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TOA
President's Update
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By
David Teuscher, MD
President, Texas Orthopaedic Association
The collective sigh of relief you heard from the TOA office
last week was in reaction to the Texas Division of Workers'
Compensation finally announcing plans to delay, indefinitely,
the requirement for filing a treatment plan for non-network
workers' compensation patients. Facing a May 1st
deadline announced by the Division in December, we have
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been scrambling to inform you of what was coming down the tracks.
All
the while we were relating to the TDI and DWC Commissioners that our
doctors were not familiar with their adopted treatment and disability
guidelines, let alone ready to start filing a “treatment plan” and
complying with additional administrative burdens.
What we were able to avoid having to do beginning on May 1st
is that a treatment plan would have been required when treatment or
services were expected to exceed or were not included in the adopted
treatment guidelines, and the services or treatment were expected to continue for
more than 60 days from the date or injury or the optimum days listed
in the guidelines. The plan would have also been required when a diagnosis
was not included in the treatment guidelines or protocols and if the
workers' compensation commissioner determined that a treatment plan
was
needed. When a plan is required, the treating doctor must identify
"all reasonably anticipated health care to be provided" for a minimum
of 30 days and must submit the plan to the carrier for
preauthorization.
If isn't a definition of “administrative burden” in Webster’s,
it should now be added. Being required to now unilaterally
predict all future care needed, in light of guidelines for disability
and treatment that we are unfamiliar with and that have not been subjected
to a controlling intellectual authority, defies all logic. We will be
asking the DWC to delay any new administrative burdens until they have
implemented an update of the Medical Fee Guidelines in October 2007.
If you want more information about treatment planning and disability
management you can find it on the on the DWC’s Web site by clicking
here.
I hope you understand the gravity of the situation we have
temporarily avoided and will consider attending the TOA Workers
Compensation Symposium on Friday afternoon May 11th as part
of our Annual Meeting at the Four Seasons in Austin. DWC Commissioner
Albert Betts, the new DWC Medical Director Dr. Howard L. Smith and
Norman Darwin of the Office of Injured Employee Counsel have all been
confirmed as speakers. You will not want to miss it, so adjust your
schedule and plan to be with us in Austin May 11-13th.
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Texas
District by District:
Ellen Cohen
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On Nov. 7th, Ellen Cohen was elected to the Texas House of
Representatives with 55% of the vote and by the largest margin of any
challenger to an incumbent in Texas. District 134 includes all of
Bellaire, West University, River Oaks, Rice University and the Texas
Medical Center, along with parts of Meyerland and Montrose. During the
80th Legislative Session, she is focusing on the Children’s Health
Insurance Program, fighting for Stem Cell Research, and improving
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Ellen
Cohen has lived in District 134 since 1977. For the past 16
years, she has been President and CEO of the Houston Area
Women’s Center, which is dedicated to eliminating domestic
and sexual violence. In that capacity she leads an over $6
million, 120 person staff serving over six thousand women,
children and men.
Ellen and
her late husband, Lyon, moved to Houston with their two
children, Marcie and Eric, in 1977. Shortly thereafter she
began serving as executive director of the American Jewish
Committee. For ten years she worked with the leadership from
Houston’s diverse religious and business communities to
foster mutual understanding and tolerance for one of the
nation’s premiere human relations organizations.
Before
moving to Houston, Ellen and her family lived in Lyon’s
hometown of Montreal where she founded Reach to Recovery of
Canada. This self-help post-mastectomy group was started two
years after her own breast cancer surgery. Allowing women in
hospital rooms to help other women was a completely foreign
idea. By virtue of Ellen’s leadership and persistence the
program was in all Montreal hospitals by the time the Cohen
family left Quebec.
Ellen has
been the recipient of numerous awards including “Women of
the Year Award” The Shattered Glass Award; Women on the
Move; Celebration of Life Honoree; Leadership Houston
Distinguished Alumnus Award and the American Jewish
Committee’s Human Relations Award. She also serves or has
served on the Boards of Congregation Beth Israel; Faith
Trust Institute; American Jewish Committee; American
Leadership Forum; Houston Area Adult Protective Services and
the National Violence Against Women Advisory Task Force. She
was been elected to several leadership positions, including
President of Leadership Houston, President of the
Association of Executive Directors of the United Way, and
President of HCA Medical Center Hospital Board.
