Robert "Sam" Tessen, Executive Director

HAPPY BIRTHDAY TO OUR COUNTRY!  INDEPENDENCE DAY, A DAY TO CELEBRATE OUR FREEDOM!!!
WE HOPE YOU HAVE A FUN-FILLED FOURTH OF JULY HOLIDAY.  ENJOY THE HOT DOGS AND HAMBURGERS; WEAR THE SUN BLOCK, AND ENJOY THE FIREWORKS.  AND....BE SAFE! 

 Freedom is the oxygen of the soul.             Moshe Dayan

We must be free not because we claim freedom, but because we practice it.               William Faulkner

"What is the essence of America? Finding and maintaining that perfect, delicate balance between freedom 'to' and freedom 'from.'" ~ Marilyn vos Savant

IN THIS ISSUE, FOR YOU:
ON THE SCHEDULE AND DISTRICT MEETINGS
DOCTORS FACE PAYMENT CUTS FOR PATIENTS ON MEDICARE
ADMINISTRATION DELAYS MEDICARE PAYMENT CUTS FOR NOW
CLAIMS PAID UNDER THE MEDICARE FEE SCHEDULE - NEWS FROM CMS 
PROPOSED FEE SCHEDULE CARRIES CUT OF MORE THAN 5%
CONGRATULATIONS TO TCOM CLASS OF 2009
TMB SCHEDULES EIGHT ADDITIONAL TOWN HALL MEETINGS
TEXAS DOCTORS WITHDRAW CORNYN ENDORSEMENT 
CMS PROPOSES CHANGES TO RURAL HEALTH CLINICS / FQHC REGULATIONS
TEXAS HOSPITALS WARY OF MAKING COMPLAINTS, ERRORS PUBLIC
Dingell, Barton Sponsor I.T. Bill
FDA DELAYS DECISION ON EXPANDED GARDASIL APPROVAL
CDC TOOL FOR EMERGENCY AND DISASTER SHELTERS

 "THERE IS LITTLE SUCCESS WHERE THERE IS LITTLE LAUGHTER."

ON THE SCHEDULE AND DISTRICT MEETINGS:

District 8               Thursday, July 24th
                           Corpus Christi, TX

District 8               Thursday, Aug. 28th
                           Corpus Christi, TX

District 7               Friday, August 8th
                           Reception and Mixer to welcome incoming residents
                           TOMA building, 1415 Lavaca
                           Austin, TX
 
District 7               Thursday, August 21st
                           Austin, TX
 
July 21                 TOMA Student Organization and TOMA Reception for New TCOM Students,

                           7-9 p.m.
                           Joe T. Garcia's Mexican Restaurant
                           2201 N. Commerce St. (in the Fort Worth Stockyards area,)
                           Fort Worth, TX
                           (Come, welcome the new D.O. Students at TCOM; show them that DO special family attitude)

August 2               Pool Party, for Medical Students (and D.O.s)
                           5:00 p.m., Home Of Mark and Rita Baker
                           Fort Worth, TX

Aug. 9-10, 2008      "Ligamentous Articular Strain Techniques" Basic Course presented by the Dallas
                            Osteopathic Study Group
                            Doubletree Hotel-Campbell Centre, Dallas, TX 75206
                            Contact: Conrad Speece, D.O. course director
                            214-321-2673  cjspeece@yahoo.com
                            August 9-10, 2008
                            CME: 16 hours OMM category 1-A anticipated from AOA

DOCTORS FACE PAYMENT CUTS FOR PATIENTS ON MEDICARE

It's been a week of ups and downs for doctors hoping to escape planned payment cuts for patients on Medicare. The U.S. House voted Tuesday to pass legislation that would void a 10.6% pay cut for doctors who treat Medicare patients, but the Senate failed by two votes Thursday to call up the bill. The payment cuts will begin July 1, and while there's a chance lawmakers will vote to retroactively increase those payments if legislation goes through, nothing will happen until after the July 4 holiday.
http://www.healthleadersmedia.com/content/214244/topic/WS_HLM2_PHY/Doctors-face-payment-cuts-for-patients-on-Medicare.html

From:  HealthLeaders Media Corner Office, of HealthLeaders Media, www.healthleadersmedia.com

ADMINISTRATION DELAYS MEDICARE PAYMENT CUTS FOR NOW

The Bush administration has announced that it will hold off processing new Medicare claims from physicians to give Congress more time to avert deep cuts in doctors' payments set to take effect Tuesday.
The move comes after Congress adjourned for its one-week July Fourth recess without clearing legislation to negate a scheduled 10.6 percent cut in the Medicare physician payments.
Senate Republicans blocked Democrats - for the second time - from passing a bill that would have erased the cut and provided doctors a small increase in their fees instead.

