March 21, 2021
1. ESOPs for Medical Practice: A Look at the Concept

2. TOA's Circle of Champions for 2021: Thanks for Their Support

3. TOA Provides Feedback on Personal Injury Payment Legislation; Latest Draft

4. Prior Authorization Bills Are Starting to Move in the Texas Legislature

5. TOA Is Coming to San Antonio on Monday, April 5; Surgeons Are Invited
6. PAs/Optometrists Push for Surgery; APRN/CRNA Independence in Austin

7. AAOS Announces New Leaders; Several Texans Included

8. TOA's Membership Induction List for Spring 2021

9. Medicare Sequester "Fix" Might Be Coming Soon

10. 70 Days Remain in Austin: TOA's Checklist of Austin & Washington

TOA is now offering two free hours of online CME to fulfill the state's new opioid prescribing CME mandate. Click here to access it. Click here to view the newest CME requirements in Texas.

1. ESOPs for Medical Practices & Physician-Owned Facilities: A Look at the Concept
Note: The following article has been provided for informational purposes only and does not provide legal or accounting guidance. Consultant a legal or tax professional.

By Susan Scherbel, Bellview Associates

Last year, just before the pandemic hit, we ran a piece about a new transition technique for physicians. Now that things are settling down, we thought it would be helpful to revisit the idea. To recap, while the typical exit strategy for physician groups involves being swallowed by a hospital or private equity or, saddest of all, just taking down the signs, selling the equipment and liquidating, there is an interesting and very financially enticing alternative. It involves the use of an Employee Stock Ownership Plan (“ESOP”). Since the piece was run last year, several practices have gone ESOP and the trend is gaining traction. Here’s why.

Click here to read the full story.
2. TOA's Circle of Champions:
Thanks to Our Sponsors
This year will be different for TOA: We will continue to watch the pandemic's course to determine whether or not we can hold a smaller retreat this October 2-3 at the Horseshoe Bay Resort in Marble Falls.

In the meantime, TOA's reliance on sponsorship revenue to support TOA's important advocacy work does not change. As a result, TOA is grateful to our 2021 Circle of Champions, which gave their commitment to TOA's work (whether TOA is able to hold a conference or not in 2021).
3. TOA Provides Feedback on Personal Injury Payment Legislation
TOA was the first medical/hospital organization to provide feedback to the latest version of SB 207, which, in its draft form, would allow government and commercial contracts to be discovered and fail to limit unnecessary discoveries.

Click here to view TOA's comments regarding the latest draft of the legislation.

TOA emphasized the fact that it is critical for SB 207 to limit unnecessary discoveries, which simply result in exercises by the defense to discourage physicians and hospitals from participating in the system.

TOA is expecting similar stakeholder comments to come from the Texas Hospital Association and Texas Medical Association this week.

While not all TOA members provide care related to personal injury cases, some of the concepts in SB 207 could ultimately apply to the entire commercial health insurance system as it relates to setting usual, customary and reasonable (UCR) standards. Therefore, this is a far more important issue than most recognize.
4. Prior Authorization Bills Are Starting to Move in the Texas Legislature
TOA is focusing on six prior authorization bills in the Texas Legislature that would affect musculoskeletal care. Click here to review the bills and the concepts.

The first bill - HB 2142 by Rep. Hubert Vo (D-Houston), will be heard in a House committee hearing this week. The bill would direct the Texas Department of Insurance to conduct regular examinations of health plans and HMOs to study the effectiveness of their prior authorization timelines.
5. TOA Is Coming to San Antonio on Monday, April 5; Surgeons Are Invited
TOA's executive director will provide a one-hour talk on the latest public policy issues affecting orthopaedic surgeons at the San Antonio Orthopaedic Society's dinner on Monday, April 5 in San Antonio.

TOA will provide a one-hour CME ethics credit.

If you're a member of the San Antonio Orthopaedic Society, look for details.
6. Scope Push for Surgery by PAs/Optometrists; APRN/CRNA Independence in Austin
Click here to learn more from TOA's issue focus e-mail on Friday. You're also encouraged to send a message to your state representatives and senators.
7. AAOS Announces New Leaders; Valerae Lewis of Houston & Kevin Bozic of Austin
AAOS announced its new leadership for 2021-22, and two Texans - Valerae Lewis, MD of Houston and Kevin Bozic, MD of Austin - were part of the team. Click here to learn more.

Dr. Bozic was named second vice president of AAOS. Dr. Lewis was named a member of the AAOS Board of Directors.

AAOS's 89th president, Daniel Guy, MD of Georgia, performed his residency at the University of Texas Health Science Center in San Antonio. (Many past AAOS presidents, including those practicing in Texas and in other states, also completed their residency in San Antonio.)
8. TOA's Membership Induction List for Spring 2021
Per TOA's bylaws, TOA is providing the list of new members at least 30 days prior to their induction later this spring.
9. Medicare Sequester "Fix" Might Be Coming Soon in Washington
TOA's last e-mail told you about the $1.9 trillion Covid-19 relief bill and the notable absence of an additional moratorium on Medicare's 2 percent sequester, which is set to expire at the end of March.

The House passed a bill last week that would extend the moratorium into December. Click here to learn more about the outlook.
10. 70 Days Remain in Austin: TOA's Checklist of Austin & Washington
What Did You Miss?
Click here to view all of TOA's e-mail updates from 2021.

Click here to view TOA's full bill tracker.

Austin: Medical Billing Tax Moves
HB 1445 by Rep. Tom Oliverson, MD (R-Spring), which would eliminate the state's tax on medical billing, moved out of the House Ways & Means Committee next week. It is likely to move to the full House for consideration within the next two weeks.

Austin: Software Integration Tool for Prescription Monitoring Program/EHR
Lawmakers in both the House and Senate are pushing budget riders that would direct the state's budget to once again fund the Appriss software integration tool for your EHR to look up the PMP.

Austin: Covid Liability Protection Legislation to Be Heard
The Senate Committee on Business and Commerce will hear a bill (SB 6) by the chairman, Kelly Hancock (R-North Richland Hills), this week that create Covid-related liability protections.

Austin: Pricing Disclosure Bills
House committees will continue to hear legislation related to pricing disclosure this week: Another bill that mirrors the Trump administration's pricing disclosure for hospitals and HB 2090, which would require the health plans to provide costs to insureds.

Washington, DC
  • Congressman Michael Burgess, MD of the north Texas area re-introduced legislation to allow physician-owned hospitals to expand.
  • Congress is expected to extend the moratorium on the 2 percent Medicare sequester cuts by the end of March. Click here to learn more from AAOS and to take action.
  • AAOS is providing stakeholder comments to the federal government related to Congress' new ban on surprise billing for out-of-network payments related to ERISA payments. TOA is disappointed that the federal legislation references median payments (as opposed to FAIR Health at the state level in Texas). But that was the best that medical groups could do in Washington.
Texas Orthopaedic Association