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8:45

Texas Medical Association - Good morning. AMA House of Delegates preliminary business has gone longer than usual. Reference Committee on Legislation won't begin for at least 15-20 more minutes.

Just been told that health system reform resolutions will be near the end of the reference committee's agenda. Will keep you up to date as we get closer.

Finally, the full House did accept for CONSIDERATION the resolution that would overturn the AMA's support of HR 3962, which passed the U.S. House last night. That resolution will be part of the health system reform debate in the Reference Committee on Legislation this morning.

Be back soon.

9:07

Texas Medical Association - Reference Committee still milling about. Will give you some background while we wait.

Texas physicians on the work group for this reference committee include Drs. Sheldon Gross (captain), Bob Gunby, Tom Garcia, Asa Lockhart, Bob Morrow, John Gill, Dan McCoy, Gary Floyd, and Travis Bias. We also have two medical students - Matt Brooker and Jessica Ngyuen.

Other Texas physicians with us today include Drs. Paul Handel and Howard Marcus as well as former AMA President Nancy Dickey, MD.

9:09	Texas Medical Association - As mentioned earlier, we have several non-health-system-reform resolutions to cover first. As we wait, I'll give you the text of the resolutions that will come up.

9:11

Texas Medical Association -

Starting with Resolution 206 - Liability Reform in Health Care Reform. It asks AMA to

Promote liability reform that mirrors the reforms of such states as Texas and California as the optimum reform plans
Strongly support that any federal liability reform does not pre-empt effective state reforms, and thereby possibly weaken proven state reforms;
Support that any alternative reforms such as specialized health courts and early offer programs not be mandated for all states, but rather be tested in states only as demonstration projects, to be incentivized only if they prove to be effective;
Support that best clinical practice guidelines represent a medical guideline not a legal one and recognize and encourage that such guidelines do not supplant clinical judgment and that failure to follow each and every clinical guideline when clinical judgment otherwise dictates should not be admissible in court as evidence or create a presumption of negligence; and
Strongly clarify the ambiguous language of several provisions (HR3200: Sections 2401, 2301, 1751, 1237, 1151,224 and 1783) in existing bills which deal with risk management, utilization review, and cost containment that might inadvertently create new legal causes of action against physicians to be sure that such provisions not lead to new theories of liability, such as presumption of negligence in cases of hospital acquired conditions.

9:12	Texas Medical Association - Russ Kridel, MD, of Texas says HR 3962 as passed last night puts physicians at risk for new causes of action. He also says it could erase the $250,000 Texas cap on noneconomic damages in liability cases.

9:14	Texas Medical Association - Dr. Kridel: "We don't want a physician who doesn't adhere strictly to a new standard of care to be subject to new liability."

9:14	Texas Medical Association - Bob Fields, CEO of Texas Medical Liability Trust, given special permission to address the reference committee.

9:16	[Comment From Adam Bloom] I wonder if they've addressed proposal 9 yet?

9:17	Texas Medical Association - Bob Fields: AMA says if there is a risk of us losing what we have, they will oppose the health care bill. There is a danger. Worried about two things: Federal preemption of state caps in Medicare Lack of global language in the bill, impact of never events

9:17	Texas Medical Association - Adam: Broader discussion of health system reform not up yet. Just talking about liability and health reform.

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