TMB institutes remedial plan to replace disciplinary actions
The Texas Medical Board (TMB) has im- plemented fairness provisions of a new state law — backed by the Texas Medi- cal Association — that allows physicians named in complaints to resolve their cases with a “remedial plan” rather than a formal disciplinary action. The board can now waive fines for minor administrative violations as long as the physician agrees to complete a program of related continuing medical education (CME). However, the physi- cian would not have to admit to wrong- doing or have his or her name published in TMB news releases or newsletters. The new policy is part of House Bill 680 by state Rep. Charles Schwertner, MD (R-Georgetown), that the legisla- ture passed last year. TMA not only en- dorsed the bill but also defeated several amendments that would have weakened the board and threatened to drive more complaints to civil courts — negating the positive effects of the 2003 liabil- ity reforms TMA pushed through the legislature. In its January newsletter, TMB gives the example of a doctor not signing a death certificate in a timely manner. Ac- cording to the article, the physician may agree to pay a small fine and complete four hours of CME but would not admit to or deny the findings and would “avoid the uncertainty of litigation.” Also, the remedial plan would not be
considered a disciplinary action, so the physician’s name would not be reported
All articles in Texas Medicine that mention Texas Medical Association’s stance on state legislation are defined as “legislative advertising,” according to Texas Govt. Code Ann. §305.027. That law requires disclosure of the name and address of the person who contracts with the printer to publish the legislative advertising in Texas Medicine: Louis J. Goodman, PhD, Executive Vice President, TMA, 401 W. 15th St., Austin, TX 78701.
38 TEXAS MEDICINE March 2012
to the National Practitioner Data Bank. Remedial plans would be developed for “administrative violations,” according to the article, and they give the medi- cal board a third option — and a degree of flexibility — in responding to a minor incident. Previously it could only dismiss the complaint or seek public disciplinary action.
The cost to taxpayers for permanent
Medicine: Use war money for Medicare
The Texas Medical Association joined the American Medical Association and doz- ens of other state and national medical organizations in urging Congress to per- manently stop the fiscally irresponsible cycle of scheduled cuts and short-term patches to Medicare physician payments. In a letter to U.S. Rep. Dave Camp
(R-Mich.), chair of the House Ways and Means Committee, physician groups called for an end to the failed Sustain- able Growth Rate (SGR) formula that threatens access to care for seniors and military families in the Medicare and TRICARE programs. They asked Con- gress to use projected spending that will not be needed as the wars in Iraq and Afghanistan wind down to help pay for ensuring access to health care for mili- tary and seniors. Congressional action in late Decem-
ber delayed the 27.4-percent cut in phy- sicians’ Medicare payments from Jan. 1 until Feb. 1.
Using the Overseas Contingency Operations “provides an opportunity to immediately repeal the SGR and to establish a pathway toward a truly sus- tainable physician payment system that focuses on improving quality and value for our nation’s Medicare beneficiaries,” the letter said. The groups said they “agree that our nation faces significant fiscal challenges, and that Medicare is not immune. How- ever, it is impossible to implement com- monsense programmatic reforms while an immediate and constant threat of massive cuts hangs over the program.”
repeal of the Medicare physician pay- ment formula has grown dramatically over the years due to Congress’ frequent short-term patches. As recently as 2005 the cost of permanent repeal would have been $48 billion. Today it is estimated to be nearly $300 billion. If Congress con- tinues to implement the same temporary patches they have in the past, the cost will double again in only five years. Sixty-three national medical organi- zations, specialty societies, and medi- cal group management organizations, as well as 45 state medical associations and the Medical Society of the District of Columbia, signed the letter. A 2011 TMA survey found that al- most half the physicians in Texas say they would consider dropping out of Medicare if fees are lowered. To illustrate the impact Medicare fee cuts could have on patients in terms even a child can understand, TMA pro- duced the “Grandma and the Big, Bad SGR” video (
www.youtube.com/wat ch?v=6CGiiTVW4VU&feature=yout ube). Feel free to share the video with your members of Congress, colleagues, friends, family, patients, and staff. n
Ken Ortolon is senior editor of Texas Medicine. You can reach him by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
ken.ortolon@texmed.org.
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