February 9, 2009

 

 
UPDATE HR2: Anti-Physician Ownership SCHIP Federal Bill
  

By Timothy L. Beck, MD
President, Texas Orthopaedic Association

We received an update from the Physicians Hospitals of America last Wednesday on federal legislation HR2. Week before last, Dr. David Teuscher and I emailed and faxed you information on the HR2 SCHIP bill and asked you to contact your legislators. Thank you for your quick response. The Senate version of HR2 passed without the anti-physician

hospital language the House version had added. Around noon on Wednesday, February 4th, the House of Representatives passed the Senate version of the SCHIP on a vote of 290-135, without any amendments. As finalized, the physician hospital language was not included on the bill. The bill has already been signed by the President (Thursday February 5th).

Click here to revisit the original January 26th E-Connect article.
Click here to view the February 4th Physicians Hospitals of America's news release.

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Memorial Hermann Healthcare System – Restraint of Trade Case Settled
 
  

By Jeseka Wallace Kreitner
Executive Director, Texas Orthopaedic Association

On Monday, January 26th Texas Attorney General Abbot resolved the antitrust investigation into Memorial Hermann Healthcare System by filing an agreed injunction with the Harris County District Court. According to the Houston Chronicle, Memorial Hermann, the largest

health care provider in the Houston area, agreed to pay the state $700,000 toward the cost of the antitrust investigation and agreed to not take the same type of anti-competitive actions alleged in the lawsuit for five years.

Houston Town and Country Hospital opened in proximity to Memorial Hermann’s Memorial City Hospital in 2005, however two years later Houston Town and Country Hospital was forced to close its doors. Memorial Hermann persuaded health insurers to exclude Town and Country from their insurance coverage networks causing Town and Country to go out of business.

According to the Office of the Attorney General, Attorney General Abbot stated, "Free and fair competition is the cornerstone of our free market system. Today’s injunction will preserve healthy competition and will help ensure that Houston-area patients have more hospital choices. Open competition on the free market amongst providers will help improve care, lower prices, and foster greater choices for patients."

For more information, please click here.

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This Week In Texas: Mignon McGarry Memos

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

 

February 4, 2009, Wednesday

Yesterday, Governor Perry declared several issues as emergency items for the 2009 legislative session. The emergency designation will allow

lawmakers to begin considering these issues in the initial 30 days of the legislative session.  The emergency items include:

 

  • Legislation to provide supplemental appropriations to state agencies and institutions related to hurricane response and recovery associated with the hurricanes of 2008;
  • Legislation to assist public and private entities with recovery from the hurricanes of 2008;
  • Legislation to reform the Texas Windstorm Insurance Association (TWIA) and legislation to fund the Catastrophe Reserve Trust Fund  related to TWIA;
  • Legislation to improve state schools and centers operated by the state of Texas; and
  • Legislation to appropriate funds to the Texas Department of Criminal Justice for the purchase and use of screening and detection devices for contraband and personnel, as well as comprehensive security equipment.

Late Friday, Lt. Governor David Dewhurst announced his Senate Committee appointments.  Dewhurst created elevated two subcommittees to full committees – Higher Education to be chaired by Sen. Judith Zaffirini (D-Laredo) and Agriculture and Rural Affairs to be chaired by Sen. Craig Estes (R-Wichita Falls).  Dewhurst created one new committee – Economic Development to be chaired by Sen. Chris Harris (R-Ft. Worth).  Sen. Tommy Williams (R-The Woodlands) was appointed Chairman of the Committee on Administration.  If you are interested in viewing committee appointments divided by committee or member, click here to visit the Texas Senate website.

You are probably asking yourself when House Committee assignments will be released.  Word on the street says next week.
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Calculation of Ambulatory Surgical Center Fully Implemented Facility Reimbursement Rates for 2009
 

The Federal Centers for Medicare and Medicaid Services (CMS) did not calculate and publish the fully implemented Ambulatory Surgical Center (ASC) facility rate for approved surgical services for calendar year (CY) 2009 in the publication of ADDENDUM AA, ASC Covered Surgical Procedures for CY 2009 as they did in CY 2008. Instead, CMS published the fully implemented weight for each approved surgical procedure and an ASC conversion factor. The Texas Department of Insurance, Division

of Workers' Compensation published a memo to provide system participants with information regarding the calculation of the CY 2009 fully implemented Medicare facility reimbursement rates for ambulatory surgical centers.

