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UPDATE HR2: Anti-Physician Ownership SCHIP Federal Bill
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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 |
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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
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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 |
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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
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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
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lawmakers to begin considering these
issues in the initial 30 days of the legislative session. The
emergency items include:
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Legislation to provide supplemental
appropriations to state agencies and institutions related to
hurricane response and recovery associated with the hurricanes of
2008;
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Legislation to assist public and
private entities with recovery from the hurricanes of 2008;
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Legislation to reform the Texas
Windstorm Insurance Association (TWIA) and legislation to fund the
Catastrophe Reserve Trust Fund related to TWIA;
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Legislation to improve state schools
and centers operated by the state of Texas; and
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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
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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,
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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
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(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
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| FOR
IMMEDIATE RELEASE |
FOR MORE INFORMATION |
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(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'
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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:
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case management and Return to Work;
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treatment guidelines;
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preauthorization;
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billing and reimbursement;
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medical documentation;
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dispute resolution;
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Maximum Medical Improvement and Impairment
Rating; and
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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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