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TMA's Health System Reform Principles

 

Your Texas Medical Association will not sit and watch as Congress and the Obama administration develop their plans to reform the nation's health care system. Acting at the direction of the TMA House of Delegates, the TMA Select Committee on Health System Reform has developed guiding principles the association will follow as it makes Texas physicians' voices heard in Washington.

"Our goal, as physicians, is to make patient care better. No one else stands for our patients as we do," said TMA President Josie R. Williams, MD.

The June issue of Texas Medicine has more on the health reform debate and the role TMA is playing in it.

The guiding principles the select committee developed are:

  1. Promote portable and continuous health care coverage for all Americans using an affordable mix of public and private payer systems.
  2. Promote patient safety as a top priority for reform, recognizing an effective mix of initiatives that combine evidence-based accountability standards, committed financial resources, and rewards for performance that incent and ensure patient safety.
  3. Adopt physician-developed, evidence-based tools for use in scientifically valid quality/patient safety initiatives that incentivize and reward the physician-led health care delivery team, and include comparative effectiveness research used only to help patient-physician relationships choose the best care for patients.  
  4. Preserve patient and physician choice and the integrity of the patient-physician relationship.
  5. Incorporate physician-developed, evidence-based measures and preventive health and wellness initiatives into any new or expanded health benefit package as a means to promote a healthier citizenry.
  6. Recognize and support the role of safety net and public health systems in delivering essential health care services within our communities, to include essential prevention and health promotion public health services.
  7. Support the development of a well-funded, nationwide emergency and trauma care system that provides appropriate emergency and trauma care for all Americans.   
  8. Support public policy that fosters ethical and effective end-of-life care decisions, to include requiring all Medicare patients to have an advance directive that a Medicare enrollee can discuss as part of a covered Medicare visit with a physician.
  9. Provide sustainable financing mechanisms that ensure the aforementioned affordable mix of services and create personal responsibility among all stakeholders for financing and appropriate utilization of the system.
  10. Invest needed resources to expand the physician-led workforce to meet the health care needs of a growing and increasingly diverse and aging population.
  11. Provide financial and technological support to implement physician-led, patient-centered medical homes for all Americans, including increased funding and compensation for services provided by primary care physicians and the services provided by non-primary care, specialist physicians as part of the patient-centered medical home continuum.
  12. Through public policy enactments, require accountability and transparency among health insurers to disclose how their premium dollars are spent, eliminate preexisting condition exclusions, simplify administrative processes, and observe fair and competitive market practices.
  13. Reform the national tort system to prevent nonmeritorious lawsuits, keeping Texas reforms in place as enacted by the Texas Legislature and constitutionally affirmed by Texas voters.
  14. Abolish the Medicare Sustainable Growth Rate annual update system and initiate a true cost of practice methodology that provides for annual updates in the Medicare Fee Schedule as determined by a credible, practice expense-based, medical economic index.
  15. Support the implementation of an interoperable National Electronic Medical Records System, financed and implemented through federal funding. 
  16. Require payers to have a standard, transparent contract with providers that cannot be sold or leased for any other payer purposes without the express, written consent of the contracted physician.
  17. Support efforts to make health care financing and delivery decision-making more of a professionally advised function, with appropriate standard setting, payment policy, and delivery system decisions fashioned by physician-led deliberative bodies as authorized legislatively

 

2010 Medicare Enrollment Extended


 

Physicians have until Jan. 31 to decide if they want to change their participation status in the Medicare program next year. The Centers for Medicare & Medicaid Services (CMS) extended the enrollment period another 30 days last month because of changes in the 2010 Medicare physician fee schedule.

The effective date for any participation status change during the extension, however, remains Jan. 1, and will be in force for the entire year.

In light of the controversy over long-term health system reform, the pending 21.2-percent payment cut, the elimination of consulting codes, and many other issues, we know that practices are thinking hard about this participation decision. While TMA can't advise you which direction to take, we can give you detailed information about your participation options and the consequences of those choices.  That's why we've turned to our in-house Medicare experts to record a Webinar to help you make an informed decision. We're moving quickly; our goal is to have this posted on the TMA Web site right after the first of the year. This will allow us to include the most current information while still giving you time to weigh your options. Check future issues of Action for details.

Signing a participation agreement means you agree to accept assignment for all covered services that you provide to Medicare patients in 2010. CMS says fees are 5 percent higher for physicians who participate.

If you choose to participate in 2010:

  1. Do nothing if you currently participate.
  2. If you are not currently a Medicare participant, complete the agreement and mail it to TrailBlazer Health Enterprises, the Texas Medicare carrier.

If you decide not to participate:

  1. Do nothing if you do not currently participate.
  2. If you are currently a participant, write to each Medicare contractor to which you submit claims, advising of your termination effective Jan. 1, 2010.

The Participation Agreement (CMS-Form 460) is available on the CD-ROM distributed by TrailBlazer Health Enterprises and is posted on the TrailBlazer Web site.  Return the form to:

Medicare Part B
Participation Agreement
PO Box 650544
Dallas, TX 75265-0544  

 

 

 Revised Texas Franchise Tax

Physicians and other businesses have more time to file their state franchise tax returns or seek a filing extension without having to pay a penalty. Learn More:


• State Franchise Tax   • Comptroller Revises Franchise Tax Rules    Definitions and calculations