TMLT — now bigger than Texas

TMLT announces launch of Lone Star Alliance

Texas Medical Liability Trust is proud to announce the launch of Lone Star Alliance, Inc., a Risk Retention Group established to provide medical liability coverage to physicians, groups, health care facilities, and allied health care professionals in multiple states.

Operated by TMLT, Lone Star can accommodate the needs of new and existing policyholders by offering TMLT’s coverage and service to those working outside of Texas. With Lone Star, TMLT can also cover physicians who leave Texas to work in another state.

Lone Star was started in 2013 when TMLT began exploring how to extend coverage to its Texas-based policyholders who were also practicing in other states.

As sponsor and program manager of Lone Star, TMLT provides all essential operational support, such as financial and accounting services, information technology, underwriting, sales, marketing, claims handling, and risk management functions.

“The launch of Lone Star Alliance is an important milestone in the growth of TMLT. With Lone Star, we are no longer bound by state lines. More importantly, neither are our physicians,” says Robert Donohoe, President and CEO of TMLT. “Current policyholders in Texas can now practice anywhere in the United States, and still receive the same strong, flexible coverage and winning defense they have come to expect from TMLT.”

More information about Lone Star Alliance, including FAQs, is found here.

(left to right) TMLT Sr. Vice President, Claim Operation, Jill McLain, Senator John Cornyn, TMLT President & CEO Robert Donohoe

U.S. Senator John Cornyn receives Soaring Eagle Award

U.S. Senator John Cornyn has received the Soaring Eagle Award from the Texas Alliance for Patient Access, TMLT, and the Texas Medical Association for playing a vital role in making sure that critically important standard of care protection language remained a part of the SGR “doc fix” bill, House Resolution 2.

The legislation passed the Senate on April 14, 2015, and was signed into law by President Obama on April 21. The standard of care language protects state liability tort laws, including Texas’ landmark reforms of 2003. It also ensures that federal health care standards cannot be used to establish legal action against health care providers.

Thank you Senator Cornyn, for your outstanding work on behalf of Texans and all Americans.

Syphilis testing required for pregnant women in Texas

In 2015, the Texas Legislature passed Senate Bill 1128 revising Texas law to require that every pregnant woman be tested for syphilis at her first prenatal visit and at the third trimester, no earlier than 28 weeks gestation. (1) This law takes effect September 1, 2015.

The Centers for Disease Control and Prevention (CDC) recommend the third trimester test should occur between 28-32 weeks gestation, ensuring timely treatment of the mother and fetus. Although not required by law, the Texas Department of State Health Services (DSHS) recommends testing for syphilis at delivery for women who:

  • Live in a high-morbidity area (rates of primary and secondary syphilis of 2.0 per 100,000 or higher);
  • Have no evidence of prior testing;
  • Are uninsured or low income;
  • Are diagnosed with a STD during pregnancy; and/or
  • Exchange sex for money and/or drugs.

If the serologic status of the mother is not known, serologic status of the newborn must be determined less than two hours post-delivery. Any woman who delivers a stillborn infant after 20 weeks gestation should be tested for syphilis. Infants should not be discharged from the hospital unless the syphilis serologic status of the mother has been determined either during pregnancy or at delivery. (2)

All infants born to women with reactive serologic tests for syphilis should be examined thoroughly for evidence of congenital syphilis (e.g., non-immune hydrops, jaundice, hepatosplenomegaly, rhinitis, skin rash, and pseudoparalysis of an extremity). (3)

For more information, please see the DSHS website.



  1. Texas Health and Safety Code 81.090. Accessed August 25 2015.
  2. Centers for Disease Control and Prevention. Accessed August 25, 2015
  3. Centers for Disease Control and Prevention. Accessed August 25, 2015.

TMLT announces 2015 Risk Management Fall Seminar

This fall, TMLT offers Real Claims: Lessons Learned on the Front Lines a 2.5-hour CME seminar presented by Austin attorney Dan Ballard.

Upon completion of this program, participants should be able to:

  • discuss lessons learned from real medical liability cases and medical board investigations;
  • analyze the risk management considerations for those cases; and
  • describe how these scenarios are affected by new rules pertaining to EHR documentation and supervising mid-level providers.

Registration is now open for the following dates and locations:

Houston — Thursday, October 22
Marriott Medical Center Hotel
Check-in & Dinner: 6 pm
Program: 6:30-9 pm

San Antonio — Tuesday, October 27
Marriott Northwest Hotel
Check-in & Dinner: 6 pm
Program: 6:30-9 pm

Fort Worth — Thursday, November 12
Worthington Renaissance Hotel
Check-in & Dinner: 6 pm
Program: 6:30-9 pm

Dallas — Thursday, November 19
Renaissance Hotel
Check-in & Dinner: 6 pm
Program: 6:30-9 pm

Austin — Tuesday, December 1
Renaissance Hotel
Check-in & Dinner: 6 pm
Program: 6:30-9 pm
TMLT policyholders $100
Non-policyholders $150

Register online two or more weeks before the seminar and receive a $10 discount.

About the Speaker
Dan Ballard, JD is a partner with Ballard & Simmons, LLP. He received a BA with honors from the University of Texas and a JD with honors from the University of Texas School of Law. He was admitted to the State Bar of Texas in 1983. Mr. Ballard has spoken extensively on risk management and medical malpractice defense issues to physicians throughout the state.

CME Credit
TMLT is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. TMLT designates this live activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course has been designated by TMLT for 1 credit in medical ethics and/or professional responsibility.

Register or learn more.

Patient diversity and cultural competence

In Texas and across the United States, the diversity of our population is increasing rapidly. More and more, physicians are coming into contact with patients from various cultural backgrounds who often hold different values, beliefs and standards. To effectively provide treatment that is socially and culturally sensitive, physicians are planning and implementing new policies and procedures to ensure “cultural competence.”

The National Center for Cultural Competence defines cultural competence as an organization’s defined set of values and principles that “demonstrate behaviors, attitudes, policies and structures that enable them to work effectively cross-culturally.”(1) For example, this may include creating office policies for examining Muslim patients. Protecting the modesty of these patients, especially in cross-gender interactions, is of great importance. Becoming informed of the sensitivities of this patient population is an important way to foster cultural competence in your practice. The Center also points out that cultural competence is a “developmental process that evolves over an extended time.”(1)

The following links and articles provide additional information on cultural competence:


(1) National Center for Cultural Competence, Conceptual Frameworks/Models, Guiding Values and Principles. Accessed August 13, 2015.