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TOA
President's
Update: Last Week To Register!
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By Timothy L. Beck, MD
President, Texas Orthopaedic Association
Save the
Date!
2009 Socioeconomic Summit
Stephen
F. Austin Hotel
Saturday, January 31 – 1:30 to 5:30 PM |
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The Business of
Orthopaedics
TOA's
Original Practice Management Course for Orthopaedic Residents
January 31
& February 1, 2009
Last week to
register. The 2009 Socioeconomic Summit of the Texas
Orthopaedic Association will be held at the Stephen F. Austin Hotel in
Austin on January 31st from 1:30pm to 5:30pm. We
will provide a shuttle to and from the TMA Winter Conference so TOA
members can attend TMA Saturday morning meetings if they wish. You
and your family are also invited to join us during the Saturday
evening reception for TOA members and their spouses!
We have a couple of
rooms held for late registrants. Call 1-800-370-1505 and ask for
Angel. She will help you with your TOA room rate and hotel
registration.
Join us at the
Socioeconomic Summit to discuss issues such as national health care
reform, workers' compensation, physician ownership and scope of
practice. TOA is accredited by the TMA to provide continuing medical
education for physicians. The Summit has been approved for 4
hours of CME credit!
Also on Saturday,
January 31st & Sunday, February 1st (8:30am-12:00pm), you won't want
to miss The Business of Orthopaedics, our 6th
annual practice management course for orthopaedic residents and
fellows…or TOA members/clinic staff new to practice.
Download Early
Registration Form
2009 Socioeconomic Registration
Form (PDF)
Hope to see you in Austin!
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Division Adopts
Amended Rules on Submitting Bills Beyond 95 Days
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The Texas
Division of Workers' Compensation announced adoption of amended
rules relating to submission of health care providers' bills after
the general 95-day deadline.
The change made in the Labor Code reflects the Legislature's
efforts to provide billing provisions similar to those maintained
in the group health system. Section 408.0272 of the code provides,
in part, that the time
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limit of 95 days for a health care
provider to submit a claim for payment to a workers' compensation
insurance carrier will not apply in three circumstances.
The first circumstance is when a health care provider submits
"satisfactory proof" to the workers' compensation commissioner that
the provider had filed for reimbursement within the 95 days, but had
filed with either the group accident and health insurance carrier with
whom the injured employee is a covered insured, a health maintenance
organization in which the injured employee is a covered enrollee or a
workers' compensation insurance carrier other than the carrier liable
for payments. Sec. 408.0272(c) establishes that once a health care
provider has been notified of the erroneous submission, the health
care provider has 95 days to submit the claim for payment to the
correct workers' compensation insurance carrier.
The second exception is if the commissioner determines that the
failure to submit the claim during the 95 days was due to "a
catastrophic event" (such as Hurricane Ike) that "substantially
interfered with the normal business operations of the health care
provider."
The third exception is where the parties agree to extend the period
for submitting a claim for payment.
The rules provide that a provider that submits a bill after the 95-day
deadline "to the correct workers' compensation insurance carrier" must
include a copy of the original medical bill submitted, a copy of the
explanation of benefits if available and "sufficient documentation to
support why one or more of the exceptions for untimely submission of a
medical bill …should be applied." The bill is subject to the billing,
review and dispute processes established for resolution of medical fee
disputes, the rules state.
To reach the division's announcement, please click
here.
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This Week In Texas: Mignon
McGarry Memos
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By Mignon McGarry
TOA Legislative Advocate
TOA Online Version: All Memos
January 19, 2009, Wednesday
All is quiet this
week in Austin as many Texas politicians are spending the week
in Washington, D.C. for the inaugural celebrations. The Texas
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House returns at 10:00am on
Thursday and could take up the House rules as soon as Friday.
The Texas Senate does not reconvene until Monday, January 26th.
Last week, the Texas Senate adopted Senate Rules for the 81st
Legislative Session but not without several hours of contentious
debate. In an almost party line vote of 18-13, the Senate approved an
exception to a decades-old rule that requires a supermajority of
senators, 21 of the 31 or two-thirds of the Senate, to bring bills up
for floor debate. The exception carved out was to enable legislation
that would require voters to show government-issued photo
identification before casting ballots at the polls to reach the
floor. Sen. John Carona (R-Dallas) voted in opposition to the rule
change along with the 11 Democrats in the Senate.
