President's Message

December 2021

Craig A. Meek, MD, MS, FACEP
TCEP President

The Battle of our Generation

Crash! I remember watching the plane striking the twin tower. The second one struck, while the first tower was burning. That is when we all knew that it was intentional. I did not know at that time, how many ways that was going to change the world.

I was an owner of a small democratic emergency medicine group in 2003 when House Bill 4 passed the Texas Legislature and tort reform was accomplished in Texas. I sat on the sidelines. I occasionally lobbed accusations at those in political medicine. Accusing those in power of inaccurate motivations and sometimes blaming our local problems on them. I did this while the leaders of our organizations fought tirelessly for us. They spent time away from their jobs and families so that we would all have lower malpractice premiums and less fear. I now deeply regret my decisions during those times.

In 2019, SB 1264 came before the Texas Legislature. The surprise billing legislation was perfectly set up for the insurance companies to implement “rate setting.” They had all the momentum. Insurance companies had given massive amounts of money to some influential legislators. They had public perception on their side. It was time for a huge win for them and their shareholders. But, some amazing leaders and volunteers in TCEP and TMA spent many hours working the problem. The legislation that passed used an arbitration system that was fair and avoided “rate setting.” Other states chapters then used the template of Texas SB 1264 to try to achieve wins in their state legislatures.

On December 27, 2020, the federal No Surprises Act (NSA) was signed into law. When it passed, it was modeled after Texas’ surprise billing legislation and was felt to be a fair law for physicians. However, in September 2021, the Department of Health and Human Services, Department of Labor, Department of Treasury, and the Office of Personnel Management issued an interim final rule, which is in conflict with the intent of the NSA by essentially allowing insurance companies to engage in “rate setting.” The law is set to take effect on January 1, 2022. This could eventually affect every aspect of medical billing.

I believe that with this legislation, TCEP and the house of medicine is engaging in the “battle of our generation.” It is imperative that we band together – employers, physicians, hospitals, small groups, large groups, and patient advocates – to fight regulations that would permit unfair reimbursement practices and prevent patient access. TCEP along with others in the house of medicine are continuously engaging in this work.

A smart man once told me, “When things look tough and it is time to circle the wagons, make sure you always point the guns out.” There will be many leaders of our organizations working tirelessly to fight for you and your patients. You can choose to sit on the sidelines and do nothing, or even criticize the organizations. They will fight for you and your patients regardless of what you do. But, from a man who has made plenty of mistakes, if you “sit out” this one, you will probably regret your decision in about 10 years. We might look back someday and think “I didn’t know at the time that was going to change our world.”