Call To Action:  Oppose Senator Lincoln's Amendment

By John Early, MD
President, Texas Orthopaedic Association

The AAOS understands that Senator Blanche Lincoln (D-AR) will offer an amendment during the Senate Finance Committee markup which would allow physical therapists to evaluate and treat Medicare beneficiaries without requiring a physician referral in rural areas. We strongly oppose this amendment.

We urge you to contact both your Senators TODAY and encourage them to oppose the inclusion of this amendment in health care reform.

Please use the Phone Action Alert Instructions below to call your Senators and urge them to oppose this amendment.

Should you have any questions, please contact the Washington DC office of AAOS at 202-546-4430.

Phone Action Alert Instructions

To find your Senators, visit www.senate.gov and select your state in the pull down menu "Find Your Senators" located at the right corner of your screen. Click "Go" to find your Senators. Your Senators names and contact information, including their phone numbers will appear. Please CALL as the email system is not as timely.

OR

Call the Capitol Switchboard at 202-224-3121 and ask to be connected to your Senators' office. You must be able to identify your Senators by name before calling.

Once connected, please use the suggested talking points below.

Hello,

My name is X and I am a constituent and a practicing orthopaedic surgeon. It has come to my attention that Senator Lincoln (D-AR) will offer an amendment during the Senate Finance Committee markup which would allow physical therapists to evaluate and treat Medicare beneficiaries without requiring a physician referral in rural areas. I strongly urge the Senator to oppose this amendment.

• A 2004 MedPAC concluded that "physician oversight requirements are a reasonable way to help beneficiaries receive medically appropriate care."

• It also found that, "The physician referral requirement may lower the amount of unnecessary care that is provided and result in a net savings to the program."

• According to MedPAC, 85% of Medicare beneficiaries reported having no problems accessing therapy services.

• Currently a physician is required to authorize the type, amount, and duration of physical therapy for a patient. This balance protects patients and ensures appropriate, timely treatment is given by the most qualified provider.

• Of the problems in rural areas MedPAC concluded that a shortage of physical therapists most likely caused the reported access problems, not the physician referral requirement.

• Again, I strongly urge the Senator to oppose this amendment

Featured Legislator: Representative Kevin Brady (8th District)

your message to Congress. Most of the Texas Congressmen met with our orthopaedic delegation in person, sometimes for extended periods of time. We want to thank each legislator and their staff for spending time with us in an effort to make sure we get reforms right for our patients and our practices.

Healthcare coverage of all Americans is important, but access to care is essential. Representative Brady sits on the House Ways & Means Committee. This committee will have the primary responsibility of developing legislation for healthcare reform. His subcommittee on health will offer legislation to the Ways and Means Committee for consideration by the whole House. Representative Brady, a seventh term Republican, has worked with members of both sides of the aisles over the last fourteen years. He clearly understands physician issues and the challenges to physicians posed by federal and private health care programs. Representative Brady's area includes Conroe, Orange, Huntsville and The Woodlands.

Thank You To Our Sponsor: Flexrad

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This Week In Texas: Mignon McGarry's Memos

Wednesday, September 23, 2009

Add Hank Gilbert, an East Texas rancher and former teacher, to the list of Democrats running for governor. He joins a group that includes

Tom Schieffer, Kinky Friedman and Mark Thompson.

Lubbock attorney Zach Brady announced that he will challenge Rep. Delwin Jones (R-Lubbock) in the Republican primary race for House District 83.

Jones County Republican Party Chairman David Andrews announced that will run for House District 85. Rep. Joe Heflin (D-Crosbyton) currently represents the district.

Former Executive Director of the Texas Legislative Council Milton Rister announced that he will run in the Republican primary for House District 20. Rep. Dan Gattis (R-Georgetown), District 20's current representative, has announced that he will run for the Texas Senate seat being vacated by Sen. Steve Ogden (R-Bryan).

