January 11, 2010

 

 

Call To Action: Oppose Independent Payment Advisory Board

 

By John Early, MD
President, Texas Orthopaedic Association

You may have seen this request from Dr. Mandell and the AAOS Committee on Advocacy, however we are asking TOA members to contact their members of Congress.  Ask them to oppose the creation of the Independent Payment Advisory Board or the Independent Medicare Advisory Commission.  We feel this AAOS Call to Action is definitely "worth repeating."

The AAOS has joined with the American College of Surgeons (ACS) and other surgical groups in an effort to encourage Members of the House of Representatives to sign a letter being circulated by Rep. Richard Neal (D-MA), expressing strong opposition to the creation of an unelected, unaccountable Medicare payment policy board which would potentially have unchecked power to impact access to quality surgical care through cost control and payment mechanisms.

The AAOS' opposition to the creation of the Independent Medicare Advisory Commission, also referred to as the Independent Payment Advisory Board (IPAB), is consistent with one of our core principles - maintaining access to high-quality surgical and specialty care.

In late December, 69 members of the House of Representatives joined together to send a letter to Speaker Nancy Pelosi (D-CA) clearly stating their strong opposition to any proposal that would divest Congress of its authority for Medicare payment policy and place this responsibility in an executive branch commission or board. Because of such a strong response, Rep. Neal is providing an opportunity for House members to add their names to this important letter.

While the House-passed health reform bill, the "Affordable Health Care for America Act" (H.R. 3962), did not include provisions to create a Medicare board, the Senate-passed bill, the "Patient Protection and Affordable Care Act of 2009" (H.R. 3590), does include provisions that would create such a Medicare payment policy board, which would be called the "Independent Payment Advisory Board" (IPAB). The creation of IPAB would effectively end Congress' authority over Medicare payment policy and would also empower this board to make policy recommendations regarding health care provided in private, non-government health care settings as well. Placing such important decisions in the hands of a commission without appropriate checks and balances in Washington could have a far-reaching adverse impact, not only for Medicare beneficiaries, but for all Americans' ability to access quality surgical care in their communities.

Please take the time to contact your Member of Congress and ask them to sign the letter if they have not already done so. By calling the number below and providing your zip code, you will be automatically connected to your Representative’s office.

Phone number: 1-877-925-8742

 

Your message to your Member of Congress:

  • I strongly oppose provisions to create an unelected, unaccountable Independent Payment Advisory Board (IPAB) that would threaten Americans' access to surgical care, particularly in already undeserved communities.

  • Please contact Rep. Neal's office and sign the letter to Speaker Pelosi opposing the creation of the IPAB if you have not already done so.

  • Also, please ask your Member to tell Speaker Pelosi, Majority Leader Steny Hoyer, and all House leadership to strongly oppose including provisions that create the IPAB or a similar board in health reform legislation.

After calling your Representative, please email the AAOS Washington office at advocacy@aaos.org so AAOS staff can follow up on your calls.
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This Week In Texas: Mignon McGarry's Memos

 

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

 

Tuesday, January 5, 2010
 OPEN SEATS As of January 4, 2010
TEXAS SENATE (1)

District 29 – currently represented by Sen. Eliot Shapleigh (D-El Paso)

          Should remain D district

          Candidate: Jose Rodriguez (D)

TEXAS HOUSE (8)

District 20 – currently represented by Rep. Dan Gattis (R-Georgetown)

          Should remain R district

          Candidates: Dr. Charles Schwertner (R); Milton Rister (R);

          Stephen Thomas (R); Patsy Williams (R)

 

District 36 – currently represented by Rep. Kino Flores (D-Mission)

          Should remain D district

          Candidates: Sandra Rodriguez (D); Sergio Munoz, Jr. (D)

 

District 66 – currently represented by Rep. Brian McCall (R-Plano)

          Should remain R district

          Candidates: Mabrie Jackson (R); Van Taylor (R); Wayne S. Richard (R)

 

District 69 – currently represented by Rep. David Farabee (D-Wichita Falls)

