Spring 2016  

Join Your Colleagues in Dallas for TexMed 2016 

TexMed 2016, TMA’s annual meeting, is just around the corner. Join us from April 29 to 30 at the Hilton Anatole in Dallas, where we will explore Bridging the Gaps in health care. Make your hotel reservations today, and be sure to mention the TexMed conference. 

Physician leaders of different specialties from across the state come to TexMed to learn, network, and shape the future of Texas medicine.  

At TexMed you can choose from more than 80 hours of free CME programming. Topics include everything from business operations and the future of medicine to quality initiatives and performance improvement. 

Conference attendees also can help mold TMA policy and business decisions by heading to the House of Delegates and participating in reference committee meetings. All TMA members can testify at the reference committees on resolutions presented before the house.  

And the EXPO provides a great way to see the newest in medical devices, technology, and practice services. Sign up for a free, 15-minute Quick Consult at the TMA Member Services booth #263 and meet face-to-face with TMA staff experts to ask specific questions on various topics, or to address your general practice needs. 

TexMed is a free member benefit, but it’s not just for physicians. Your practice manager and front office staff can benefit from attending TexMed 2016, too. Register today, or check out the Advance Program for more information.  

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Don’t Miss the Young Physician Section Meeting at TexMed 2016

Join us for the next TMA Young Physician Section Business Meeting on Friday, April 29, at the Hilton Anatole in Dallas during TexMed 2016. Conference attendance is free for TMA members. 

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 TMA-YPS to Elect Executive Council Members During TexMed 2016

The TMA Young Physician Section (YPS) elects Executive Council members annually to direct section activities. Take part in elections for the 2016-17 term during TexMed 2016 on April 29. To apply for an open position, submit a letter of intent and CV to your section coordinator

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 Apply for 2017 TMA Leadership College Class by July 1

The TMA Leadership College (TMALC), established in 2010, is part of TMA's effort to ensure strong and sustainable physician leadership within organized medicine. TMALC graduates serve as thought leaders who can close the divide among clinicians and health care policymakers, and as trusted leaders within their local communities.

To apply for the TMALC class of 2017, submit an application, two reference forms, and any other supporting material requested to leadershipcollege@texmed.org by July 1, 2016. For more information, read the program overview, and review the application process and criteria. And check out the 20 young physician graduates of the TMALC class of 2016.

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TMA’s Plan Preserves Physicians’ Billing Rights

The TMA Board of Trustees has approved and sent to the TMA House of Delegates a plan to preserve physicians’ right to bill for their services. Quite a few other states, some members of Congress, and the Obama administration have enacted or proposed legislation that would severely limit or prohibit physicians from billing patients for services provided out of network. The board-appointed Task Force on Balance Billing, which included hospital-based physicians and representatives of several other specialties, devised the plan. 

Board member Keith Bourgeois, MD, a Houston ophthalmologist, chaired the group. Striving to “align [physicians] with the best interests of our patients” and “address the behaviors of insurers that finance health care and apply to all practitioners involved in patient care,” the report recommends:  

  • That TMA “ardently pursue legislative goals” in existing policy designed to “hold insurers accountable for their actions”;
  • Extending mediation for out-of-network billing disputes to patients at all facilities — for all practitioners and all facilities — while maintaining the $500 threshold for mediation;
  • “Mandatory increased state agency oversight of insurers that are often brought to mediation”;
  • For planned surgical procedures or labor and delivery, “development of a standard form for physicians to disclose to patients the identity of other physicians or nonphysician practitioners typically utilized in the facility”; and
  • Continued monitoring of current and proposed laws that rely on large billing databases to set benchmarks or billing standards. 

TMA expects Texas insurance companies and their allies to push a balance billing ban in the 2017 legislative session. TMA’s plan involves extensive public and patient education on insurance industry tactics — narrow networks and arbitrary “maximum allowables” — that increase the likelihood of patients needing services out of network and push more charges onto the patients. 

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TMA Workshop Focuses on E&M Coding Made Easy

E&M services are the target of many audits by government and commercial payers. While other services may have higher claim dollar amounts, E&M services are the overwhelming leader by volume of services billed and a huge target for audits. To keep audits at bay, TMA is offering professional coders a full-day coding workshop for office staff — E&M Coding Made Easy, April 19 in Austin from 8:30 am to 4:30 pm CST— presented by auditing expert Shannon Deconda. TMA also will offer a webcast specifically for physicians — E&M Services From the Physician Perspective — from 6 to 8 pm CST April 19.  

Completion of the E&M documentation and coding seminar will help professional coders and physicians:    

  • Establish medical necessity for the level of service provided,
  • Lower the risk of payment recoupment and audits, and
  • Get paid what is due the first time.    

The workshop will delve into how payers mine physicians’ billed levels of services to identify and focus audits on overutilized codes.  

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  New Mexico Law Protects Patients’ Access to Care in Texas

Texas doctors will continue to receive a full range of liability protections even when treating New Mexico patients. That issue was in doubt until the New Mexico Legislature took decisive action Feb. 17. 

The legislation preserves vital access to Texas physicians and hospitals for residents of Eastern New Mexico who routinely cross the state line for care. The Texas Alliance for Patient Access (TAPA) says the New Mexico Legislature recognized access to health care is a public policy priority. Without legislation, thousands of patients would lose ready access to primary and specialized care, said Howard Marcus, MD, TAPA chairman. 

Under the legislation, the medical liability laws of the state in which a patient received care now will govern cases involving New Mexicans seeking medical care across state lines, provided the patient signs a written consent before receiving treatment. The House and Senate passed the bill unanimously. Gov. Susana Martinez signed the measure into law on March 3. 

The new law is good news for Texas because the state’s doctors and hospitals have expressed a reluctance to treat visiting New Mexico patients. That followed a New Mexico court ruling that questioned where and under which state laws a suit can be filed if an alleged medical mishap occurs. That case, Montano v. Frezza, is pending before the New Mexico Supreme Court. (Read “Border Battle” in the November 2015 issue of Texas Medicine.)  

For Texas doctors, this meant accepting increased liability risk and costs when treating New Mexico patients. Consequently, many Texas doctors and hospitals were reconsidering their willingness to accept the transfer or referral of a New Mexico patient for elective care. 

The New Mexico law has big implications for access to care in the state. According to the American Medical Association, the Eastern New Mexico counties of De Baca, Guadalupe, Harding, Quay, Roosevelt, and Union have no cardiologist; no neurologist; no plastic surgeon; no orthopedic surgeon; no radiologist; and no ear, nose, and throat doctor. Of those counties, only Roosevelt County has an oncologist. 

Recent data from the New Mexico and Texas departments of health show 13 counties in Southern and Eastern New Mexico send more than 22 percent of their hospitalized patients to Texas for care. 

For a detailed look at the new law, see the June issue of Texas Medicine

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Become More Business Savvy with Help from TMA

Visit TMA’s new Business of Medicine resource page for information and education on the fundamentals of the business side of medical practice, including contract negotiation, human resources management, financial policies, and more. Read more about life after residency in the April issue of Texas Medicine

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Stay Connected 
Keep up with important news, and connect with colleagues across the state through TMA’s Young Physician Section webpage

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