Senate passes new business tax

The Senate passed House Bill 3, which imposes a new tax on the gross receipts of all businesses earning more than $300,000 per year, on Tuesday, May 2, without a single change from the version of the bill that left the House last week. That means the centerpiece of Gov. Rick Perry’s plan to avoid a constitutional showdown over the state’s method of public school finance is headed straight to his desk for signature, bypassing the conference committee process altogether.

HB 3 would place a 1-percent tax on gross receipts minus cost of goods or employee compensation for businesses earning more than $300,000 per year, including physician practices. Physicians would be able to deduct from their taxable income the full amount of all revenue from Medicaid, CHIP, Medicare, worker’s compensation, the County Indigent Health Care Program and military insurance programs plus the cost of any uncompensated charity care they provide.

During one general legislative session and four called special sessions to deal with school finance, TAFP has argued consistently that unlike virtually any other business, physician practices do not have the option of passing the cost of a new tax on to their customers because physicians’ rate of pay is determined largely by either government programs or private third-party payers. Representatives of TAFP have told lawmakers that since Texas physicians provide $1 billion of uncompensated charity care each year, they already pay a significant “hidden” tax.

Those arguments have not fallen on deaf ears. Although legislators proved unwilling to let any businesses out of the tax, the inclusion of deductions for Medicaid, CHIP, Medicare, charity care and more shows that the Legislature and the governor did not ignore physicians’ concerns.

The business tax will not go into until Feb. of 2008, providing TAFP an opportunity to address potential tax implications to physician practices during the 80 th legislative session beginning in January of 2007. TAFP is also working with legislative leadership to increase Medicaid and CHIP reimbursement rates for those participating in the program to help ameliorate new tax burdens.

This week’s message: Cover the uninsured

Cover the Uninsured Week, taking place May 1-7, 2006, will draw attention to the nearly 46 million Americans who lack health coverage by encouraging participants to sponsor community events, forums and enrollment drives. Many organizations and individuals have joined the Robert Wood Johnson Foundation to urge lawmakers to address the issue of decreasing access to medical care and propose national solutions to the problem.

Volunteers can help coordinate activities such as press conferences, health fairs, business seminars, interfaith group meetings or campus activities during the week. Events already scheduled are listed by state on an interactive Web site, which also has an online search-and-send feature that allows individuals to look up congressional representatives and contact them with concerns. Cover the Uninsured Week representatives from across the nation will also gather in Washington, D.C., to attend forums and encourage lawmakers to make health coverage a top priority.

The most important events of the weeklong campaign are the enrollment drives for uninsured adults and children. At the public events, volunteers will work with uninsured people to determine coverage options or eligibility for public coverage programs. Those qualifying for public coverage programs could get enrolled in the free or low-cost programs that day. This means that, in the long run, more people would have insurance and would rely less on expensive emergency room care.

Find out how to get involved by visiting the official Web site. To request assistance with contacting the media or drafting a press release for your event, contact Kate McCann by e-mail or by phone at (512) 329-8666 ext. 16. Also use TAFP’s sample letter to the editor (link) to help spread the word.

Resources:

Ideas for events and free materials to download or order are available through the official Web site.

Send the sample press release, provided by TAFP, to the media around your town to raise awareness for this issue.

Some of your patients may be entitled to health insurance in Texas and not even know it. Help them find out with the document, “Guide to Finding Health Insurance Coverage in Texas.”

Free credentialing database now available

Now available for physicians is a free standard credentialing program to help save time and money in completing and updating credentialing data. The Universal Credentialing DataSource, provided by the Council for Affordable Quality Healthcare, will help improve administrative efficiency as it streamlines the completion of numerous health plan credentialing applications and other supplemental documents, such as copies of medical liability insurance and medical licenses.

Information is entered one time, online or by fax, to meet the credentialing and recredentialing requirements of participating health care organizations. Data can only be accessed by health care organizations that have been authorized by each physician. Each health care organization reviews and verifies credentialing data, and decides whether or not a physician meets its standards for participation.

To access the database, physicians should log on to CAQH’s Web site with their UCD Provider ID. The Provider ID is sent automatically to physicians who work with participating health plans. Those physicians who work with one of the listed plans but have not received a Provider ID should call the health plan provider and ask its staff to submit his or her name to CAQH.

AAFP endorses member participation in CAQH’s UCD. CAQH is a not-for-profit alliance of health plans and networks that promotes collaborative initiatives for affordable health care, shares knowledge to improve the quality of care and simplifies administration tasks for physicians and their patients.

Resources

For more information and for a list of participating organizations, visit CAQH’s Web site.

Medicare Part D deadline approaches

Only two weeks remain until May 15 -- the deadline for seniors to sign up without a permanent monthly penalty for the Medicare Part D prescription drug program. During this final rush, both physicians and their patients can use the resources listed below to help answer last-minute questions. The next enrollment period will take place Nov. 15, 2006 through Dec. 31, 2006, so officials of the Centers for Medicare and Medicaid are encouraging immediate action to make the May 15 deadline.

Important numbers for patients:

Centers for Medicare and Medicaid (800) MEDICARE

Call the Medicare call center for basic Medicare information or to request detailed information about the Medicare Advantage plans available in your area. Call 2-1-1 for a referral to a local Area Agency on Aging.

Texas Medicaid Agency (888) 834-7406 or (512) 424-6500

Get information and free counseling related to Medicare, Medigap, MA plans and long-term care through the state Health Insurance Assistance Program.

Long-term Care Ombudsman (512) 438-4356

The Long-term Care Ombudsman protects the rights of nursing home or long-term care facility patients.

National Social Security Hotline (800) 772-1213

Call for information on Medicare enrollment and eligibility, to set up an appointment at a local Texas field office or to report lost Medicare cards.

Additional resources:

Talking About Medicare, a comprehensive guide to Medicare developed by the Kaiser Family Foundation, is now available on the organization’s Web site. The guide delves into detailed explanations for topics such as long-term care, prescription drug costs and insurance to supplement Medicare. The seven tabbed topic pages each contain several sub-pages of information, charts, graphs and tips for choosing a correct plan. A printable PDF version of the guide will be available May 1.

Additional resources are available on TAFP’s Web site.

Redi or not, here come retail health clinics

As fast as their names imply, retail health clinics like MinuteClinic, Take Care, Little Clinic and RediClinic are rapidly popping up in shopping centers all over the country. Most are staffed by mid-level providers and offer acute care plus a selection of immunizations, diagnostic screenings and physical exams. Each model is slightly different but feature similar core concepts: extended weekday and weekend hours, an easy-to-understand pricing menu and quick service with little or no wait for treatment of the most common ailments.

The sudden expansion has surprised opponents of the clinics who question quality, conflicts of interest between the clinic and host sites and competition with family physicians. The debate only gets juicier. Read more about retail health clinics in the latest TEXAS FAMILY PHYSICIAN online.

The family man: TAFP’s Physician of the Year

Family comes first with this year’s Family Physician of the Year, Cayetano E. Barrera, III, M.D. In addition to his immediate family, comprised of his wife, three grown children and their three spouses and eight grandchildren, he also counts his clinic staff and patient base as a second family, the Valley community as his third family and the residents of Texas as his fourth family. Somehow he watches out for them all. Read more about Dr. Barrera in the latest TEXAS FAMILY PHYSICIAN online.

Copyright 2006, Texas Academy of Family Physicians