          Should switch to R district

          Candidates: Lanham Lyle (R); Joe Clement (R); Michael L. Smith (D)

 

District 84 – currently represented by Rep. Carl Isett (R-Lubbock)

          Should remain R district

          Candidates: Mark Griffin (R); Ysidro Gutierrez (R)

 

District 87 – currently represented by Rep. David Swinford (R-Amarillo)

          Should remain R district

          Candidates: Victor Leal (R); Walter "Four" Price (R); Abel Bosquez (D)

 

District 122 – currently represented by Rep. Frank Corte(R-San Antonio)

          Should remain R district

          Candidates: Lyle Larson (R); Denise Barnhill (R); Masarrat Ali (D); Frances                           Carnot (D)

 

District 127 – currently represented by Rep. Joe Crabb (R-Kingwood)

          Should remain R district

          Candidates: Dr. Martin Basaldua (R); Dan Huberty (R); Addie Wiseman (R);
          Dr. Susan Curling (R)

 

Wednesday, January 6, 2010

The cast list is set for the 2010 elections.  Here is a brief recap:

 

Statewide offices

In the Republican gubernatorial primary, Kay Bailey Hutchison and Debra Medina will challenge Governor Rick Perry.  Democrats Bill White and Farouk Shami along with five other Democrats will compete to take on the Republican primary winner.

 

Democrats Marc Katz, Ronnie Earle and Linda Chavez-Thompson will face each other in the Democratic primary for lieutenant governor.  The winner will face Republican incumbent Lt. Governor David Dewhurst in the general election.

 

Texas Attorney General Greg Abbott will face Democrat Barbara Ann Radnofsky in the general election in the attorney general race.

 

Republican incumbent Susan Combs faces no major party opposition in her reelection bid for the office of state comptroller.

 

Republican Todd Staples, Texas Agriculture Commissioner, will be challenged in the general election by either Kinky Friedman or Hank Gilbert.

 

Republican incumbent Land Commission Jerry Patterson will face one of two Democrats in the general election in November: Hector Uribe or Bill Burton.

 

One seat on the Texas Railroad Commission is up for reelection.  Incumbent Republican Victor Carrillo faces a primary challenge from David Porter.  The winner will face Jeff Weems in the general election.

 

Texas House

In the Texas House, all 150 seats are up for reelection.  Eight seats are open races due to the retirements of Frank Corte, Joe Crabb, David Farabee, Kino Flores, Dan Gattis, Carl Isett, Brian McCall and David Swinford.  Fifteen Republican incumbents in the Texas House have primary challengers: Dan Flynn, Betty Brown, Fred Brown, Chuck Hopson, Edmund Kuempel, Rob Orr, Sid Miller, Myra Crownover, Delwin Jones, Kelly Hancock, Todd Smith, Vicki Truitt, Charlie Geren, Tommy Merritt and John Davis.  Eight House Democrats face contested primaries: Eddie Lucio III, Mando Martinez, Tara Rios Ybarra, Terri Hodge, Patrick Rose, Norma Chavez, Doro Olivo and Al Edwards.  Fifty-one incumbents face general election challengers with a few facing primary and general election challenges.  Seventy-two incumbent House members face no major party opposition. 

 

Texas Senate

In the Texas Senate, 15 Senate seats are up for reelection.  Four Republican incumbents face contested primaries: Kip Averitt; Bob Deuell; Steve Ogden; and Florence Shapiro.  Seven incumbents will face at least one major party opponent in the general election in November: Bob Deuell; Rodney Ellis; Glenn Hegar; Steve Ogden; Carlos Uresti; Kirk Watson and John Whitmire.  Five have earned themselves a free ride with no opposition: Kevin Eltife; Jane Nelson; Robert Nichols; Dan Patrick; and Jeff Wentworth.  One seat – Senate District 29 being vacated by Sen. Eliot Shapleigh – will be decided in the Democratic primary.  Three candidates have filed for the El Paso district: Jose Rodriguez; Louis Irwin; and Liza Montelongo. 

