Contact Information

1415 Lavaca Street
Austin, TX 78701-1634
Phone:
(512) 708-8662
Fax:
(512) 708-1415
toma@txosteo.org

Texas FYI

San Antonio Hospitals are Dedicating Significant Resources in Response to a Nursing Shortage

In the face of a nursing crisis that is expected to get significantly worse in the next five to seven years, Methodist Healthcare System is dedicating more than $6 million for nurse recruitment, while University Health System is dedicating more than $2.3 million to fill as many of its nursing vacancies as possible. Methodist is directing its recruitment efforts overseas and hopes to recruit 150 to 175 new registered nurses over the next two years from the Middle East, while the University Health System Foundation recently created a nursing scholarship fund for system employees, awarding scholarship recipients up to $3,000 per year to attend the school of their choice. (San Antonio Business Journal, 7-9-01)

The Heart Hospital of Austin has Named a New Chief Financial Officer

Appointed to the post was Scott Logan, previously regional controller for the Paracelsius Healthcare Corp. in Houston. (Austin American-Statesman, 7-10-01)

A North Texas Radiology Group Said It Will No Longer Provide Services

Phymed, which operates and manages diagnostic imaging centers in North Texas, has informed Texas Health Choice-which insures 80,000 Texans-that it will no longer provide services, prompting the
insurer to redirect members to other facilities. In a fax sent to providers, Texas Health Choice said that Phymed, which operated three diagnostic centers in Dallas and served as a management company for others in the area, including several in Tarrant County, was closing because of financial difficulties. (Fort Worth Star-Telegram, 7-13-01)

Texas is Increasing Medicaid Reimbursement for Managed Health in Bexar County By 8.78 Percent, Compared to the Statewide Average Increase of 9.72 Percent

The largest increase approved by Health and Human Services Commissioner Don Gilbert will go to El Paso, which will get a 15.33 percent increase. Officials said that Bexar and El Paso counties traditionally have had low Medicaid reimbursement rates because of the method for determining funding, which takes into account such things as demand and cost for services, as well as wages. The increases, which are funded by the state budget approved by lawmakers this year, take effect Sept. 1. (San Antonio Express-News, 7-19-01)

Seguin, Texas-Based Guadalupe Valley Hospital (GVH) Plans a $28 Million Expansion Project

GVH Administrator Don Richey is seeking final board approval for a project to include construction of a new six-floor structure, increasing the hospital from just over 100 beds to nearly 150 beds. GVH is one of only two remaining hospitals in Texas that is jointly owned by city and county governments, and the deal still needs to go before the city and county for final budget approval before the hospital can go to bid for construction. (San Antonio Business Journal, 7-16-01)

One of San Antonio’s Largest Medical Groups Has Filed for Chapter 11 Protection

Quantum Southwest Medical Associates, which manages two practices totaling 40 primary care doctors in 18 locations in Bexar and surrounding counties, has filed for Chapter 11 protection in the U.S. Bankruptcy Court of the Western District of Texas. Quantum, which provides health services to 35,000 people in HMOs and another 10,000 in fee-for-service plans, said it hopes to complete the reorganization in the next six to nine months, and attributed its mounting debts to rising health care costs and flat reimbursements, as well as to reimbursement disputes with several large health care providers in San Antonio, including Baptist Health System. (San Antonio Express-News, 7-20-01)

The Board of Medical Select Management, a Fort Worth-Based Physician Association, Announced that it has Petitioned to Reorganize Under Chapter 11 Bankruptcy Laws

Medical Select said the group saw petitioning the U.S. Bankruptcy Court in Fort Worth as the best way to preserve assets for creditors and stabilize its physician network, while the Texas Department of Insurance said that the action will not disrupt medical care for patients served by the group's 1,700 doctors, for whom Medical Select negotiated health insurance contracts and collected and paid their fees. State insurance regulators also said they had placed Heritage Southwest Medical Group P.A. under supervision because of concerns about its financial stability. (Dallas Morning News, 7-25-01)

New Prompt Pay Rules Proposed

On the heels of the Governor’s veto of H.B. 1862, Texas Insurance Commissioner Jose Montemayor announced, “We’re escalating our enforcement and strengthening our rules so that health plans fully understand that Texas is serious about addressing this issue.” The Texas Department of Insurance recently released proposed new prompt pay rules. The proposed clean claims rules would: establish penalties at the greater of billed charges or the contracted penalty rate for the late payment; establish rules for requiring attachments or additional elements; limit the audit process period for a clean claim to no more than 180 calendar days from the date the clean claim is received; provide a process for a physician or provider to establish a rebuttable presumption as to when a claim is considered received; and establish provisions that cannot be altered by contract between HMOs and PPOs and physicians and providers. The proposed new rules would apply to claims filed for non-confinement services, treatment, or supplies rendered on or
after September 5, 2001, and to claims filed for services, treatment, or supplies for inpatient confinements in a hospital or other institution that began on or after September 5, 2001. A public hearing on the proposed rules was scheduled for August 22, 2001. Written comments were accepted until September 4. The proposed rules are available at: http://www.tdi.state.tx.us/commish/clean.html.
(Vinson & Elkins Health Headlines Newsletter, 7-30-01)

Despite State Legislation Allowing Patients to Sue Their HMOs, Texas Has Not Seen a Flood of Such Lawsuits

