CAPITOL UPDATE:

House fails to suspend rules on hearing bills

The House of Representatives will not be able to hear any bills on the floor for the first 60 days of the session or any bills in committee for the first 30 days of the session after failing to suspend rules that prevent those actions. The provision was originally instated to ensure legislatures had enough time to deliberate on bills. In recent years it has passed with little dissent and hasn’t failed since 1981. Several representatives including Warren Chisum, R-Pampa, say they will keep filing the resolution until it passes. House Speaker Tom Craddick told the Houston Chronicle that failure to suspend this rule was due to “a group that wanted to slow the process down.”

BCBS agrees to TAFP request: Identify family physicians who provide obstetrics

Some victories come from the floor of the House and Senate, while others happen outside of the trenches. The latter is the case with the recent decision by Blue Cross and Blue Shield of Texas to designate family physicians who practice obstetrics in their network directories and on-line Provider Finder. These physicians will receive a special “practice information” line item in their listing.

Currently, patients seeking obstetrical care might never know that some of the family physicians in their network practice obstetrics because only obstetricians are listed in health plan provider network lists as providing those services. One of TAFP’s policy goals for the legislative session is to rectify this problem. If legislation is required, the Academy is prepared to advocate for it but if negotiation with the plans will achieve the goal, that’s one less front to fight at the Capitol. Blue Cross is the first plan to agree to the Academy’s request and talks with other plans are ongoing.

According to a letter from Dee Whittlesey, M.D., Vice President of the BCBS Office of Physician Advocacy, a provider must complete two steps to receive this designation:

1. Send a letter requesting that he or she have an the additional listing for obstetrics in the directory, and
2. Submit a letter or statement on hospital or hospital staff letterhead verifying obstetrical privileges at the network hospital.

Physicians can mail letters to Blue Cross and Blue Shield of Texas Core Provider Services, P.O. Box 650267, Dallas, Texas 75265-0267.

TAFP President Douglas Curran, M.D., says this step reflects the magnitude of the bag of services family physicians offer and sees this as a great step forward that other major health plans can follow. “Family physicians offer unique services of all kinds,” Curran says. “This action allows us to be recognized for the services we provide.”

Appropriations Committee puts health care funding on the agenda

The House Appropriations Committee met on Thursday, Feb. 1, to discuss funding for Health and Human Services. Among the issues under discussion were funding for CHIP and Medicaid and provider-payer relations. Check back soon for more information.

Harris and Woolley file “smart card” bills

Every health plan issuer should provide an electronic health record via “smart card” or magnetic strip technology for all beneficiaries according to bills filed in the House and Senate this week. Senate Bill 334, filed by Sen. Chris Harris, R-Arlington, and House Bill 522, filed by Rep. Beverly Woolley, R-Houston, would embed a patient’s information on the cards to aid health care providers in rendering appropriate care.

In Harris’ bill, the card would contain the enrollee’s name, birth date and health plan subscription number, current enrollment and eligibility status, and any co-pay or deductible requirements. Woolley’s bill would require cards to contain similar information.

These bills will likely serve as the platform for addressing electronic verification of benefits and electronic claims adjudication.

TAFP publishes Issue Briefs at www.tafp.org

Texas Medicaid enrollment has increased to 2.7 million Texans — about 12 percent of the state’s population — yet only 38 percent of Texas physicians accept new Medicaid patients. Two factors, poor reimbursement and the complexity and fragmentation of the Medicaid delivery system, discourage physicians from reasonably entering the program without sacrificing their bottom lines. Additionally, decreasing CHIP funding and dropping enrollment threatens Texas children, a population where one in five is uninsured.

Supporting these public health programs is one of the top priorities for TAFP and the Primary Care Coalition this legislative session. For this reason, the PCC has released the first in a series of one-page issue briefs on Medicaid and CHIP to educate policymakers and the public on the challenges facing Texas’ health care system. Access the Medicaid and CHIP issue brief and other policy initiatives such as the report “Fractured: The State of Health Care in Texas” on the policy initiatives page of the TAFP Web site. Check the Web site often as more issue briefs will be posted throughout the session on graduate medical education and workforce issues, fair contracting, transparency and others.

House committee appointments announced

After some anticipation last week, House Speaker Tom Craddick posted the House committee appointments late Friday afternoon. TAFP will pay close attention to three House committees expected to handle health care issues, the House Committee on Appropriations, the House Committee on Insurance and the House Committee on Public Health. View a complete list of House committee assignments though the Texas Legislature’s Web site.

Thanks to these Physicians of the Day

Thanks to Michael Dominguez, M.D., Mary Helen Morrow, M.D., Love Paul, M.D., and Keith Miller, M.D., who each served as Physician of the Day at the Capitol. For more information on how you can serve as Physician of the Day, contact Kate McCann at TAFP. Spots are still available in February, March, April and May.

OTHER NEWS:

Grade Your Payers survey turns the tables on health plans

Air gripes or praises about interactions with health plans through AAFP’s Grade Your Payers survey. On March 1, the national Academy will collect physicians’ feedback and compile the data to use when advocating for positive change directly to the private payers. Physician members can access the survey once logged in on the AAFP Web site, www.aafp.org/fpm/payersurvey.

ABFM certification exam applications, test sites and dates now available

Online applications, test center selection sites and dates for the summer 2007 Certification, Recertification and Sports Medicine exams are available on the American Board of Family Medicine’s Web site. Providers can log in to their physician portfolios to access the application. Once the application is complete, providers can choose a testing site.

Reserve your room now for the C. Frank Webber Lectureship

The C. Frank Webber and Interim Session group rate at the Hilton Austin Airport ends
Feb. 15. To get the discounted rate, $109 per room, make your reservation by calling (512) 385-6767.

Copyright 2006, Texas Academy of Family Physicians