Texas Tech University Health Sciences Center
SPIRIT Awards, Telemedicine, and ACA

SPIRIT Awards, Telemedicine, and ACA

Not all those who wander are lost.

---J.R.R. Tolkien

You’ll see a little wandering around today as I cover this, that and the other. I want to talk about one local matter, one state matter and one national matter.

The local issue is the most important thing because it directly involves our Texas Tech Physicians family and appropriately comes first. It is the offering of my hearty congratulations to the 2015 winners of the SPIRIT Awards. What a great honor! And, it is so fitting that we recognize those who exemplify our SPIRIT values.

This year’s winners are:

Service Excellence - Carla Zavala – Orthopaedics

Patient First - Andrea Thomas – Pediatrics

Innovation - Erica McDonald –Pediatrics

Respect - Marshall Clements – Ophthalmology

Integrity - Joe Guerra – Surgery

Teamwork - Michell Trevino – Internal Medicine

Excellence - Georgia Miller – Pediatrics

Please join me in congratulating these folks if you have not already. And, on the subject, the breakfast and awards event was first-rate in all aspects. I extend a special “shout out” to the People Development COPIC, including, but not limited to, Julian Gutierrez, John Berry, Nancy Swinford, Joni Davis, Sandra Owen, Nora Condray, Tim Hayes, Alex Scoggins, Dylan Pearce and Natalie Bryant.

Now, to the state matter. Pay attention to the court injunction, won by telemedicine provider, Teladoc, which blocks Texas Medical Board rules requiring doctors to have an in-person visit with a patient before being allowed to conduct a telemedicine visit (with certain exceptions). There is more to this than reported in the “lay” media.  Basically, the TMB rules expand opportunities for patients to interact with their physicians beyond the traditional office visit and clarify that a physician-patient relationship can be established through a “face-to-face” visit held either in person or via telemedicine.  Basically, the only scenario prohibited in Texas is one in which a physician treats an unknown patient using telemedicine, without any diagnostic data, and no ability to follow up with that patient.  Telemedicine is an area of medicine to watch and of great interest to us in West Texas given the significant distances often between the patient and the nearest physician. Furthermore, Texas Tech University Health Sciences Center School of Medicine has a long history of utilizing telemedicine.

Finally, the national matter. It is the case before the U.S. Supreme Court, King v. Burwell. Watch for a decision before the end of June. This is the case in which a key component of the Patient Protection and Affordable Care Act (ACA) is being challenged. In a nutshell, the people who brought the lawsuit say tax credits that help cover the cost of premiums currently being paid to health insurers in 34 to 37 states that use the federal health insurance exchange (not the state exchanges) are illegal because of language in the ACA. They assert that the language says the exchanges must be established by the state. So, once again, we see the specific words matter. If the Supreme Court stops these tax credits, more than 6 million people will be required to pay the full premiums for policies obtained though the federal exchange. It is a big deal. Another legal complication for the ACA is yet another lawsuit arguing that Congress did not appropriate the subsidies for out-of-pocket expenses paid by treasury funds. Remember, tax credits help with premiums and the subsidies are for out-of-pocket expenses.

So, now that you’re caught up on the news for the week, make it a great one!