The Weekly Dose           Bexar County Medical Society

Week of June 2,  2013 

Vol. 2, No. 38

Paying for CME


By John K. Wisniewski

BCMS CEO/Executive Director


Traditional physician compensation models include a discretionary CME allowance, which is commonly used for coursework at travel destinations.


Bring the family, let them enjoy some sights, take a few classes and mix a little business with pleasure. 


There can be tax advantages to learning/vacationing and for some, this model is still a great motivator.


Others may prefer good, cheap online CME, a taxable raise and separate, unencumbered vacations.

Talk with your partners, employers or employees.  Perhaps offer several options. Be sure to get qualified guidance on tax implications, and don't forget to make membership in TMA/BCMS a direct benefit for all members of your practice.




for the June 4 General Membership Meeting 

at the Club at Sonterra


Mix and mingle

Cash bar

Hors d'oeuvres

6:30 p.m.


'To Congress and Back' featuring guest speaker Charlie Gonzalez

7 p.m.


To RSVP click here





When should you

take Social Security?


While the goal is to maximize the lifetime family benefit, there is no single correct answer to this question. Your benefit can start as early as age 62. The longer you wait (up to age 70), the larger your benefit grows.


 Two obvious factors to consider are your health and cash flow from other sources. Many filers leave significant money on the table because they aren't aware of advanced strategies that can maximize their benefits.


One strategy includes filing for benefits, immediately suspending so your benefit continues growing, and then having your spouse file for spousal benefits on your account. This can effectively create a third Social Security income stream (yours, your spouse's and the spousal benefit). Aspect Wealth has a system to identify the optimal strategy for your family to maximize your hard-earned benefits. Please contact us for a free evaluation.


BCMS is grateful for Aspect's long-term support and commitment through its ongoing Gold Membership in the Circle of Friends, by managing money for the society for most of the past decade.


Contact Michael Clark, CIMA, CRC, at or

Jeffrey Allison, CFP, at Phone: 877-702-7732.


Registered Representative of and securities and advisory services offered through Cetera Advisor Networks LLC, member FINRA/SIPC. Cetera is under separate ownership from any other named entity.


Circle of Friends web logo  

This information is sent on behalf of a valued BCMS Circle of Friends sponsor at the GOLD level, but it is not an endorsement. Donations from Circle of Friends sponsors help keep down the cost of dues and allow BCMS to continue to provide quality service to its members. The society continues its pledge to you and only will involve itself in services and programs that benefit you, the member, and your patients.




83rd Legislative Session adjourns Sine Die on May 27

Governor calls special session within an hour after adjournment  


By Mary E. Nava, MBA

BCMS Chief Governmental and

Community Relations Officer



Last Monday, Memorial Day, was the last day of the 83rd regular legislative session.  The Senate and House adjourned Sine Die and then within the hour following, Gov. Rick Perry called the first special session, and the legislators were back at work at 6 p.m. that evening.


As had been the buzz around the halls of the Capitol during the last weeks of the session, the first topic on the special session agenda: redistricting. The governor sets the agenda, and it's quite possible more items may be added in the coming weeks.


Now that the regular session has ended, the governor has 20 days to act on legislation that has passed. Perry can sign bills into law, veto bills or allow bills to become law without his signature. We will provide you with updates in the coming weeks on the status of legislation awaiting the governor's pen.


Some highlights on key TMA bills for the 83rd Session (since the last issue of The Weekly Dose):


Signed into law


Drum roll, please ...


SB 822, the silent PPO bill, by Sen. Charles Schwertner, MD (R-Georgetown) and Rep. Craig Eiland (D-Galveston) was signed into law on May 25.  This law goes into effect Sept. 1, 2013.  This new law establishes fair and transparent insurance markets and subjects the companies that sell, lease or share physician-contracted discounts to oversight by TDI.


On the governor's desk

  • SB 1221 by Sen. Ken Paxton (R-McKinney), a bill similar to SB 822, would stop Medicaid HMOs from selling or trading physician discounted rates.
  • SB 644 by Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Simonton), requires TDI to appoint a stakeholder workgroup to design a standard prescription drug prior-authorization form applicable across all payers, including Medicaid and CHIP.
  • SB 1216 by Sen. Kevin Eltife (R-Tyler) and Rep. Sarah Davis (R-West University Place) requires TDI to appoint a stakeholder workgroup to design a standard request form for prior authorization of healthcare services applicable to all payers.
  • HB 1803 by Rep. Bill Callegari (R-Katy) and Huffman would start the renewal of physicians' DPS controlled substances registration with their online medical license renewal at the Texas Medical Board.  A provision was added that defines pain management as the practice of medicine.
  • HB 500 by Rep. Harvey Hilderbran (R-Kerrville) and Sen. Glenn Hegar (R-Katy) establishes a $1 million state franchise tax deduction for small businesses. It could give many Texas physicians needed relief from the state's franchise tax. TMA added an amendment to the bill that allows physicians to deduct vaccine purchase cost from taxable revenues.
  • SB 1150 by Sen. Chuy Hinojosa (D-McAllen) and Rep. Bobby Guerra (R-McAllen) requires HHSC to implement a "provider protection plan" under Medicaid HMOs or other arrangements and incorporate the plan into the contracts between HHSC and the plans. Plans must pay claims properly and promptly. The bill imposes penalties on plans that engage in low-pay, slow-pay, no-pay activity.
  • SB 7 by Sen. Jane Nelson (R-Flower Mound) and Rep. Richard Raymond (D-Laredo) aims to save money in the Medicaid program by expanding Medicaid HMOs to people with intellectual and developmental disabilities and to nursing home residents.
  • SB 227 by Sen. Tommy Williams (R-The Woodlands) and Zerwas would allow physicians to dispense aesthetic pharmaceuticals in excess of the patient's immediate needs without a pharmacist license. Drugs include bimatoprost for growing eyelashes; hydroquinone, a skin whitener; retinoid for improving skin; and metronidazole for treating rosacea.
  • SB 646 by Sen. Robert Deuell, MD (R-Greenville), and Rep. Elliot Naishtat (D-Austin) amends current law relating to court-ordered outpatient mental health services.
  • SB 1643 by Williams and Rep. Carol Alvarado (D-Houston) improves access to prescription information by physicians. It allows them to delegate information retrieval to a nurse and allows for connection to DPS through a health information exchange, as long as proper security measures are in place to protect against disclosure to unauthorized individuals. The bill also allows physicians to include that information in a patient's medical record, but that information would be subject to any applicable state or federal confidentiality or privacy laws.  

Stay tuned to this column and San Antonio Medicine magazine for more updates on the status of legislation on the governor's desk and updates from the special session.



For local discussion on the wrap-up of the 83rd Legislative Session, the first called special session and other advocacy topics, consider joining the BCMS Legislative and Socioeconomics Committee by contacting Mary Nava at



 About The Weekly Dose 

  The Weekly Dose is a service of the Bexar County Medical Society.

Some of the suggestions conveyed may not be applicable to your practice today,
 but the goal is to offer information over time that returns value in excess

of the cost of your membership.

If you would like to recommend future topics to share with your colleagues,

please submit them to the BCMS executive director at

All rights reserved. Unauthorized use prohibited.

Copyright 2013
 Bexar County Medical Society, San Antonio, Texas.



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