September 18, 2006

TOA President's Update

Whether you volunteer or not to treat workers’ compensation patients, this message is for you. I will be meeting this week with the Texas Division of Workers' Compensation (DWC) Commissioner Albert Betts and other invited guests to discuss update of the Medical Fee Guidelines (MFG). You remember that this important fee schedule was slashed to 125% of Medicare in 2003, precipitating the current crisis in access to care for injured workers. To their credit, Commissioner Betts and Texas Department of Insurance (TDI) Commissioner Mike Geeslin, have recognized the significant need for the MFG to be restored to the levels that reflect current and historic market rates.

The MFG governs the allowable reimbursement for your treatment of injured employees of companies who are voluntarily in the Texas system (subscribers). The MFG applies to both non-network and out-of-network services you provide to subscriber employees whether you are on the Approved Doctor List (ADL) or choose not to participate but still cover the emergency room. The MFG does not apply to those companies and their employees who choose to not join (non-subscribers), who may contract directly with physicians such as you. The MFG also does not apply to contracted services you provide in one of the certified workers’ comp subscriber networks.

The message I will carry on our collective behalf is simple: Restore the MFG cuts now. It is essential that respect be restored for the essential role that Texas orthopaedic surgeons play in promptly returning Texans to gainful employment in an expeditious and optimal manner. Restoring the cuts now will begin to level the playing field, but we all know that it is only one of many steps needed to fix the broken Comp system. My purpose is to provide the voice of reason from the front lines of the treatment battles. If you agree with me, wish me luck. If you disagree, let me know.
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TMLT Declares a 20% Dividend for Renewing Policyholders

The Board of Governors of Texas Medical Liability Trust (TMLT) has declared a 20% dividend amounting to approximately $35 million for 2006 effective January 1, 2007 for renewing TMLT policyholders. Dividends will be credited to each policyholder’s premium as a lump sum when his or her policy renews in 2007.

In addition, the Trust will be reducing rates 7.5% for all specialties across the state beginning January 1, 2007. Current TMLT policyholders will receive this rate decrease when their policy renews. 

TMLT has now reduced annual rates four times since the passage of House Bill 4 and Proposition 12—12% in 2004; 5% in 2005; 5% in 2006; and now 7.5% in 2007, a total of 29.5% in four years. By the end of 2007, TMLT’s rate reductions, since 2004 will amount to nearly $139 million and returned dividends of 25% will amount to nearly $45 million. Since the passage of Prop 12 and medical liability reform of 2003, TMLT policyholders will have realized cumulative savings of over $180 million.
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AAOS Communication Course will be held at the TOA 2007 Annual Meeting

According to an article in the Boston Globe, physicians need to work on their communication skills. Only one in six adults are health-literate says a study by the National Center for Educational Statistics. The fact that most adults have “intermediate” health literacy is problematic since they will have difficulty “using health-related materials with accuracy and consistency.” Many health instructions are not communicated in a language that reflects the way people talk and think. The AAOS Communication Course can help you get through to your patients. The course will be held on Friday morning, May 11, 2007 at the Four Seasons Hotel in Austin. This course earns 4.5 hours of AMA Category credits and qualifies attendees for a 3% premium discount for TMLT policy holders. More details will be coming next month.   [more]
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Capital Bulletin - Fall 2006 Newsletter

In this issue: 

  • Election 2006 Update
  • Issues to Watch
  • Leadership Changes

  • Useful Websites
    [    more]

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Online Forms On TOA Website

Please go to the TOA website at www.toa.org to find online forms such as the Peer to Peer Review forms.  Dr. Andy Kant needs your input.  He has agreed to testify before the Joint Committee on Peer Review on September 27th and he needs your comments.
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