TMA is supporting a physician who wants the Texas Supreme Court to take another look at a breach-of-contract lawsuit in which he claims he was fired without due process.
TMA intervened in support of physicians' right to make clinical decisions "in the best interest of the patient" without "fear of termination."
TMA filed a friend-of-the-court brief in Community Health Systems Professional Services Corporation, et al. v. Hansen, telling the Supreme Court it's important that nonprofit health corporations provide due process when a physician "faces termination based on the physician's medical performance or professional conduct."
According to court filings, Henry A. Hansen II, MD, was terminated three years into a five-year contract with Regional Employee Assistance Program (REAP), a nonprofit health corporation in College Station that employs physicians who practice at for-profit hospitals.
Dr. Hansen’s contract, which ran through April 2012, could be terminated for cause during the first three years or without cause beginning in the fourth year if annual practice losses for years three, four, or five exceeded a certain amount. If the contract was terminated without cause for practice losses, he wasn't entitled to due process rights — but if he was fired for cause, he was entitled to due process.
Dr. Hansen claims that the decision to terminate him was in the works long before the REAP board did so, at the request of hospital Chief Executive Officer Thomas W. Jackson, in February 2010. Mr. Jackson asked the board to do so because of "clinic losses" in 2008 and 2009 and because of "several behavioral problems" he said Dr. Hansen was exhibiting, Dr. Hansen's court filings claim. The REAP board's termination was purportedly without cause.
But Dr. Hansen's filings claim the board wasn't given any information on practice losses for the contract's third year to make its decision, so it was "impossible" for the board to terminate him without cause. The filings say Dr. Hansen didn't learn of the termination until the end of the third year of his contract, more than two months after the board made the decision. He filed suit the following October.
The Supreme Court in June held that REAP had conclusively established that it "complied with the contractual conditions to a 'without cause' termination."
TMA's brief supporting Dr. Hansen's motion for rehearing says the "use of the term 'behavioral problems,' like the use of the term 'disruptive behavior,' often fails to tell the full, or even an accurate, story." TMA says in order to determine whether such conduct "is merely patient advocacy … or is actually patient endangerment," a physician must receive due process.
"Otherwise, physicians may be inhibited from exercising their independent medical judgments and doing what they believe to be in the best interest of the patient due to fear of termination," TMA wrote. "This strikes at the very heart of the prohibition against the lay control of medical practice."
Dr. Hansen requested a rehearing in late July. TMA filed its brief on Aug. 14.
More changes are afoot at the Texas Health and Human Services Commission.
The state agency that oversees state health and human services activities announced last month that it will consolidate several programs while adding four members to its leadership team. TMA staff is assessing how the changes might affect the provision of quality Medicaid, mental health, and public health services in the state.
The changes are the second phase of a planned transformation, Executive Commissioner Charles Smith said in a statement.
Starting Sept. 1, most Department of Aging and Disability Services programs will move to the commission's new Regulatory or Facilities divisions, Mr. Smith said. Also, many of the regulatory functions of the Texas Department of State Health Services and the Texas Department of Family and Protective Services will be transferred to the commission.
Mr. Smith said additions to the leadership team include:
- Enrique Marquez, who will be the new deputy executive commissioner for Medical and Social Services. His new division will include Medicaid and CHIP Services, Access and Eligibility Services, Intellectual and Developmental Disabilities and Behavioral Health Services, and Health, Developmental, and Independence Services.
- David Kostroun, who will take over the newly created role of deputy executive commissioner for the Regulatory Services Division. He will oversee programs such as health care facilities, long-term care facilities, and child care licensing.
- Mike Maples, who will be the commission’s first deputy executive commissioner for the State Facilities Division. He will oversee 10 state hospitals and clinics and 13 state-supported living centers.
The commission is also creating a chief policy officer, who will oversee innovation, performance management, policy development, and data analysis, Mr. Smith said.
Although the rains have stopped, the public health concerns associated with Hurricane Harvey will continue. The knowledge and expertise of Texas physicians will be called upon as hundreds of thousands of people begin to move back into affected areas and rebuild their lives.
Help Reopen Practices Damaged by Harvey
The Texas Medical Association and the TMA Foundation are asking physicians statewide to help their colleagues rebuild or repair practices damaged by Hurricane Harvey.
Make a tax-deductible donation today to support TMA's Disaster Relief Program, administered by the Physicians Benevolent Fund, which provides grants to affected physicians.
"You will receive many solicitations in the coming days to help meet the needs of the thousands of Texans forced out of their homes, and I hope you find it in your heart to support those worthy causes," TMA President Carlos J. Cardenas, MD, said in a letter to TMA members. "But as physicians and friends of medicine, I also hope you will help the Texas Medical Association and the TMA Foundation reestablish patient care in the disaster zone. We don't know yet how many physician practices were damaged or demolished by Harvey, but the widespread damage all the way from Corpus Christi through East Texas tells us that number will be high. Too high. Much too high."
Established originally after Hurricane Rita, the TMA Disaster Relief Program helps cover expenses (not covered by insurance or other funding) related to relocating or rehabilitating a physician's medical office. This may include replacing equipment, aiding needed staff, rebuilding patient records, and other similar costs — all towards the goal of helping physicians once again begin treating their patients.
After Rita and then Ike, TMA's Disaster Relief Program helped physicians meet uncovered expenses such as vaccines, telephone system replacements, signage, and medical laboratory supplies. Thanks to your help, they overcame those obstacles more quickly and got back to taking care of patients sooner.
Thank you for donating to the TMA Foundation, the philanthropic arm of TMA, and supporting "Physicians Caring for Texans."
Note: Contributions are deductible for federal income tax purposes in accordance with applicable law.
Rain Not in Friday Forecast, But Flooding to Continue
The forecast remains dry Friday for areas that have seen catastrophic flooding, according to a situation report from the Texas Department of Public Safety.
Although rains have stopped, flooding is expected to continue in areas near the coast as waters move downstream.
According to the Department of State Health Services, the majority of medical resources have moved out of Houston's NRG Stadium to support patient evacuation and patient care operations in Beaumont and Orange County, where a mobile medical unit (MMU) is expected to arrive Saturday.
New Walmart, Sam's, and Brookshire pharmacy contracts are in place to provide medications in the affected areas, officials say. Three medical shelters are open, though few evacuees remain at those facilities: As of Friday morning, San Antonio had 39 evacuees, Austin had nine, and NRG Stadium had one.
About 1,100 patients have been evacuated or transferred from affected areas, and three MMUs have treated 320 patients, 53 of which have been transferred to hospitals, officials say.
Helpful Links, Resources, and Information on Hurricane Harvey
Over the past week, TMA has sent daily Action newsletters offering information that physicians working in areas affected by Harvey would need. Below are links to those stories and more.
More information on Hurricane Harvey recovery can be found on the TMA's Disaster Preparedness & Response Resource Center.
Physicians looking for more information on Hurricane Harvey can email the TMA Knowledge Center or call (800) 880-7955 or (512) 370-1544.
Physicians who wish to volunteer should register at the Texas Disaster Volunteer Registry or contact the American Red Cross.
The Texas Department of Insurance (TDI) has information for injured employees, health care providers, and workers' comp carriers. TDI also has an online guide for homeowners on filing claims, deadlines, and resources.
The Department of Health and Human Services website contains information on HIPAA and Public Health as well as HIPAA and Emergency Preparedness and Response.
The Department of State Health Services website also contains information on Harvey disaster relief as well as Laboratory Specimen Handling and Newborn Screening Guidance.
The New York Times has published a Q&A on Health Threats From Hurricane Harvey.