 

State Board of Education

Races for the State Board of Education feature one contested Democratic primary and four contested seats now held by Republicans.  Two current members are retiring from the SBOE.  Rick Agosto (D-San Antonio) is vacating his District 3 seat. Michael Soto of San Antonio is the only Democrat seeking the seat. Republicans will choose between Tony Cunningham and Joanie Muenzler.  Incumbent Cynthia Dunbar (R-Richardson) is retiring from her District 10 seat.  Republicans seeking to replace Dunbar include Brian Russell of Austin; Marsha Farney of Georgetown; and Rebecca Osborne of Austin. Judy Jennings of Austin is the only Democrat running for the District 10 nomination. In District 5, incumbent Ken Mercer (R-San Antonio) faces Tim Tuggey in the Republican primary.  The winner of that primary goes on to face the winner of the Democratic primary.  Democrats contending for the District 5 nomination include Rebecca Bell-Meterau of Austin; Robert Bohmfolk of Seguin; Daniel Boone of Canyon Lake; and Josiah Ingalis of Austin. In District 9, incumbent Don McLeroy, (R-Bryan) faces a primary challenge from Thomas Ratliff, son of former Lt. Gov. Bill Ratliff. In District 12, incumbent Geraldine "Tincy" Miller (R-Dallas) faces a GOP primary challenge from Dallas educator George M. Clayton. 
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Thank You To Our Sponsor: Austin Radiological Association
   


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American Physicians Insurance Company: Orthopaedic Surgery - Risk Reduction Strategies

 

Musculoskeletal injuries are the leading cause of disability in the United States.  They account for one-half of chronic conditions in people over 50 years of age.  Among the claims data submitted to the Physician Insurers Association of America (PIAA), regarding 28 different specialties, orthopaedic surgery ranks 5th in the number of claims reported.

Areas of increased risk for orthopaedic surgeons include:

  1. Tourniquet usage

  2. Not using intraoperative x-rays with fluoroscopy in joint replacement surgery to confirm hardware placement resulting in inadequate positioning

  3. Post operative infection

  4. Undiagnosed/Mismanaged fractures

  5. Failure to recognize and manage medical complications

  6. Failure to document adequate informed consent

  7. Inadequate record keeping

  8. Failure to appropriately evaluate x-rays and lab studies

Of the closed claims data submitted to the PIAA in 2008, approximately 31% of orthopaedic closed claims data resulted in indemnity payment to the plaintiff of $269,761 and the average cost to defend the claims was $59,524. Procedures on joint structures resulted in the most claims in this specialty. Consent and documentation issues also remain a problem in many cases.

American Physicians Insurance individual data results trend very similar to PIAA cumulative data. For claims closed in 2008 the average indemnity payout is $238,186 and average expenses were $63,550.

The goal of the API risk management department is to provide physicians the tools and information to implement risk management and mitigation techniques within their practice.

The following are risk reduction strategies we recommend:

  • Review the patient’s entire clinical picture prior to surgery. This includes lab and x-ray studies.

  • Explain the risks, benefits and alternatives of the procedure with the patient and family in easy to understand language and provide educational materials.

  • Document all consent discussions.

  • Reduce wrong site surgery mishaps by marking the correct site and performing a "timeout" with the surgical team prior to incision.

  • Use computer order entry systems if available, if not write legibly.

  • Standardize treatment policies and protocols to avoid confusion.

For more information please contact:

Sherri Morrison, RN, CPHQ, Risk Manager • 1301 S. Capital of Texas Hwy. Suite C300
Austin, Texas 78746 • 800-252-3628, ext. 4329 • Fax: 512-314-4398 • www.api-c.com
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Volunteers Needed For CME Program On MRSA 

 

Texas Orthopaedic Foundation (or Association) is calling on volunteers to assist in the development of a CME program on post-fracture osteoporosis treatment.

Please email Donna Parker (donna@toa.org) or call the Texas Orthopaedic Foundation office at 512-370-1500 to volunteer. Teaching methods will include film presentations, panel discussions, and other

multimedia learning opportunities.
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