has to offer. Highlights include:  

  • Free lunches Friday and Saturday in the EXPO. Tickets included with registration.
  • Free 15-minute practice help consults Friday and Saturday.
  • Keynote speakers — William H. McRaven, chancellor of The University of Texas System; Kevin Pho, MD,; and Pete Blair, PhD, executive director of ALERRT.
  • EXPO — Visit the Disaster Preparedness Pavilion, and then explore the latest medical devices, technology, practice services, and pharmaceuticals.  

Road Closures and Parking. Expect road closures Saturday for the Cinco de Mayo parade. We recommend arriving at the Avenida Houston (Discovery Green) parking garage before 8:30 am and leaving after the Closing General Session at 2:30 pm to avoid traffic. Use the parking flyer for a map of garages and associated costs.  

What to Bring? Pack a light jacket or sweater, and wear comfortable shoes for walks between CME programs, business meetings, and the EXPO. Business cards are also a must. Attendees receive a free conference tote, and charging stations are available in the EXPO Physician Lounge, so bring your charger.

We're excited to see you at the brand new Houston Marriott Marquis and the George R. Brown Convention Center. For more information about how to get to TexMed and where to park, visit TexMed Travel.

Get Social Savvy at TexMed With KevinMD

Kevin Pho, MD (aka KevinMD), will host a Social Media Meet and Greet from 2:30 to 3 pm on Friday, May 5, in the TexMed 2017 EXPO hall at the George R. Brown Convention Center before his Opening General Session talk at 4 pm. 

Can't attend in person? We'll be using Facebook Live to broadcast the event on the TMA Facebook page. Tune in at 2:30 pm to hear Dr. Pho speak and to submit any social media-related questions you have for him via Facebook. 

Dr. Pho, a social media expert and coauthor of the book Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices will present his talk, "Connect and Be Heard: Making a Difference in Health Care With Social Media," during the TexMed Opening General Session on Friday. 

TMA will record both Dr. Pho's "Connect and Be Heard" presentation and the "Physicians in the Age of Terrorism" address by University of Texas System Chancellor William H. McRaven, who is well-known for his former life as a U.S. Navy four-star admiral. Both will be posted on the TMA YouTube channel shortly after the conclusion of TexMed 2017.

Empower Future Physicians in Three to Four Weeks

Follow in the footsteps of the physicians who influenced your work in primary care. Sign up to serve as a physician mentor for the 2017 General Internal Medicine Statewide Preceptorship Program (GIMSPP), hosted by the Texas Chapter of the American College of Physicians (ACP). 

Each summer, GIMSPP preceptors open their practice doors to provide a medical student with personal instruction, training, and supervision for three to four weeks. Hundreds of eager students from across the state have already signed up to be matched. You can support these budding physicians by providing hands-on guidance before the start of their residency, which in many cases commits them to working in primary care. Sign up to submit your availability today.

This year, preceptors may receive $100 off annual ACP dues through the Texas chapter, as well as one of the following incentives, based on availability:  

Preceptors must be board certified in internal medicine and possess a current Texas medical license with no restrictions from the Texas State Board of Medical Examiners. 

For more information, visit the GIMSPP guide.

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Beware of Buying, Prescribing Illegal and Unlicensed Drugs

TMA reminds physicians and providers that buying medical devices and drugs from illegal or unlicensed sources not only puts patients in danger but also can result in criminal charges, fines, and jail time.

"Since 2012, the U.S. Food and Drug Administration (FDA) has notified nearly 3,500 physicians that their drug purchasing practices might be illegal," the FDA said in a statement. "The U.S. Department of Justice has successfully prosecuted more than 95 corporations and individuals, including physicians, for criminal charges related to selling unapproved drug products, or receiving and administering unapproved drug products to patients."

Texas examples have included physicians purchasing misbranded products or medical devices from outside the United States not approved by the FDA. Other physicians have unknowingly bought products from a distributor not licensed and not authorized to do business in Texas or the United States.

The Texas Attorney General's Office generally says receiving and using unapproved drugs or devices violates the Texas Deceptive Trade Practices Act, which is punishable by a fine of up to $20,000 per violation, plus an added penalty of up to $250,000 if the affected consumer is older than 65. Physicians also can find themselves facing violations of the Texas Food, Drug, and Cosmetic Act, which carries a civil penalty of up to $25,000 a day for each violation.

Physicians can verify all drug distributor and in-state medical device distributor licenses online through the Public License Search feature provided by the Texas Department of State Health Services (DSHS) Division of Regulatory Services. 

DSHS recommends physicians verify that distributors of medical devices located outside Texas are lawfully engaged in the wholesale or retail distribution of such devices in their resident state.

The FDA provides online services for physicians to verify a wholesale distributor or report suspicious activity.

Physicians may contact the TMA Knowledge Center with any questions and concerns about buying and prescribing wholesale devices and drugs. The knowledge center can be reached at (800) 880-7955 or by email.

This Month in Texas Medicine

The May issue of Texas Medicine takes a look at The University of Texas at Austin Dell Medical School and its unique curriculum that practically does away with traditional lectures and focuses instead on solving problems and working together with other health care professionals. The May issue will also include stories about the rise in locum tenens doctors taking the places of permanent physicians, the early promise seen in the trend away from fee-for-service and toward value-based payment models in the Texas Medicaid program, and TMA’s recommendations to the legislature to address doctor-shopping and opioid diversion.

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.  

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. 

Medicaid EHR Incentive Program Attestation Deadline for 2016 Participation

Texas Franchise Tax Returns Due

Office-Based Lab Financial Reporting

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.  


The Best Front Desk: Transforming Customer Service
April 11-May 25
Live webcast: May 25

On-Demand Webinars

Innovation in Education for Cardiovascular Risk Patients: Heart Healthy Diet and Lifestyle

Making Discussions About Death and Dying Easier

HIPAA Training for Medical Office Staff

Conferences and Events

TexMed 2017 
May 5-6

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Last Updated On

May 01, 2017