In a notice to Congress sent late June 27, the Centers for Medicare and Medicaid Services (CMS) said it would not apply the cut in physicians' fees immediately, instead holding doctors' claims for 10 business days.This would give Congress until July 15 to pass a bill. Doctors have warned that if their fees are cut, they will see fewer Medicare patients.
Some Republicans and President Bush object to the bill because it would pay for the fee relief by trimming payments to private insurers who offer Medicare Advantage plans.
Rather than negotiate with Republicans on compromise legislation, Senate Majority Leader Harry Reid , D-Nev., is hoping that doctors' groups like the powerful American Medical Association can pressure vulnerable Republicans over the recess.

The bill failed to clear the Senate last week by a single vote. Under an agreement between the parties, it needed 60 votes.
Even if the Senate can find one more vote to send the bill to Bush, he has vowed to veto it. Given the stakes, a compromise is likely at some point.

From:  CQ TODAY MIDDAY UPDATE, Congressional Quarterly Inc.,  www.cq.com

CLAIMS PAID UNDER THE MEDICARE FEE SCHEDULE - NEWS FROM CMS 

To the extent possible, the Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other Fee-For-Service (FFS) providers of services paid under the Medicare physician fee schedule, beginning July 1.  In this regard, CMS has instructed its contractors to hold these claims for the first 10 business days of July, for dates of service in July.  This should have minimum impact on provider cash flow because, under current law, electronic claims are not paid any sooner than 14 days (29 days for paper claims) after the date of receipt.  Meanwhile, all claims for services delivered on or before June 30 will be processed and paid under normal procedures.

After 10 business days, contractors will begin releasing claims into processing under the fee schedule which implements current law.  This, of course, could result in claims being processed with the negative 10.6 percent update.  If a new law is enacted which changes the negative 10.6 percent update, retroactive to July 1, CMS is prepared to automatically reprocess most of those claims which have already been processed. 

Under the Medicare statute, Medicare pays the lower of submitted charges and the Medicare fee schedule amount.  Claims with dates of service July 1 and later billed with a submitted charge at least at the level of the January 1-June 30, 2008, fee schedule will be automatically reprocessed if Congress retroactively reinstates the update that was in effect for that time period.  Any lesser amount will likely require providers to re-submit a revised claim. 

To the extent possible, providers may hold claims in-house until it becomes clearer as to whether new legislation will be enacted or until cash flow becomes problematic.  This will reduce the need for providers to reconcile two payments (i.e., the initial claim and the reprocessed claim), and it will simplify provider billings of beneficiary coinsurance and payment calculations for payers which are secondary to Medicare.

In addition, be on the alert for more information about other legislative provisions which may affect Medicare FFS providers.
 
PROPOSED FEE SCHEDULE CARRIES CUT OF MORE THAN 5%
 
Medicare payments to physicians and other healthcare professionals would fall more than 5% under the program's proposed fee schedule for 2009.
The CMS projects it will pay $54 billion to 980,000 physicians and other healthcare professionals in calendar year 2009, down from an estimated $57 billion this year.
A separate 10% cut is scheduled to go into effect July 1, but the agency said it would take administrative measures to delay that cut for another two weeks.
The proposed rule would add 56 new measures to the Physician Quality Reporting Initiative, for a total of 175 in 2009. Physicians who participate in PQRI get a small bonus for reporting on these quality measures.

Provided that certain conditions are met, the proposed rule would offer an exception to the prohibition on physician self-referral that would permit remuneration provided by a hospital to physicians on its medical staff under programs that use economic incentives to promote high-quality care, such as value-based purchasing.
Another provision would enable physicians to bill for follow-up inpatient consultations delivered electronically.
The CMS will accept comments on the proposed rule until Aug. 29, and will respond to those comments in a final rule to be issued by Nov. 1. -- by Jennifer Lubell
 
From:   Modern Physician Online, Modern Physician, Crain Communications, Inc., www.modernphysician.com

CONGRATULATIONS TO TCOM CLASS OF 2009

Congratulations to our new fourth year medical students for their performance on the COMLEX (Comprehensive Osteopathic Medical Licensing Examination) Level 1 examination this past year.
The current fourth year medical students not only performed the best in the nation; but our mean scores were a phenomenal nearly 2/3 standard deviation above the national mean, and our pass rate of >98.5% was 8.5% above the national mean pass rate. 

