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PRESIDENT’S
MESSAGE
Constant vigilance
helps protect organized
medicine from harmful laws
By James L. Humphreys, MD
2015 BCMS President
During a year in which numerous actions of considerable
import could have changed the practice of medicine in Texas,
not that many aspects actually changed. The list of things
that didn’t change is instructive, however, and illustrates just
how fluid a situation our practices are in and the need to pay
careful attention to our regulating bodies and their actions.
We had lots of potential action in both the state and federal
legislatures this year and an important case before the Supreme
Court to boot. Here’s a quick review of what happened. First,
the Affordable Care Act provision for federal subsidies sur-
vived a technical attack that easily could have made it fiscally
non-viable. This situation could have gone either way, and
there was very broad interest in the court decision, which de-
clared the federal premium subsidies to be constitutional and
kept the act unchanged. Further attacks by opponents of the
act will no doubt be forthcoming, but this looked like their
best shot to derail the act.
In the federal legislature, the much-hated SGR formula was
finally repealed, after 17 years of concerted lobbying to have
the broken and misguided formula removed. While this is
generally a good thing for physicians, the federal government
managed to tack on a lot of potentially bad offsetting condi-
tions in the usual fashion. I consider this a positive first step, County Medical Society. He is a pathologist with Precision
but feel that our work on this issue is not complete as long as
8 San Antonio Medicine • September 2015
physician reimbursement is at least partially based on a seri-
ously flawed quality outcome metrics scheme.
At the state level, we have just seen the occupations tax re-
pealed and the franchise tax reduced which is good for taking
off a few hundred dollars in fees for physicians each year. As
an aside, it may be hard to feel the benefit of this in the face
of egregious Bexar County property tax assessments that also
were levied this year. The state finally increased the funding
for graduate medical education in a small step toward easing
the physician shortage in the state. What didn’t happen at
the state level was any allied health provider scope of practice
expansion despite a number of efforts to do so. There was
no significant alteration to the hard-won tort reforms of 2003
either this session. Medicaid was neither expanded nor par-
ticularly reformed, although I don’t believe that the state will
not be able to avoid either of those two things for long.
While many of the worst possible changes to medicine were
avoided this year, you can see that there is unrelenting pres-
sure on medical practices from a broad number of fronts.
Constant vigilance is our only effective defense.
James L. Humphreys, MD, is the 2015 president of the Bexar
Pathology in San Antonio.