This session's appropriations bill, Senate Bill 1, has been filed.
The Senate and the House alternate having their "side" author the bill
each session and it is the Senate's turn. The common practice is for
both the House and Senate to file appropriations bills and fashion
their own budgets. When Senate Bill 1 moves over to the House, the
House will substitute their language and the bill will wind up in a
conference committee towards the end of session. Governor Perry will
also lay out his budget priorities next week during his State of the
State address on January 27th.
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HR2 - Anti-Physician Ownership SCHIP Federal
Bill
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By David
Teuscher, MD
TOA Legislative Chair
With the
MLK holiday and Inauguration Day behind
us, the U.S. Congress will be gearing up
again for legislative business. The U.S.
Senate is expected to vote on its SCHIP
bill on Monday, January 26. The Senate
version does not contain the harmful
physician-owned hospital language while the House
passed version does. The House and
Senate will then
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go to
conference
to produce a uniform bill for both chambers to consider
before sending to President Barack Obama's desk.
It is
the express policy of the American Medical Association, the
American Association of Orthopaedic Surgeons, the Texas
Medical Association, and the Texas Orthopaedic Association
that there should not be restrictions placed on physicians
investing and operating hospitals as long as they play by
the same rules on a level playing field of competition.
All Texas physicians who own
or are developing plans to build hospitals are STRONGLY
encouraged to continue calling
Texas Democratic
members of Congress to urge them to talk to Speaker
Nancy Pelosi and the House Democratic Leadership about
removing the harmful physician-owned hospital language from
the House SCHIP bill. Phone calls to the Washington
offices remain the most effective way to reach Texas members
of Congress.
Telephone numbers have been provided in this e-mail. If your
hospital is close to a Democratic member of Congress, please
have as many from your hospital as possible call to tell
your story. If you are not
near a Democratic member of Congress, please contact your
colleagues across Texas to get the word out. Many
physicians have been calling their colleagues all across
Texas to activate everyone.
Remember:
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The 50-plus physician-owned
hospitals in Texas employ approximately 22,000 Texans.
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There are another 50
physician-owned hospitals in Texas that are under
development.
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Texas physician-owned
hospitals will pay close to $86 million in payroll, income
and property taxes in 2009.
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Tell the story about how
your hospital is delivering incredible safety and quality
to patients.
Many of you
are wondering why we are placing the emphasis on Democratic
members of Congress from Texas. House rules dictate that the
majority party (Democratic Party) has the power to bring up
legislation and determine what is in it. This is so that
legislation can move quickly through the House. The U.S.
Senate is a slower body and has more obstacles for passing
legislation.
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Dallas Area |
Waco/Bryan Area |
Cong. Eddie Bernice Johnson
202.225.8885
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Cong. Chet Edwards
202.225.6105 |
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Austin Area |
El Paso Area |
Cong. Lloyd Doggett
202.225.4865 |
Cong. Silvestre Reyes
202.225.4831
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Houston Area |
South Texas |
Cong. Al Green
202.225.7508 |
Cong. Ruben Hinojosa (Valley)
202.225.2531 |
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Cong. Sheila Jackson Lee
202.225.3816
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Cong. Henry Cuellar (Laredo)
202.225.1640
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Cong. Gene Green
202.225.1688
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Cong. Solomon Ortiz (Brownsville/Corpus Christi)
202.225.7742 |
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San Antonio Area |
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Cong. Charlie Gonzalez
202.225.3236 |
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Cong. Ciro Rodriguez
202.225.4511 |
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Keep in mind that many of these members of Congress have
been big supporters of physician-owned hospitals and deserve
our thanks. We're making great progress so keep making the
calls.
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TSBPME -
Proposed Rule Amendment
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We are asking TOA members to
read and respond with your views and comments! Please write a
letter to TSBPME on your letterhead and fax a copy to TOA.
Deadline for comments: January 30, 2009.
The Issue:
The podiatry board and Texas Podiatric Medical
Association have now |
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asked the Texas Supreme Court to postpone their appeal of the Third
Court of Appeals (Austin) 2008 ruling that the Board did not have
the authority to expand the practice of podiatry through
rule-making. The postponement is sought while TSBPME withdraws the
rule, only to propose replacing it with a more expansive definition
of podiatry... [more]
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