Marc Hahn, DO, Dean, reports, "The quality of our students, the caliber of our faculty and the creativity of our administrators has truly made your Texas College of Osteopathic Medicine the number one osteopathic medical school in the nation!"

TMB SCHEDULES EIGHT ADDITIONAL TOWN HALL MEETINGS

Town Hall meetings/licensing seminars will be conducted at the following locations:

July 8 and 9 - Bryan/College Station - Both sessions will be conducted in Lecture Hall 1 on the first floor of the Joe Reynolds Medical Building at Texas A&M University, at the southwest corner of University Drive and Olsen Boulevard. The Town Hall meeting will be at 7 p.m. on July 8 and the licensing seminar will begin at 8:30 a.m. on July 9.

July 15 and 16 - Houston - Both sessions will be at the University of Texas Medical School at 6431 Fannin St. The Town Hall meeting will be in Room MSB 1.006 (the first floor lecture hall) at 7 p.m. on July 15 and the licensing seminar will be in Room MSB 2.006 at 8:30 a.m. on July 16.

July 29 and 30 - Lubbock - Both sessions will be conducted in the Texas Tech University Health Sciences Center, 3601 4th Street (4th Street and Indiana Avenue). The Town Hall meeting will be at 7 p.m. on July 29 in Room ACB100, and the licensing seminar will begin at 8:30 a.m. on July 30 be in Room ACB120.

August 5 and 6 - Tyler - Both sessions will be in the Biomedical Research Auditorium at The University of Texas Health Science Center, 11937 U.S. Highway 271. The Town Hall meeting will be at 7 p.m. on August 5 and the licensing seminar will begin at 8:30 a.m. on August 6.

August 12 and 13 - Dallas - Both sessions will be conducted in the T. Boone Pickens Biomedical Building Auditorium, Room NG3.112 on the third floor, at the University of Texas Southwestern Medical Center at Dallas, 6001 Forest Park Road. The Town Hall meeting will begin at 7 p.m. on August 12, and the licensing seminar will begin at 8:30 a.m. on August 13.

August 19 and 20 - El Paso - Both sessions will be conducted in Auditorium B on the second floor of the Administration Building at Texas Tech University Health Science Center, 4800 Alberta Avenue. The Town Hall meeting will begin at 7 p.m. on August 19 and the licensing seminar will begin at 8:30 a.m. on August 20.

August 25 and 26 - San Antonio - Both sessions will be conducted at the School of Medicine at the Joe R. and Teresa Lozano Long Campus of the University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive. The Town Hall meeting will begin at 7 p.m. on August 25 in Lecture Room MED 309L. The licensing seminar will begin at 8:30 a.m. in Lecture Hall 3.104A.

September 3 and 4 - Galveston - The meetings will be held at the University of Texas Medical Branch at Galveston. The rooms will be announced.
 
September 9 and 10 - Amarillo - The meetings will be held at the Texas Tech University Health Science Center. The rooms will be announced.
 
TEXAS DOCTORS WITHDRAW CORNYN ENDORSEMENT 

By ROBERT T. GARRETT / The Dallas Morning News, Friday, June 27, 2008

AUSTIN - The main political arm of Texas physicians today withdrew its endorsement of U.S. Sen. John Cornyn for re-election.
Texas Medical Association spokesman Steve Levine said its 43,000 doctors and medical students are furious because Mr. Cornyn voted Thursday night to block Senate consideration of a House-passed bill to stave off 10.6 percent cuts in doctors' Medicare fees.
http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/062608dnmettma.4565b56c.html

From;  Texas Weekly News Clips, by Printing Production Systems, Inc., www.texasweekly.com

CMS PROPOSES CHANGES TO RURAL HEALTH CLINICS / FQHC REGULATIONS
See information and links below for the new proposed regulation for RHCs and FQHCs.
 
Please click on the following two links to access the June 26, 2008, CMS press release and fact sheet, respectively, on the Medicare proposed rural health clinic (RHC) rule which went on display today:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3174&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

http://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3175&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Please note that the proposed rule is expected to be published in the Federal Register tomorrow, on June 27, 2008.  Comments must be submitted by 5:00 PM Eastern time on August 27, 2008.

