Page 18 - BCMS History for 2016 Booklet FINAL2

2016 Medical Practice Issues

Medical practices continually face challenges from many
fronts:

 Narrow Networks: Patients get limited choices because insurance companies
do not contract enough physicians in a plan.

 Balance Billing: Physicians must bill patients directly for services rendered,
but not fully covered by the health plan because the physician is “out-of-
network.”

 Scope of Practice: Non-physicians are lobbying to do physician work without
the medical training of a physician.

 Prompt Pay: Insurers are required by law to pay physicians promptly for
services provided to patients.

 Affordable Care Act Insurance Grace Period: Physicians take the risk of not
being paid because patients don’t pay premiums.

 Physician-Patient Relationship: Non-physicians interfere with physician
decisions about diagnosis and treatment of patients.

 Medicaid/CHIP Funding: Texas is allowing federal funding to go to other
states; physicians are not fairly paid for services.

 Graduate Medical Education Funding: There is not enough state funding for
residency programs for medical school grads.

 Telemedicine: Physicians believe the physician/patient relationship is
essential: telemedicine must navigate carefully.

 Red Tape and Regulations: Rules, reporting, approvals, and other
administrative hurdles take time away from patient care. Government
programs change constantly creating a maze of administration and costs for
medical practices.

The Bexar County Medical Society, in combination with the Texas
Medical Association, exists to help physicians deal with the very
complicated world of medicine.