tients and their infants at a time when the quality of that treatment is critical. That’s according to joint comments by
the Texas Medical Association, the Texas Academy of Family Physicians, the Texas Pediatric Society, the Texas Association of Obstetricians and Gynecologists, the American Congress of Obstetricians and Gynecologists/Texas, and the Texas Soci- ety of Anesthesiologists. HHSC said the rule change is nec-
essary to comply with federal law and determined it will expand access to care and choice of care for those Medicaid patients.
It follows a provision in the federal
Patient Protection and Affordable Care Act (PPACA) that requires states to pro- vide Medicaid reimbursement to “all pro- vider types defined as birth attendants by state law.” Texas defines a birth at- tendant as a physician, certified nurse midwife, or licensed midwife. PPACA also requires licensed mid- wives to be reimbursed for services pro- vided to Medicaid patients in a birthing center if the midwives are licensed by the state. In Texas, they are licensed by the Department of State Health Services. But unlike certified midwives, the training requirements for licensed mid- wives are minimal, physicians warned. In addition, the proposed rule does not maintain the same referral protocols that apply to the more highly educated and trained certified midwives, who by state law must have a referral agreement with a physician as a safeguard in the event of complications — incidents that
happen suddenly and occur more fre- quently within the Medicaid population, doctors testified. “We cannot believe the state intends to dismantle the maternity care team, which depends on timely communica- tion, collaborative management and transfer of care among appropriately trained and certified practitioners at all levels,” the physician comment letter states. “It is absurd, therefore, that these rules permit licensed midwives to pro- vide care without an ounce of oversight.” The physician organizations “un- equivocally” opposed the rule change. If adopted, however, doctors demanded patient protections, including written proof of a referral arrangement with a physician and requirements that licensed midwives carry liability insurance. The comment period ended Sept. 2,
and HHSC is expected to adopt and pub- lish a final rule sometime in November.
the latest on the transition from Trail- Blazer to Novitas Solutions Inc. as the new Medicare administrative contractor for Texas beginning Nov. 19. Novitas representatives will be on site to help physicians prepare an action plan to minimize disruptions to their practices during the switch. Physicians will walk away with a checklist to help streamline the transition process and comply with the new documentation requirements, such as the completion of an electronic funds transfer agreement. Participants also will learn the ins and outs of enrollment, claims filing, appeals, and audits, as well as the differences be- tween Novitas’ and TrailBlazer’s local coverage determinations. Novitas Medicare experts also will discuss the new Medicare trends and topics, including the fate of the Sustain- able Growth Rate formula, the govern- ment’s fraud, waste, and abuse initia- tives, and the latest payment and policy issues.
Physicians may enroll online at www
Hear all about it: TMA Medicare seminars under way
The Texas Medical Association is bring- ing important updates on the Medicare system to a Texas city near physicians of all specialties as part of its annual Medi- care seminar series. This year’s meetings also will include
(Medical Review Officer Training Special CME Programs)
Come learn the technical, legal and business procedures and guidance to act as a Medical Review Officer. This valuable certification and occupational medicine credential is required by some state drug testing laws and the U.S. Department of Transportation.
Comprehensive MRO Training Including Hair, Sweat, Oral Fluid, Alcohol Testing, and AAMRO Certification Exam
Las Vegas, NV
November 30–December 2, 2012 (Friday-Sunday)
Breckenridge, CO January 18–20, 2013 (Friday-Sunday)
800-489-1839
www.aamro.com 30 TEXAS MEDICINE November 2012
.texmed.org/medicare2013 or by calling (877) 880-1335. The remaining dates and cities for the seminars are:
• Nov. 6: Corpus Christi, Corpus Christi Medical Center – Doctors Regional; San Antonio, Bexar County Medical Society;
• Nov. 7: Abilene, Abilene Christian University, Hunter Welcome Center; Austin, Texas Medical Association, Thompson Auditorium;
• Nov. 8: Lubbock, Texas Tech Univer- sity Health Sciences Center;
• Nov. 13: Houston (central), United Way of Greater Houston;
• Nov. 14: Houston, Methodist West Houston Hospital; and
• Nov. 15: Rio Grande Valley, Golden Palms Retirement and Health Center in Harlingen. n
Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
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