Some former state representatives were in the news this week. The U.S. Senate confirmed Juan Garcia as assistant secretary of the Navy. Rick Noriega will serve as the President and CEO of AVANCE Inc, a non-profit focusing on literacy and families living in at-risk communities.

Lowell Keig, general counsel at Youth & Family Centered Services Inc., has been appointed by Governor Perry to the board of the Texas Department of Housing and Community Affairs.

DWC Form-074, Description of Injured Employees Employment

The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) has created the DWC Form-074, Description of Injured Employee's Employment. Employers may use this form to provide a description of an injured employee's job functions and physical responsibilities in response to a request from a treating doctor.

Use of the DWC Form-074 can facilitate an injured employee's return

to work as soon as it is considered safe and appropriate. TDI-DWC encourages employers to use this form. Information provided to the treating doctor on DWC Form-074 does not constitute a request by an employer that the injured employee return to work; an offer by the employer for the injured employee to return to work; or an admission of the compensability of the injury or illness of the employee.

The form is available for download from the TDI website and can be obtained by clicking here. For additional information regarding the DWC Form-074, contact Pat Crawford, TDI-DWC Return-To-Work Coordinator, at 512-804-4683 or via email (Pat.Crawford@tdi.state.tx.us).

Therapeutic Laser Treatment

The Chiropractic Board is adding the use of the "therapeutic laser" to their rules of practice. Is this a concern? Please email donna@toa.org to submit your comments.

This is the language of the proposed rule.

Chapter 75. RULES OF PRACTICE
22 TAC §75.17

The Texas Board of Chiropractic Examiners (Board) proposes an amendment to §75.17(e)(2)(K) to clarify the classes of lasers that licensed doctors of chiropractic may use to provide therapeutic care for a patient. The current rule is vague and without scientific value in identifying the kinds of lasers that may be used. The proposed rule amendment would allow an adequately trained licensee to use lasers in the therapeutic treatment of patients provided that the licensee has received adequate training in the use of the laser and appropriate safety precautions; that the patient, the licensee and all others present are provided with appropriate safety devices; and that the laser is used within the chiropractic scope of practice in Texas.

Glenn Parker, Executive Director of the Texas Board of Chiropractic Examiners, has determined that for each year of the first five years that this amended rule is in effect there will be no additional cost to state or local governments.

Mr. Parker has also determined that for each year of the first five years that this amended rule is in effect the public benefit will be greater clarity in the types of therapeutic laser equipment that a licensed doctor of chiropractic may provide for his or her patients and that patients will receive care more appropriate to their needs. Mr. Parker has also determined that there will be no adverse economic effect to individuals, small or micro businesses during the first five years that this amended rule will be in effect as this rule imposes no burdens.

Comments on the proposed amendment to §75.17 and/or a request for a public hearing on the proposed rule amendment may be submitted to Glenn Parker, Executive Director, Texas State Board of Chiropractic Examiners, 333 Guadalupe St., Tower III, Suite 825, Austin, TX 78701, (512) 305-6705 fax, no later than 30 days from the date that this proposed amendment is published in the Texas Register.

The rule amendment is proposed under Texas Occupations Code §201.152, relating to rules. Section 201.152 authorizes the Board to adopt rules necessary to regulate the practice of chiropractic. Section 201.1525 requires the board to adopt rules that clarify the scope of practice for chiropractors.

No other statutes, articles, or codes are affected by the proposed rule amendment.

§75.17.Scope of Practice.

(a) - (d) (No change.)
(e) Treatment Procedures and Services

(1) (No change.)

(2) In order to provide therapeutic care for a patient or patient population, licensees are authorized to use:

(A) - (J) (No change.)
(K) Therapeutic lasers, with adequate training and the use of appropriate safety devices and procedures for the patient, the licensee and all other persons present during the use of the laser; [cold or low-level light laser;]
(L) - (Q) (No change.)

(3) (No change.)
(f) (No change.)

This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.

Filed with the Office of the Secretary of State on September 3, 2009.
TRD-200903932