June 2, 2008
 

 
TOA President's Update:  Changing Of The Guard
  

Introducing our 2008-2009 TOA President, Timothy L. Beck, MD, of Tyler

Dr. Tim Beck was elected President of the Texas Orthopaedic Association during its 72nd Annual Meeting, held May 22-24, at Westin Riverwalk Hotel in San Antonio. Dr. Beck also serves on the Board of Councilors of the American Academy of Orthopaedic Surgeons and is a founding member of the Texas Orthopaedic Foundation.

Specializing in foot and ankle, Dr. Beck is currently an orthopaedic surgeon in practice at Azalea Orthopedics Clinic in Tyler. After earning his medical degree from the University of Texas Health Science Center in San Antonio, Dr. Beck completed his orthopaedic residency at the University of Tennessee-Campbell Clinic. He also completed a fellowship in Foot & Ankle Reconstructive Surgery at the University of Texas at Houston under Thomas Clanton, MD.

"I am honored to serve as President of TOA. Our organization is one of the strongest state orthopedic associations in the country and continues to be a leader in representing the members on a statewide and national basis." - Tim Beck, MD
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CMS Has Announced A New Acute Care Episode (ACE) Demonstration
     

CMS has announced a new Acute Care Episode (ACE) demonstration for hospitals, designed to align financial incentives across providers and offer flexibility to hospitals and physicians by bundling all related inpatient services into an “episode of care.” The ACE demonstration is scheduled to begin operation in January 2009.

CMS plans to start a three year program which will bundle payments for

physicians and hospitals in four states which includes Texas.  Part A and Part B payments will be bundled as one payment in the ACE program. The payment will go to a physician-hospital organization (PHO).  Each PHO, formed by hospitals and physicians, will then decide how much of the bundled payment goes to each group.  It will include all services rendered during the inpatient stay.  All nine orthopaedic inpatient surgical services are limited to hip and knee replacement surgeries. 

Hospitals and physician groups will bid through a PHO.  If you are not a member of the PHO and your hospital PHO gets the DEMO project, you will need to either negotiate an agreement with the PHO or do your procedure elsewhere. 

A PHO is defined as an affiliation between a hospital and with at least one physician group. Also, applicants must:

1.      meet particular procedure volume thresholds

2.      have established quality improvement mechanisms, and

3.      be located in Medicare Administrative Contractor (MAC) Jurisdiction 4 (Texas, Oklahoma, New Mexico and Colorado)

In addition, to qualify applicants must have also received the full IPPS annual payment update for reporting quality measures to CMS since at least fiscal year 2006. Eligible applicants are required to continue participating in quality data collection efforts throughout the demonstration and meet additional quality reporting and monitoring standards as specified on the ACE demonstration webpage.

CMS plans one demo site for each of 15 markets across the 4 states (Texas, Colorado, New Mexico, and Oklahoma).
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This Week In Texas: Mignon McGarry Memos

By Mignon McGarry
TOA Legislative Advocate
TOA Online Version: All Memos

 

May 28th, Wednesday

Of interest to physicians concerned with scope of practice issues, the Third Court of Appeals has denied a Motion for Rehearing in a case

involving a rule defining the word “foot” adopted by the Texas State Board of Podiatric Medical Examiners.  The ruling by the Court reversed a decision by a Travis County District Court and declared the rule invalid.  The full text of the recent opinion can be accessed by clicking here.

Former Democratic Congressman and candidate for Governor Chris Bell announced that he is considering a run for Senate District 17, currently held by Sen. Kyle Janek (R-Houston). Two other Republicans are considering the race as well: Houston lawyer Grant Harpold, a precinct chairman, and Houston money manager Austen Furse. The district covers parts of six counties in the greater Houston area.  Senator Janek is said to be working on his resignation letter as we speak to coincide with his previously announced June 2nd departure date.

In addition to attending political conventions this summer, state legislators will be attending summer legislative conferences to discuss key issues with their counterparts from other states.  The Southern Legislative Conference (SLC) will meet in Oklahoma City from July 11th through July 15th.  The National Conference of State Legislatures (NCSL) will hold its 2008 Legislative Summit in New Orleans from July 22th through July 26th.  Finally, the American Legislative Exchange Council (ALEC) will hold their annual meeting in Chicago July 30th through August 3rd.  Each of these groups develops model legislation on certain topics that sometimes provides the base for legislation here in Texas. 
 

