Historic Senate Vote Provides Medical Liability Protections

The U.S. Senate has passed a bill that forbids federal quality-of-care and payment guidelines for Medicare, Medicaid and the Affordable Care Act to be used in medical liability lawsuits. The so-called “doc fix”  bill marks the first time Congress has ever passed medical liability protections.

The standard of care language is in a bill that replaces the Medicare payment system for doctors and hospitals with a new payment formula that rewards quality, value and efficiency. Doctors were concerned that these new quality measurements and payment guidelines might be used in a lawsuit to create a presumption of medical negligence.

“This bill eliminates that uncertainty,” said Austin internist, Dr. Howard Marcus.

The “doc fix” bill passed the House overwhelmingly last month. It now heads to the president who has expressed his intention to sign it.

“Practice guidelines are one of many sources of valuable information for health care providers. All patients are unique and many patients, especially those with complex health issues, don’t necessarily fit a guideline,” said Marcus,  the chairman of Texas Alliance For Patient Access.  “There is often more than one possible answer and that is where clinical judgment is required. Practice guidelines should be just that, a guideline and not a rigid, unaltering edict that creates new opportunities to sue.”

Those sentiments are underscored in a 2010 article in the New England Journal of Medicine entitled “Medical Malpractice Liability in the Age of Electronic Health Records.” The authors write “Physicians routinely override even relatively simple clinical-decision support protocols…for clinically appropriate reasons.”

“The “doc fix” bill does not change current medical liability laws nor does it alter the way courts determine if an act of medical negligence occurred,” said Bob Donohoe, president and CEO of the physician-governed Texas Medical Liability Trust.  “It simply preserves the status quo, “he said.

Historically, practice standards for physicians have been governed by the states and medical specialty societies.

In casting his vote in favor of the bill, Texas Senator John Cornyn said “This legislation provides our health care professionals with a predictable expectation for reimbursement rates, an idea that only sadly had been a dream for many physicians in Texas and across the country.”

Quotes from lawmakers that played a pivotal role in getting and keeping the standard of care language in HR 2, which passed out of the House on March 26.

“The passage of today’s legislation will permanently fix the flawed sustainable growth formula and relieve doctors of the fear of undue legal issues,” said Texas Congressman Henry Cuellar. Rep. Cuellar had introduced similar stand-alone legislation.

“This is the first step toward real, meaningful, entitlement reform, said Texas Congressman Michael Burgess, chief author of the bill. “I have worked my entire congressional career to address this problem and, after years of uneven progress, we have finally taken this opportunity to do what is right for seniors, providers and the American taxpayer. “Furthermore, the bill includes important standard of care provisions that protect state liability law and ensures that federal health care standards cannot be used to establish legal action against health care providers.”

“Today we have provided the Senate and White House with the best opportunity to write a new chapter in the history of the American health-care system that focuses on creating stability for those most in need,” said Texas Congressman Kevin Brady, the chairman of the House Ways & Means Health Subcommittee.

Read the original press release at the Texas Alliance for Patient Access website.

P@$$w0rd! Not password

We can sometimes be too neglectful of our passwords. We give them out freely, or post them on our computer screen, or use only the minimum requirements to create one. We sometimes forget that passwords are our key, signature, or stamp. Ask yourself, would you leave multiple keys to your practice out in the open? Would you sign any document put in front of you without looking?

Sharing your password is akin to giving people the key to your business and allowing them the opportunity to sign anything for you. In our current, constantly changing environment we forget how important it is to have a good password and how important they are to us. Outside of a locked door, a strong password is one of your last barriers to an individual accessing or changing sensitive information in your name

How to create a strong password

According to Microsoft, a strong password should:

  • be at least 8 characters long;
  • not contain any names;
  • not be a complete word;
  • be significantly different than previous passwords; and
  • contain both uppercase/ lowercase letters, numbers, and symbols.

Simply put, add as many elements as you can to make it easy enough for you to remember, but hard for another to guess.  Many make it too easy for hackers, by using passwords such as, “123345,” “qwerty,” or even “password” as their passwords. Avoid this. Also, try not to create a password from simple sequences found on your keyboard or common words found in dictionaries. Also, avoid anything that’s too personally identifiable to you, such as your home address, phone number, or the last four digits of your SSN. One trick to making a good password is to use an acronym that only you know and then mix it up.

Examples

Word Example:  As an example of building a password from a word, let’s use the word “password.”  On its own, this would be easily hacked. It uses just one whole word, and is lower case.  “Password” is always at the top of lists of the most commonly used passwords. Why? It’s easy to remember. If you are going to use “password,” which I hope you don’t, I would suggest using a combination of special characters in place of the letter that would be easily identifiable to you. For instance, “Pa$$w0rd” may work. Using a combination of letters, special characters, upper and lowercased letters, as well as numbers (0 instead of O) can make a weak password stronger (“Pa$$w0rd” or, even better, “P@§w0rd!”).

