REPORT OF COUNCIL ON SOCIOECONOMICS
CSE Report 2-A-06
Subject: Ten-Year Policy Review
Presented by: Susan M. Strate, MD, Chair
Referred to: Reference Committee on Socioeconomics
House of Delegates policies included in the association's Policy Compendium are reviewed periodically for relevance and appropriateness. The council reviewed the following policies this year and recommendations are offered as follows:
The following Texas Medical Association policy is recommended for deletion, as it is outdated and addressed by other policy.
190.016 Single Application Form for Eligibility of Services : The Texas Medical Association supports the use and provision of a single application form and/or computer software program for determining the eligibility of children and/or families to receive benefits from social support programs administered by any level of government (Committee on Child and Adolescent Health, p127, I-96).
Recommendation 1 : Delete.
It is recommended the following policies be retained, as they are current, valid, and relevant.
130.013 Interhospital Transfer for Nonmedical Reasons : Any payer requesting transfer for nonmedical reasons should remain fiscally responsible for all appropriate medical care incurred prior to the transfer of an infant from an out-of-network facility to a network facility (Amended Res. 29E, p193, I-96).
235.022 Clinical Pathology Services Payment : Clinical pathology represents a medically necessary service from which patients directly benefit. The Texas Medical Association supports the ability of physicians to bill patients directly for services not covered by the patient's insurance, in the absence of contractual arrangements that forbid balance billing. TMA reaffirms policy supporting the separation of physician and hospital payments (see 230.003 and 235.0120) (Council on Socioeconomics, p176-A, A-96).
320.006 Managed Care Academic Health Centers Medicaid Patient Base : In communities where academic health centers or residency programs are located, or will be, and are at risk of losing a significant portion of the patient base (Medicaid patients), the Texas Medical Association supports and will facilitate collaboration between managed care entities and the at-risk programs to preserve accreditation (Medical Student Section, p181, I-96).
Recommendation 2 : Retain.
TMA House of Delegates: TexMed 2006