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April 5, 2010 |
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TMA Petition "Stop the Medicare
Meltdown"
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 By John Early, MD
President, Texas Orthopaedic Association
For the 43 million Americans receiving Medicare
coverage, we are concerned there could be a problem
with access to physicians if Medicare reimbursement
is cut by almost 22%. A new formula is
needed to
determine Medicare reimbursement that will
accurately reflect the cost of providing care for
Medicare patients. Although Congress has used
temporary fixes to push back these Medicare cuts, a
permanent fix that doesn't rely on the sustainable
growth rate formula is mandatory.
Although the Center for Medicare and Medicaid
Services states that 96.5% of all practicing
physicians - nearly 600,000 doctors - are
participating in Medicare, there are many physicians
who are not accepting new Medicare patients.
Physicians and their clinic administrators are
evaluating their patient bases carefully and are
beginning to refer some of their Medicare patients
to other doctors, or, are systematically reducing
the number of Medicare patients they treat each year
in hopes of being able to maintain a financially
viable practice.
Early results from our
Medicare Survey
published in the last TOA eConnect,
show us that 34% of TOA members now taking Medicare
are not accepting new patients. Of those still
accepting Medicare patients, 65% will restrict or
limit the number of new patients seen. The majority
(78%) of respondents showed they are considering
dropping their participation in Medicare because of
the 21% Medicare cut. The next most common issue of
concern to our membership was the increase in the
hassle factor, followed by the decreased loss of
control over factors affecting their practice -
which was third on the list. Over 91% of survey
respondents showed that other physicians had voiced
concerns about not being able to refer Medicare
patients.
If
you have not filled out this survey please
view the last article in this
eConnect and give us your feedback. We will take
this information to Washington when we are at the
National Orthopaedic Leadership Conference. Also,
you may have seen Lou Goodman's TMA EVP Gram about
the TMA petition to stop the medicare meltdown.
Please join our TMA colleagues by signing the
petition to
"Stop the Medicare Meltdown."
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Congress Takes Vacation
With Medicare Cuts Pending
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 By
Lou Goodman, PhD
Texas Medical Association EVP
For the second month in a row, the U.S.
Senate left town unable even to put another
Band Aid on Medicare's Sustainable Growth
Rate (SGR) formula. That means the
21.2-percent cut in physicians' Medicare
payments takes effect April 1. Congress
reconvenes from its Easter recess on April
12. The Centers for Medicare and Medicaid
Services will hold all claims for the month
until April 14. That gives lawmakers two
days for another flash freeze. Congress'
constant toying with physicians on this
issue - and legislators' inability to
approve a permanent replacement for the SGR
- is totally unacceptable. Next week, TMA
and county medical societies will hold news
conferences across the state to emphasize
what this means to gain access to care for
the elderly, Texans with disabilities, and
military families. Please sign TMA's
petition to
"Stop the Medicare Meltdown."
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Will Orthopaedic
Patients Be Misled?
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 Texas
Board of Chiropractic Examiners
RULE 71.15 RECOGNIZED SPECIALTIES
On August 13, 2009, the Board adopted new
rule 71.15 to "contain a listing of those
areas of chiropractic practice that the
Board has officially recognized as being a
legitimate chiropractic specialty field of
practice. Recognition of a chiropractic
specialty by the Board is a multi-step
process in which the Board reviews an
application from a recognized organization
that represents the specialty area." Texas
Chiropractic Board Report – August 2009
Chiropractors around the country have added
these specialty areas such as nutrition,
acupuncture and homeopathy to "aid their
patients in overcoming back pain, knee pain,
neck pain, and hip pain." Chiropractors have
also added areas such as "preventive health
care and anti-aging to ease or help prevent
arthritis pain and osteoarthritis; pain
management techniques to improve coping
skills; sports medicine, and chiropractic
neurology for post-stroke care and central
nervous system rehabilitation."
The TBCE minutes suggest that rule 71.15 was
created and published because national
organizations and academies had asked to be
recognized in Texas as a "Chiropractic
Specialty." Some of the academies or
associations certifying chiropractic
specialties on a national level include
Chiropractic & Anti-Aging, Chiropractic &
Pain Management, Chiropractic Radiology,
Chiropractic & Homeopathy, Chiropractic
Neurology, Chiropractic Pediatrics,
Chiropractic Sports Medicine and . . .
Chiropractic Orthopedics.
The Texas Board of Chiropractic Examiners
Adopts Rule Concerning Recognized
Specialties
On March 12, 2010, the Texas Board of
Chiropractic Examiners published an adopted
rule in the Texas Register concerning
recognized specialties (35 Tex. Reg. 2156).
Under the adopted rule, chiropractic
orthopedics will be listed as a recognized
specialty. The rule also outlines the
qualifications and continuing education
requirements for this specialty.