Acronyms Example: Acronyms are another good option, especially if they make no sense to another individual, but make a lot of sense to you.  For instance, instead of “I love to be a doctor,” you could use the acronym “!Lv2badr,” which breaks down into ! (I) Lv (love) 2 (to) b (be) a (a) dr (doctor). This makes your password both effective and strong since it has a combination of special characters, numbers, and upper- and lower case letters. Remember to make your password easy for you to remember.  Try to stay away from name combinations that could be easily guessed, such as linking family member names or the names of pets. Instead, consider using a line from your favorite book. For example, the famous quote from Shakespeare’s Hamlet, Act III, Scene 1, “To be or not to be, that is the question”, could translates into a password 2B0n2bT!t?. Below are some more examples of what you may apply to your password to help protect yourself.

Current Replacement
I !
A @
A &
I *
S $
O #
O 0 (zero)
G 6
Alt+any number
combination on number
keypad (exp alt+21=§)
Many different characters

Once you start to use a core password it should help you move away from basic, common passwords and into more advanced and strong ones.

Update: TMLT website services are back and fully available

Our system upgrades are complete. Website services, including online payments, the myTMLT members-only site, and online CME are once again available.

Please note: you will now need to log in using your myTMLT account information to make a payment. If you do not have an account, you may create one by selecting the “New User” registration link for either an individual or group administrator on the myTMLT log in page. These links will take you to the appropriate application form to create an account.

As a way of saying “thank you” for your patience during this upgrade, you should have received a complimentary gift in your email on April 8. If you did not receive this email, please check your spam or junk folder. Be sure to add TMLT to your email address book to ensure you receive all communications from TMLT. Also, if we do not have your email address on file, please contact TMLT Customer Service at 1-800-580-8658, ext. 5050.

Thank you, again, for your patience.

SGR update: Let Senator Cruz hear from Texas physicians on SGR repeal

When the U.S. Senate convenes on April 14, senators will have just 34 hours to take up and pass HR 2, the Medicare Access and CHIP Reauthorization Act, before the 21 percent Medicare cuts kick in.

At the end of those 34 hours, the Centers for Medicare & Medicaid Services will no longer hold claims for services provided after April 1, and physicians will begin to see the cut mandated by the Sustainable Growth Rate (SGR) formula in their Medicare payments.

We’re grateful for the House of Representatives’ overwhelming approval of the bill — authored by Rep. Michael Burgess, MD (R-Lewisville) — and for the support we’ve seen from Senate Majority Whip John Cornyn of Texas. But we need to make sure our other senator, Sen. Ted Cruz, hears from Texas physicians about why the SGR must go.

Please call Senator Cruz’ district offices today to deliver that message. Use these talking points.

• Austin (512) 916-5834
• Dallas (214) 599-8749
• Houston (713) 718-3057
• McAllen (956) 686-7339
• San Antonio (210) 340-2885
• Tyler (903) 593-5130

Historic House vote protects right of states to set medical liability laws, says TAPA

March 26, 2015

Contact: Jon Opelt
Executive Director
Texas Alliance For Patient Access
2301 South Capital of Texas Highway, J-101
Austin, Texas 78746
512-703-2156
opelt@tapa.info

Austin, TX — Today the U.S. House of Representatives passed historic medical liability language in a bill that replaces the often-criticized Medicare physician payment formula known as the sustainable growth rate.

The measure passed overwhelmingly with strong bi-partisan support.

Language in the sustainable growth rate replacement bill ensures that federal quality and payment provisions may not be used in court to sue or to advance or defend a medical malpractice lawsuit.

“The passage of today’s legislation will permanently fix the flawed sustainable growth formula and relieve doctors of the fear of undue legal issues,” said Texas Congressman Henry Cuellar.

Rep. Cuellar had introduced similar stand-alone legislation.

“It is my hope that the Senate swiftly votes and passes this bill,” he said.

“This is the first step toward real, meaningful, entitlement reform, said Texas Congressman Michael Burgess, chief author of the bill.

“I have worked my entire congressional career to address this problem and, after years of uneven progress, we have finally taken this opportunity to do what is right for seniors, providers and the American taxpayer.

“Furthermore, the bill includes important standard of care provisions that protect state liability law and ensures that federal health care standards cannot be used to establish legal action against health care providers.”

“The Affordable Care Act does not specifically mention a new basis for liability, nor does it preclude it,” said Robert Donohoe, president and CEO of the physician-governed Texas Medical Liability Trust. The law is silent, and its silence is subject to judicial interpretation, which lawmakers were trying to avoid.

“We know from years of experience that when the law does not address something head on, all kinds of interpretations are possible,” he said.

“This much is clear: Never before has Congress passed a bill reining in federal intrusion of existing state medical liability laws, said Dr. Howard Marcus, chairman of the Texas Alliance For Patient Access, an organization that advocated the bill’s passage.

“Today we have provided the Senate and White House with the best opportunity to write a new chapter in the history of the American health-care system which focuses on creating stability for those most in need,” said Texas Congressman Kevin Brady, the chairman of the House Ways & Means Health Subcommittee.