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June 28, 2010

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Medicare Payment Problems Hurting Texas Patients

 

TOA President L. Edward Seade, MDBy L. Edward Seade, MD
President, Texas Orthopaedic Association

Many of you probably saw Lou Goodman's TMA EVPGram this week.  TMA took a flash survey that is shown below and it looks a lot like the survey results from the Texas Orthopaedic Association Survey we asked our members to take back in April.  Just in case, we thought that Dr. Goodman's news brief on the Medicare Payment Problem was worth repeating.


TMA logoBy Lou Goodman, TMA Executive Vice-President
from the TMA EVPGram

 

Medicare payment checks to physicians are flowing again — but they’re 21.3 percent smaller than they were this time last week as Medicare officials could no longer wait for Congress to figure out how to apply the latest Band-Aid. A TMA flash survey that accompanied our news reports of the latest Medicare Meltdown finds that Texas physicians will take or are considering some very drastic action in response. The chart below shows the preliminary responses to the question, "Regardless of the outcome of the current Medicare payment cut, the ongoing cash flow problems and constant uncertainty over Medicare payments has led my practice to take, or consider, the following steps:"

 

Reduce my total Medicare caseload.

 

 

252

68%

Refuse all new Medicare patients.

 

 

210

57%

Lay off staff.

 

 

197

53%

Refer Medicare patients to the emergency room.

 

 

120

33%

Drop out of Medicare altogether.

 

 

117

32%

Stop seeing existing Medicare patients.

 

 

91

25%

It doesn’t matter, I don’t take Medicare anyway.

 

 

2

1%

We will keep the survey open for a few more days, so please share your opinion if you haven’t yet. The U.S. Senate on Friday approved a deal stopping the cuts and raising fees 2.2 percent until Nov. 30. But the House of Representatives had already gone home for the weekend and was not scheduled to resume voting until tomorrow. That led the Centers for Medicare & Medicaid Services, which had held Medicare payments since the first of the month, to direct Medicare contractors to begin processing claims dated June 1 and later under the new rates on a first-in, first-out basis. "Washington obviously doesn’t realize the damage they’re doing to our practices and our patients," said TMA President Sue Bailey, MD.

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Thank You To Our Sponsor: FlexRad

 

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This Week In Texas: Mignon McGarry's Memos

 

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

Wednesday, July 23, 2010
The results are in from the runoff in the special election in Senate District 22. Republican Brian Birdwell, a retired Army officer, defeated former state senator David Sibley by getting 58 percent of the vote to Sibley's 42 percent. Birdwell will represent the district through January, the remainder of former Sen. Kip Averitt's current term.

Rep. Leo Berman (R-Tyler) filed the official paperwork Tuesday to challenge fellow Republican Joe Straus as speaker of the Texas House.

Gov. Rick Perry has set Tuesday, Nov. 2, 2010, as the special election date to fill the Texas House District 84 seat vacated by the resignation of former Rep. Carl H. Isett (R-Lubbock). The state representative elected in this special election will serve out the remainder of Rep. Isett's unexpired term.

Speaking of Governor Perry, he is in China attending the 2010 World Expo in Shanghai, which is expected to draw 70 million visitors from more than 170 nations.

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Podiatry Case - Texas Supreme Court Denied Petitions For Review

 

TOA LogoTHE FOLLOWING PETITIONS FOR REVIEW ARE DENIED:  08-0485

TEXAS STATE BOARD OF PODIATRIC MEDICAL EXAMINERS, TEXAS PODIATRIC MEDICAL ASSOCIATION AND BRUCE A. SCUDDAY, D.P.M. v. TEXAS ORTHOPAEDIC ASSOCIATION, TEXAS MEDICAL ASSOCIATION, AND ANDREW M. KANT, M.D.; from Travis County; 3rd district (03-05-00620-CV, 254 SW3d 714, 05-23-08)

Event Information:

Event Type:

Petition for Review disposed 

Description:

Indicates filing re Petition for Review 

Date:

6/18/2010 

Disposition:

Denied with Justice not sitting. 

Opinion Written:

 

PART 18. TEXAS STATE BOARD OF PODIATRIC MEDICAL EXAMINERS  - April 30, Chapter 375 Page 3394

CHAPTER 375. CONDUCT AND SCOPE OF PRACTICE

22 TAC §375.1

The Texas State Board Podiatric Medical Examiners has proposed changes to §375.1 regarding Definitions. The changes to §375.1 are being proposed to remove the definition of foot which is currently found at paragraph (2). Although this rule remains valid while it is in litigation and the Board's reasons and justification for adopting the rule still exist, this change is proposed solely due to ongoing discussions amongst the parties to the litigation. Those discussions are aimed at reaching mutually agreeable language that would also represent the current practice of podiatric medicine. The case being litigated is Case No. 08-0485 Texas Supreme Court - Texas State Board of Podiatric Medical Examiners, Texas Podiatric Medical Association and Bruce A. Scudday, DPM v. Texas Orthopedic Association, Texas Medical Association, and Andrew M. Kant, MD. Apart from a potential final decision of the Texas Supreme Court that would completely invalidate this rule, removal of this rule possibly would not occur as a result of this notice unless the discussions with the parties to the litigation resulted in Board adoption of a written agreement that would justify removal of the rule.

Hemant Makan, Executive Director, has determined that for each year for the first five years the rule is effective, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule.

Mr. Makan has also determined that for each year for the first five years the rules are in effect, the public benefit anticipated as a result of adopting the changes for §375.1 will be a better understanding of the practice of podiatry and its scope, including its limitations provided that the parties to the litigation reach a written agreement on the representation of the current practice of podiatric medicine. There will be no cost to small businesses, micro-businesses or individuals.

Comments on or about the proposed changes may be submitted in writing within the 30 days after this notice of proposed amendment appears in the Texas Register to Janie Alonzo, Staff Services Officer V, Texas State Board of Podiatric Medical Examiners, P.O. Box 12216, Austin, Texas 78711-2216, janie.alonzo@foot.state.tx.us.

The changes are being proposed under Texas Occupations Code, §202.151, which provides the Texas State Board of Podiatric Medical Examiners with the authority to adopt reasonable or necessary rules and bylaws consistent with the law regulating the practice of podiatry, the laws of this state, and the law of the United States to govern its proceedings and activities, the regulation of the practice of podiatry and the enforcements of the law regulating the practice of podiatry.

The proposed changes for §375.1 implement Texas Occupations Code §202.001(a)(4).

§375.1.Definitions.

The following words and terms, when used in this chapter, shall have the following meanings, unless the context indicates otherwise:

(1) Board--The Texas State Board of Podiatric Medical Examiners.

[(2) Foot--The foot is the tibia and fibula in their articulation with the talus, and all bones to the toes, inclusive of all soft tissues (muscles, nerves, vascular structures, tendons, ligaments and any other anatomical structures) that insert into the tibia and fibula in their articulation with the talus and all bones to the toes.]

(2) [(3)] Medical Records --Any records, reports, notes, charts, x-rays, or statements pertaining to the history, diagnosis, evaluation, treatment or prognosis of the patient including copies of medical records of other health care practitioners contained in the records of the podiatric physician to whom a request for release of records has been made.

(3) [(4)] Office --In the singular, includes the plural.

(4) [(5)] Public communication --Any written, printed, visual, or oral statement or other communication made or distributed, or intended for distribution, to a member of the general public or the general public at large.

(5) [(6)] Solicitation --A private communication to a person concerning the performance of a podiatric service for such person.

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 April 19, 2010.

TRD-201001897

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