Click on the following link to see the proposed rule currently on display:
http://federalregister.gov/OFRUpload/OFRData/2008-13280_PI.pdf

 
TEXAS HOSPITALS WARY OF MAKING COMPLAINTS, ERRORS PUBLIC
Fort Worth Star-Telegram - July 1, 2008

Across Texas over a recent three-year period, hospitals reported that 53 newborns with no obvious birth defects died unexpectedly. Medical blunders killed or crippled another 78 patients. Foreign objects - sponges, needles, tools - were accidentally left in 218 patients. More than 120 times, surgeons cut into the wrong body part or wrong patient. Which hospitals bungled their jobs? The state knows, but, by law, you can't find out. In fact, from now on you won't even be able to see such statistics. Since September, the state no longer requires hospitals to own up to their mistakes, even anonymously. The Legislature let the law expire.
click here for more:  http://www.star-telegram.com/health/story/733352.html

FROM:  The Quorum Report, EDITOR: Harvey Kronberg, www.quorumreport.com

Dingell, Barton Sponsor I.T. Bill

Reps. John Dingell (D-Mich.) and Joe Barton (R-Texas) have introduced health care information technology legislation in the U.S. House a month after issuing a draft bill for public comment.
The bill would make several changes to the HIPAA privacy and security rules. It would make security safeguards under the security rule and penalties for violations apply to business associates in the same manner as applied to covered entities. Further, it would require individuals affected by breaches of unencrypted protected health information to be notified "without unreasonable delay and no later than 60 calendar days after discovery," according to the bill. Further, the bill would require the Secretary of Health and Human Services, in consultation with stakeholders, to annually issue guidance on the latest technologies for protecting information.
http://www.healthdatamanagement.com/news/legislation26523-1.html?ET=healthdatamanagement:e485:121328a:&st=email&channel=policies_regulation

From:  Health Data Management, SourceMedia Inc., www.e.healthdatamanagement.com

FDA DELAYS DECISION ON EXPANDED GARDASIL APPROVAL

The FDA has postponed a decision on whether to allow the use of Gardasil, Merck & Co.'s cervical-cancer vaccine, in women from 27 to 45 years old, citing issues that it can't resolve within the allotted review period. Merck said it has addressed the FDA's questions regarding the vaccine's efficacy in the age group and will send a response to the agency in July. Reuters (6/25)
http://www.reuters.com/article/healthNews/idUSWNAS917720080625?pageNumber=1&virtualBrandChannel=0

CDC TOOL FOR EMERGENCY AND DISASTER SHELTERS
 
It's hurricane season, and the Centers for Disease Control and Prevention and partners have developed an environmental health shelter assessment tool to strengthen efforts to provide safe and healthy shelters in the wake of disasters and emergencies. An assessment form (available in English and Spanish) covers 14 general areas of environmental health and allows for documenting immediate needs. The assessment tool also provides guidance and information that can be used with existing plans, procedures, resources, and management systems. The environmental health shelter assessment tool, including instructions and training materials for its use, is available here. For more information about the environmental health shelter assessment tool, please contact CDC via e-mail at Shelterassessmentform@cdc.gov.

"THERE IS LITTLE SUCCESS WHERE THERE IS LITTLE LAUGHTER."              ~ Andrew Carnegie

Here is what Jeff Foxworthy has to say about folks from Texas:
If someone in a Lowe's store offers you assistance and they don't work there, you may live in Texas;
If you've worn shorts and a parka at the same time, you may live in Texas;
If you've had a lengthy telephone conversation with someone who dialed a wrong number, you may live in Texas;
If you measure distance in hours, you may live in Texas;
If you know several people who have hit a deer more than once, you may live in Texas;
If you install security lights on your house and garage, but leave both unlocked, you may live in Texas;
If you carry jumper cables in your car and your wife knows how to use them, you may live in Texas;
If the speed limit on the h ighway is 55 mph -- you're going 80 and everybody's passing you, you may live in Texas;
If you find 60 degrees 'a little chilly,' you may live in Texas;
If you actually understand these jokes, and share them with all your Texas friends, you definitely live in Texas.

-------------------------------------------------------------------------

ADVOCATE DO MEDICAL LIABILITY COVERAGE FOR DO's

As a TOMA member, you are eligible for the TOMA Preferred Program which offers discounted rates on medical malpractice insurance premiums from Advocate, DO.  TOMA has partnered with Advocate, DO to bring you competitive rates, free risk management assessments, in-house legal assistance, aggressive claims management and a claims-made policy that does not expire.  In addition, you will receive Texas Medical Board coverage with separate limits, no deductible and no out of pocket expenses!  Advocate, DO does not require any surplus charges, TMA or County Medical Association dues and will provide prior acts coverage.

Take full advantage of your TOMA Preferred Program discounts, call Advocate, DO today - (800) 686-2734 or visit www.advocatedo.com.

Advocate, D.O.
Underwritten by Advocate, MD Insurance Company of the Southwest Inc.
800-686-2734 or 512.275.1830
www.advocatedo.com