Email
Ellen Cohen to thank her for her work!
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This Week In Texas: Mignon
McGarry Memos
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By Mignon McGarry
TOA Legislative Advocate / Memos: Thu Mar. 22 & Tue
Mar. 20, 2007
TOA Online Version: All Memos
March 29, 2007, Thursday
Today the House is considering their budget bill and we expect
them to work into the early morning hours of Friday. While
there is a lot of angst
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about what items get in or are kept
out of this bill, keep in mind that the Senate will also submit a budget
bill and the differences will be ironed out in a conference committee
consisting of five Representatives and five Senators.
As further proof that the
legislature is hard at work, three bills have passed both the House and
Senate and have been signed by Governor Perry.
The three “it’s not even Easter yet” bills are:
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SB 78 by
Sen. Jeff Wentworth (R-San Antonio), known as the Castle
Doctrine, authorizes the use of deadly force in defense of a
person.
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HB 2061 by
Rep. Jim Keffer (R Eastland) relating to the acquisition or
disclosure of the social security numbers by a governmental
body.
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HB 542 by
Rep. Dennis Bonnen (R-Arlington) regarding the name of the
Brazos River Harbor Navigation District.
March 27, 2007, Tuesday
Monday was the deadline for filing floor amendments to the
House Appropriations bill which will be on the House floor for
debate Thursday. Currently there are 200 amendments that will be
debated.
The purpose of that deadline is to smooth out the logistics of
queuing up amendments and culling duplicates, there will still
be plenty of room for amendments to the amendments during
Thursday’s floor fight.
Thursday will be a long day for the House, but we expect them to
pass a budget bill sometime late Thursday or early Friday
morning.
The rest of the real action is taking place in both House and
Senate committees. Now that virtually all bills have been
referred to committee, the committees have a firm idea of their
workload and the fun has begun.
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AAOS
Files Amicus Brief On MRI Issue In Maryland
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The American Association of Orthopaedic Surgeons (AAOS) has filed an
amicus brief in a case involving the Maryland Self Referral Law. The
case, Potomac Valley Orthopaedic Associates et al. v. Maryland State
Board of Physicians, is an appeal of a declaratory ruling of the
Maryland
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State Board of Physicians (Board). In 2006, 13 years after passage
of the Self Referral Law, the Board ruled that physicians could not
refer patients for tests to be conducted on magnetic resonance imaging (MRI)
equipment that the physician owned or leased.
Insurance carriers have since indicated that they will seek refunds
from physicians who were paid for such tests conducted in violation of
the Self Referral Law. The AAOS argues that the ruling is unnecessary
and contrary to a federal policy determination and medical community
views. The Board's response is expected in 30 days. A PDF file of the
ruling can be viewed by clicking
here.
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T-BONES Annual Meeting
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T-BONES
Annual Meeting
Michael Berkowitz, KSF Orthopaedic Center
I am
pleased to announce the Spring Meeting of the Texas
Orthopedic Administrators Association (T-BONES) will be held
Friday, May 11th,
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2007 at the Four Seasons Hotel in Austin. In addition, there will be a
4 hour, Billing and Collections Course, for T-Bones Members and Office
Staff on Thursday, May 10th from 1PM – 5PM. On Thursday
evening T-Bones Members have been invited to a dinner hosted for our
members by Genzyme Biosurgery, which will be held at a location near the
hotel.
T-Bones will he held
in conjunction with the
Texas Orthopedic Association (TOA)
Annual
Meeting. All T-Bones attendees are invited to participate in the TOA
meetings and events (May 10th and 11th). I will be email
to you the
TOA program.
I have received
commitments from speakers who will provide valuable information to our
group. They will address a variety of relevant topics.
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Kelly Cronsell is Regional Vice President of Real Med Corporation.
Kelly will be speaking about “What they didn’t tell you in revenue
cycle management school.”