Chiropractic Radiology was one of the first
specialties in Texas to be "recognized" by
the TCBME. Chiropractic Acupuncture and
Chiropractic Neurology have also been listed
as specialties. One could definitely argue
that the Texas public could be very confused
or misled by chiropractors calling
themselves radiologists, orthopedists or
claiming their medical specialty is
neurology. The Texas Occupations Code
section states that a licensee shall not
participate in "the use of any form of
public communication which contains a false,
fraudulent, misleading, deceptive, or unfair
statement of claim, or which has the
tendency or capacity to mislead or deceive
the general public."
After checking with other physician
organizations, it seems that to effectively
address
this issue we need to identify
patients with stories of being deceived by
the titles used by limited licensed health
care providers. If your patients believed
the chiropractor they saw was a physician
and/or (particularly) an orthopedic surgeon,
please let us know as this information can
be given to the Texas Attorney General
Consumer Protection Division and there can
be a request for relief filed.
Contact: Donna C. Parker at 512-370-1505 or
donna@toa.org |
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This Week In Texas: Mignon
McGarry's Memos
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 By Mignon McGarry
TOA Legislative Advocate
TOA Online Version: All Memos
Wednesday, March 31, 2010
U.S.
Sen. Kay Bailey Hutchison
announced this morning that
she plans to complete her term rather than
resign early as she had planned. Hutchison,
who was first elected to the Senate in a
special election in 1993, won re-election to
a third full term in 2006. Her term runs
through 2012.
Rep.
Brian McCall
(R-Plano) was named the sole finalist for
the post of chancellor of the Texas State
University System. McCall announced last
year that he would not seek reelection to
the Texas House where he has served for 20
years. The Board of Regents for the Texas
State University System will meet in late
April to take an official vote. The Texas
State University System is comprised of
Texas State University, Lamar University,
Sam Houston State University, Sul Ross State
University and their components.
Governor Perry
recently made two appointments to the Texas
Ethics Commission. James Clancy, Jr., an
attorney from Portland, Texas and Thomas
Ramsay, a former state representative and
licensed real estate broker in Mount Vernon,
Texas.
The April 13th
runoff is less than two weeks away. Early
voting begins April 5th and continues
through April 9th. |
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NOLC Needing TOA Members To
Attend
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 NEED
HELP IN WASHINGTON
On Thursday, April 29, 2010, The TOA
Legislative Delegation will meet with our
Texas Senators and Representatives in
Washington DC during the National
Orthopaedic Leadership Conference. We start
on Thursday, April 29th at 8 am in a room in
the Capitol and then we move to a room in a
House Office Building that afternoon.
Representatives, Senators and their Health
Issue Staff will come to talk to us about
healthcare reform, Medicare cuts and other
health issues. We also send TOA members to
select Congressional offices to speak with
Senior Staff if those arrangements have
already been made. TOA and AAOS will give
you talking points and help you make your
appointments, but we need to get you
registered for NOLC first. Let us know if
you can attend and we will make sure you are
able to register online with AAOS. The
cut-off date for J.W. Marriott reservations
is soon, but there should be rooming still
available for Wednesday, April 29th and
Thursday, April 30th if you need to stay
that evening.
WE NEED YOUR ATTENDANCE
The Senators and Representatives ALWAYS ask
who is from their district and we need you
there to represent orthopaedic surgeons in
your area. Please consider attending this
year. You will need to arrive Wednesday
4/28/10 and can usually leave late Thursday
night or early Friday morning.
Please contact
Andy Kant (apk@ksfortho.com)
or Angel Moss (angel@toa.org)
if you can take time for this VERY crucial
visit to Washington. |
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Medicare Cuts: Please Take
Our Brief Survey
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 If
you were wondering about the Medicare Cuts
... Lou Goodman, Texas Medical Association EVP sent this message.
"The U.S. Senate passed another Band Aid for
Medicare's SGR formula - this time freezing
current Medicare payment rates until Oct. 1.
We don't know if the House will follow suit
before the 21.2% cut comes back again
on April 1. The other piece of the puzzle is
House Speaker Nancy Pelosi's announcement
that the House will consider the same "reform" bill the Senate approved on
Christmas Eve. TMA opposed the Senate bill
in December because it was bad for patients
and bad for the profession. It is still bad
for patients. It is still bad for the
profession. We still oppose it."
Now more than ever before, please help us with this brief TOA Survey on
Medicare by clicking
here and using the password: Medicare.
We will compile the results and our TOA
leadership will use this information during
their Capitol Visits in Washington DC during
the National Orthopaedic Leadership
Conference April 28 to 30. If you are
interested in attending the National
Orthopaedic Leadership Conference please
contact Andrew Kant, MD at
apk@ksfortho.com or call TOA
(800) 370-1505.
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