The calculated CY 2009 fully implemented Medicare ASC facility reimbursement rate is used in the calculations required to determine the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) facility reimbursement to a specific ASC. The memo concerning the calculation of ASC fully implemented facility reimbursement rates can be located by clicking here.

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Physician Hospitals of America Congratulates Congress on Its Passage of a Clean Children's Health Bill
  
FOR IMMEDIATE RELEASE

February 4, 2009

Media Contact:

Molly Sandvig, Executive Director
Physician's Hospitals of America
(605) 321-3483

(Washington, D.C.) – "Physician Hospitals of America (PHA) congratulates Congress on its passage of the SCHIP bill which will provide healthcare access and insurance to millions of children nationwide," said Molly Sandvig, PHA Executive Director. "Congress recognized that the SCHIP bill was too important to delay its passage to address the contentious issue of physician ownership of hospitals, which was inappropriately attached to this important package."

For the seventh time in 18 months, Congress has rejected special interest legislation intended to shutdown hospitals owned and operated by physicians, including general hospitals, children's hospitals, women's hospitals and specialty orthopedic, heart and rehab hospitals. The challenge faced by reform minded physician hospitals in HR 2, the House SCHIP bill, was one of these many attempts by Representative Pete Stark and/or Senator Max Baucus, to kill hospitals owned and operated by physicians in the last 18 months. Previous failed attempts included efforts to insert anti-physician hospital language into the Farm Bill, the Supplemental War Spending Bill and the 2008 SCHIP bill.

Countless lobbying hours and millions of dollars have been spent by the opponents of physician hospitals in their multiple attempts to destroy an industry that truly represents the closest thing to actual healthcare reform our country has seen. "Time and again, physician hospitals have demonstrated quality excellence, cost efficiencies, and extremely high patient satisfaction," said Sandvig. "It is truly unfortunate that the time, money and effort expended by our opponents to destroy this physician directed healthcare reform movement has not been spent in a more appropriate way – for instance, in an attempt to solve a few of the many real problems healthcare is facing today."

If passed, this latest attempt would have had devastating economic effects with the loss of over 78,000 current and potential jobs, restrictions on healthcare access in hundreds of communities across the country, and severe restrictions on patient's ability to choose and access some of the best and safest hospitals in the country.

Besides the impact on the 199 existing physician-owned hospitals, 34 are under-going major construction with an estimated $357,500,000 in outstanding expenditures that could be affected by legislation. Further, the failed legislation would have stopped the current development of 85 hospitals in their tracks with the loss of an estimated $1,830,909,350 already invested and another $574,358,090 in outstanding financing.

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Basic Workers' Compensation for Medical Office Staff Seminar Offered in Longview on March 3
 

FOR IMMEDIATE RELEASE

FOR MORE INFORMATION

 

(General) Michelle Banks @ (512) 804-4203
(Media) John Greeley @ (512) 463-6425

AUSTIN, TX — The Kilgore College Small Business Development Center will sponsor an educational seminar for medical office staff, including office managers and billing staff, entitled Basic Workers' Compensation

for Medical Office Staff on Tuesday, March 3, 2009. The seminar is presented by the Texas Department of Insurance, Division of Workers' Compensation. The seminar will be held from 9 a.m. to 3 p.m. at the Hampton Inn North, 3044 Eastman Road in Longview. The cost is $99 per person and includes Continental Breakfast.

The educational seminar will provide medical office staff practical information about rules and processes affecting health care delivery to injured employees, enabling them to participate effectively in the Texas workers' compensation system. The educational seminar will provide information on the following topics:

  • case management and Return to Work;
  • treatment guidelines;
  • preauthorization;
  • billing and reimbursement;
  • medical documentation;
  • dispute resolution;
  • Maximum Medical Improvement and Impairment Rating; and
  • other issues effecting workers' compensation claims.

 

To register, contact Janet Hughes, Kilgore College Small Business Development Center, at 1-800-338-7232 or jhughes@kilgore.edu.
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