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Kurt Mosely is Vice President of Business Development for
Merritt, Hawking and Associates. He will be discussing “How to
recruit Orthopaedics in today’s marketplace.”
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Kevin Ward. Is Chief Executive Officer for Iowa Orthopaedic
Center, PC in Des Moines, Iowa? He will be speaking about “Incentives
to Support Staff in the Clinic and ASC.”
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Voncil Webb is a Senior Consultant for Department B. She will be
talking about “Credentialing”.
I am enclosing a tentative program as well as a registration form, which
give additional information about this meeting. The expense for the
Friday, May 11th, meeting is $75, which includes breakfast and lunch.
Please send your registration form as soon as possible
since I must notify the hotel of the number of registrants. The meeting
will be held at
Four Seasons Hotel. The hotel has agreed to reserve a
block of rooms under the name of TOA for those interested
individuals, but there is a deadline for reserving rooms at the
convention rate. Reservations need to be made through the hotel
512-478-4500.
Please contact me at 281-440-6960 (office) or 713-728-4882 (home) if you
have any questions concerning this information. I hope you will be able
to attend this most important meeting. Thank you for your time and
cooperation.
Sincerely,
Michael A. Berkowitz
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WWII Orthopaedic
Surgeons Honored in 'Legacy of Heroes' Exhibit
At The Texas State Capitol in Austin
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A traveling
exhibit honoring the contributions of orthopaedic surgeons
during World War II will be available for viewing at the Texas
State Capitol in Austin May 7-11th.The public is invited to
view the Legacy of Heroes exhibit at no charge.
The Legacy of Heroes exhibit, commemorating the
contributions of orthopaedic surgeons during WWII, will be in
the ground floor rotunda in the main Capitol building (as
opposed to the extension). The ground level is one level below
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The American Academy of Orthopaedic Surgeons developed the
Legacy of Heroes exhibit and supporting web site and book to
preserve the wartime stories of its members and the advances in
orthopaedic surgery during WWII.
More than 100 orthopaedic surgeons - all World War II veterans now in
their 70s and 80s - were interviewed to record and preserve their
individual experiences. The multimedia traveling exhibit showcases
individual veterans through photographs and personal memoirs.
Many of the veterans entered the war as medics or litter-bearers and
then were pushed forward as necessary to treat the wounded. Often they
received formal training as orthopaedic surgeons after the war. The
sheer number of the wounded created opportunities to attempt bold new
surgical techniques. The intricacies of hand surgery, prosthetics and
spine surgery were developed and refined as orthopaedic surgeons
treated tens of thousands of casualties.
The Legacy of Heroes exhibit runs through Friday, May
11th. The Legacy of Heroes Video will be featured during the Texas
Orthopaedic Association’s Annual Meeting May 11-13 and the Member
Reception on Friday evening at the Four Seasons Hotel. TOA’s program
is also featuring a presentation by Col James R. Ficke, MD, BAMC,
entitled "From Iraq - Back To Iraq: Modern Combat Orthopaedic
Care".
From Iraq—Back
to Iraq: Modern Combat Orthopaedic Care
Please join us for the TOA Annual Member Reception, May 11th, 7 pm to
9 pm at the Four Seasons Hotel in Austin.
During 2007 TOA Annual Member Reception Col. James R. Ficke, MD will
tell the story… “From Iraq—Back to Iraq”… of military traumatologists
focused on the challenges and results being achieved with today’s
modern orthopaedic techniques.
Approximately 70 percent of war wounds are musculoskeletal injuries;
55 percent are extremity wounds. Fractures account for 26 percent of
injuries, and 82 percent of them are open fractures. The likelihood of
surviving battlefield wounds was 69.7 percent during World War II, but
had risen to 76.4 percent by the end of the Vietnam War. Today, the
likelihood of survival for those wounded in the current Iraq War has
increased to an astounding 90.4 percent. Still, the extremity injuries
coming out of Operation Iraqi Freedom and Operation Enduring Freedom
have been devastating. The fact that these injuries take place in an
austere and dangerous environment, with limited resources, only adds
to the challenge.
For more information please see the Legacy of Heroes
exhibit by clicking
here.
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