In the four years since Texas enacted patients' bill of rights legislation, a total of 20 lawsuits have been filed under the 1997 Health Care Liability Act. Several cases have been settled for undisclosed amounts, and the one case that has gone to trial resulted in a victory earlier this month for the HMO. The Texas law, which allows patients to appeal decisions of their health insurers to one of three entities certified by the Texas Department of Insurance, has by the end of this May resulted in 1,349 people requesting such a review, with 58 percent having the decisions by their HMOs fully or partially overturned. (Houston Chronicle, 7-26-01)

Reminder: Up-to-Date Immunization Records Needed for Children in Schools, Child-Care Facilities

Immunization requirements remain the same for this school year with one exception, said Monica Gamez of the Immunization Division at the Texas Department of Health (TDH). "TDH is deferring for one school year the requirement that students have a booster dose of tetanus and diphtheria (Td)." This 10-year booster is usually given to students at about age 14.

The action applies to Texas schools from July 1, 2001, to August 1, 2002. Once the deferment is lifted, all students will be required to show proof of a Td booster. The deferment is due to a national shortage of adult tetanus and diphtheria vaccine that resulted when one of two manufacturers discontinued production.

Vaccines required at various ages for all children are polio; diphtheria, tetanus and pertussis or acellular pertussis (DTP/DTaP); Haemophilus influenzae type b (Hib); measles, mumps and rubella (MMR); chickenpox (varicella); and hepatitis B.

A hepatitis A vaccine requirement affects only children attending school or child-care facilities in 32 counties along the Texas-Mexico border. Children with proof of a previous hepatitis A infection do not need to be vaccinated.

A chart version of the requirements is available online at: http://www.tdh.state.tx.us/immunize/summary.htm

Note: The hepatitis A vaccine is required only in these 32 border-area counties: Brewster, Brooks, Cameron, Crockett, Culberson, Dimmitt, Duval, Edwards, El Paso, Frio, Hidalgo, Hudspeth, Jeff Davis, Jim Hogg, Kenedy, Kinney, La Salle, Maverick, McMullen, Pecos, Presidio, Real, Reeves, Starr, Sutton, Terrell, Uvalde, Val Verde, Webb, Willacy, Zapata and Zavala.

Texas Immunization Rates for Young Children Close to 70 Percent in New CDC Survey

A federal survey released August 3 by the U.S. Centers for Disease Control and Prevention (CDC) shows that 69.5 percent of Texas children ages 19 through 35 months were fully immunized against seven diseases in 2000. The state rate the previous year was 74.7 percent.

Results of the National Immunization Survey (NIS) for 2000 put Texas 50th in the nation for children in this age group to have the 4:3:1 vaccine series. This series includes four doses of diphtheria-tetanus-acellular pertussis (DTaP) vaccine, three doses of polio vaccine and one dose of measles-mumps-rubella (MMR) vaccine.

The telephone survey, covering about 30,000 children, was conducted from January through December 2000 in all 50 states and in 28 specific metropolitan areas. The national immunization rate for 2000 for the 4:3:1 series was 77.6 percent, down from 79.9 percent the previous year.

"We are, of course, concerned that about a third of Texas' young children are not fully protected from vaccine-preventable diseases," said Dr. Sharilyn Stanley, associate commissioner for disease control and prevention at the Texas Department of Health (TDH). "However, this does not mean that 30 percent of Texas children are totally unprotected. Many youngsters have received most of their shots, and we know from previous surveys that a major cause of lower rates is simply that the fourth dose of DTaP is missed."

Stanley said the 2000 NIS covers children born between February 1997 and May 1999 and reflects intervention methods in place two to three years before the survey. The figures include a margin of error for Texas of plus or minus 3.8 percent.

The survey began in 1994.

"With the exception of 1995 when Texas reached the U.S. level of 76 percent, this state has ranked below the national average each year," Stanley said.

With that fact in mind, TDH developed a comprehensive state action plan in May 2000 to focus on activities to improve childhood immunization levels. The plan includes enhancing community involvement, improving provider awareness and participation, increasing parent awareness and participation,
improving data systems including the statewide immunization registry and providing coordination among programs that deal with children's health issues.

"The 2000 NIS data reflect immunization practices and activities that took place from 1997 to 1999," Stanley said, "long before this plan was put in place. We probably will not see the impact of this state plan on coverage rates until the 2002 NIS, at the earliest."

Four Texas communities are among the 28 metropolitan areas surveyed nationally. Their immunization rates are: El Paso, 71.5 percent, down from 75 percent in 1999; Dallas County, 68.9 percent, down from 76 percent; Bexar County, 68 percent, down from 70.2 percent; and Houston at 65.4 percent,
down from 66.5 percent.

"A high immunization level is important in preventing serious and sometimes deadly childhood illnesses," Stanley said. "In general, Texas has not had increased numbers of vaccine-preventable diseases recently. Texas rates for measles, mumps, rubella and pertussis are similar to those for California, New York and Florida."

In 1999, Texas listed seven cases of measles, six of tetanus, nine of rubella and 35 cases of mumps. No cases of diphtheria have been reported in the state since 1982, and the last case of polio occurred in 1977.

"TDH places a high priority on childhood immunizations," Stanley said. "Raising immunizations levels will take a collaborative effort that includes parents, providers, school, businesses, local and state government."

© 2002 Texas Osteopathic Medical Association
Last updated 01/14/2004