May 21th, Wednesday
Despite the sudden rise in temperatures, the level of activity at the Capitol shows no sign of waning. Senate and House committees are busy holding hearings in Austin and other cities around the state. State agencies are hard at work preparing their legislative appropriation requests (LAR). At this point, the issues that seem to be headed for the center stage when the Texas Legislature reconvenes in January of 2009 include the franchise tax, transportation, health care and the development and regulation of energy.

Rep. Nathan Macias (R-Bulverde) has withdrawn his lawsuit challenging the results of the March primary vote. Macias lost to Doug Miller by 17 votes. Miller will now face Democrat Daniel Boone in the November election for House District 73.

Rep. Roland Gutierrez (D-San Antonio) was sworn in on May 14th as the new representative for House District 119. Since Gutierrez was the only candidate who filed for the special election to finish out the term of former Rep. Robert Puente, the election was cancelled and Gutierrez declared the winner. Gutierrez will run unopposed on the November ballot for a full term in the District 119 seat.
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The Final Judgment Of The 3rd Court Of Appeals
    

The final judgment of the 3rd Court of Appeals regarding the Texas Orthopaedic Association & Texas Medical Association v. Texas State Board of Podiatric Medical Examiners (TSBPME) was rendered last week.

In March of this year, the Third Court of Appeals rendered its Opinion regarding Texas State Board of Podiatric Medical Examiners expanding their scope of practice through rulemaking.  The Judges’ Opinion stated:

"We conclude that the board exceeded its authority when it promulgated the rule and that the rule is invalid."  The case was: Texas Orthopaedic Association, Texas Medical Association and Andrew M. Kant, M.D., Appellants v. Texas State Board of Podiatric Medical Examiners; Texas Podiatric Medical Association; and Bruce A. Scudday, D.P.M., Appellees

The Opinion from the 3rd Court of Appeals reversed the judgment of the district court and remanded the case back to the district court for further proceedings. The TSBPME requested a motion for a rehearing from the District Court of Travis County.  The rehearing was officially rejected.  There will be no additional proceedings in the Travis County trial court or the 3rd Court of Appeals in this case.

Texas Orthopaedic Association appreciates the court’s careful consideration of this important issue affecting healthcare for all Texans.

The court’s thorough discussion and consideration of the issues raised by TOA’s challenge to the subject rule provides helpful guidance for lawful rulemaking by Texas agencies regulating the practice of all healthcare practitioners in Texas.
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Thanks To The 2008 Annual Meeting Sponsors!
  

TOA gratefully acknowledges the following contributors for their generous support of the 2008 Annual Meeting!

 

                            Gold Level

                   Texas Medical Liability Trust

                            Sanofi-Aventis

 

Silver Level

GE Healthcare

Genzyme

Acumed

Arthrosurface

Texas Institute for Surgery at Presbyterian Hospital of Dallas
    l

Bronze Level

MedStar Funding

Bacterin International, Inc.

Tenet Healthcare

SpineMED-CERT Health Sciences, LLC

Simplify MD

OrthoView

Merrill Lynch

BME (BioMedical Enterprises, Inc.)

DePuy

Encompass Home Health

Synthes

Acentec, Inc.

Arteriocyte Medical Systems

Ancillary Care Solutions, LLC

American Physicians Insurance Company

HealthCare Plus

Nimbic Systems

Orthofix, Inc.

Phoenix Ortho

Advocate, MD

Ascension Orthopedics

Austin Radiological Association

Biomet Spine/Trauma

Breg, Inc.

Fluoroscan Imaging a Hologic Company

Hanger Prosthetics and Orthotics

OrthoScan

PriCara

Smith & Nephew

SRSsoft

Stryker Orthopaedics

Victory Pharma

Wright Medical Technology, Inc.

FlexRad

Pfizer

DEC

Remington Medical Resort - San Antonio

Select Physical Therapy

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