May 23, 2024 • 19 mins
Welcome to TMA's Practice Well podcast, where we help you improve the health of all Texans. In this episode, we cover the latest updates and essential news for Texas physicians. Scroll down to get links referenced in this episode.
Firstly, we discuss a crucial payer update: Cigna will start denying claims without Z-code documentation from July 14th. Learn how this change might impact your practice and what you need to do to comply.
Next, we highlight Aetna's decision to pay Medicare Advantage G-2211 claims. Discover how this new policy can benefit your practice and ensure you are up-to-date with Medicare's latest coding requirements.
We also introduce TMA's new Leadership Development Program, designed to support physicians at every career stage. This 18-month self-paced program offers in-person and on-demand courses to help you become a leader in organized medicine, practice management, or advocacy.
Finally, we celebrate the installation of Dr. Ray Callas as the 159th President of TMA. Dr. Callas shares his journey and vision for the future, emphasizing the importance of physician advocacy and leadership.
For more details on these stories, check the episode description. Remember to like and follow TMA Practice Well to receive every episode. Until next time, stay well!
- Physician Payment Resource Center
- Cigna to Deny Claims Without Z-Code Documentation
- Aetna Set to Pay Medicare Advantage G2211 Claims
- Lifelong Leadership: TMA Debuts Development Program for Physicians at Every Career Stage
- Straight Shooter: Incoming TMA President Ray Callas, MD, Aims for Practice Protections, Membership Gains
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Thank you for listening to TMA's Practice Well podcast.
TMA, helping you improve the health of all Texans.
Music.
TMA has a long, proud history of promoting patient rights, advocating for physicians,
(00:24):
and providing real solutions for your practice. us.
We can accomplish so much when we unite in one voice.
Call the TMA Knowledge Center at 1-800-880-7955 or visit textmed.org to find
out how you can join or renew your membership today. day.
Music.
(00:54):
Hi, I'm Cheryl Krhoviak. I produce the TMA Practice Well Podcast and manage the
TMA Education Center, where through on-demand webinars, PDF publications,
and CME2Go podcast episodes, We strive to help physicians thrive.
Texas Medical Association, TMA, provides several timely curated newsletters and magazine issues.
(01:16):
Delivered to your email daily, look for TMT, Texas Medicine Today,
for top stories and association news, and Medical News Roundup,
for mainstream news that affects Texas physicians.
Texas Medicine Magazine delivers timely information on public health,
medical legal issues, medical economics, science, medical education,
(01:37):
and legislative affairs affecting Texas physicians and their patients.
With the hundreds of things fighting for your attention at any given time,
it's easy to miss that negative information that could make your life easier
or keep you from being caught and aware.
So, in case you miss them, here are three recent stories that Texas physicians
found most interesting.
(01:58):
First up is two-payer update. Cigna to deny Deny claims without Z-code documentation.
Starting July 14th, Cigna Healthcare will deny certain claims that are billed
with the Z-code and without documentation.
Z-codes are used to document social, environmental, and personal circumstances
that influence a patient's health status but are not disease or injuries themselves. selves.
(02:20):
Cigna will deny claims when practices bill certain evaluation and management
codes known as E&M codes 99202 to 99215 with a preventative service code and
a supporting Z diagnosis code,
but not supplemental medical record documentation.
Physicians will need to refer to multiple policies by the payer to utilize both
(02:40):
preventative services and problem-oriented E&M services for new and established
patients on the same date of service.
Texas Medical Association Billing and Coding experts caution this could add to practices workload.
Moreover, these services will not be payable by Cigna when billed with a Z diagnosis code alone.
TMA experts recommend including supporting medical record documentation with
(03:05):
the diagnosis code for the problem E&M claim to identify why a preventative
service, like dietary counseling, for example, was performed.
Physicians can also check Cigna's preventative services policy for examples
of Z codes or refer to Cigna's E&M reimbursement policy for more payment information from the payer.
Aetna is set to pay Medicare Advantage G-2211 claim. The list of health plans
(03:30):
providing payment for Medicare's new add-on G-code continues to grow with Aetna
as the latest insurer to cover G-2211 for Medicare Advantage claims.
Aetna confirmed with Texas Medical Association coding experts that its Medicare
Advantage claims platform was updated in March to allow payment for the code
used to document the coordination of care for patients with complex or serious conditions.
(03:53):
For now, the plan's policy is only accessible through the physician's Aetna portal.
Previously, three other national payers had confirmed coverage of G-2211,
Cigna for Medicare Advantage only, Humana for Commercial and Medicare Advantage,
and UnitedHealthcare for Commercial and Medicare Advantage.
The 2024 Medicare Physician Fee Schedule allows physicians to list G-2211 in
(04:17):
addition to codes used in office or outpatient visits for new or established
patients, in other words, 99202 to 99215.
Physicians can also use it for telehealth visits. TMA continues to push for
increased code guidance from federal officials as confusion over its use persists.
The Center for Medicare and Medicaid Services does not restrict G-2211 to medical
(04:41):
professionals based on specialty.
It recommends physicians fill the code if they are a continuing focal point
for all needed services,
like a primary care practitioner, or are giving ongoing care for a single serious
condition or complex condition, like sickle cell disease or HIV.
TMA experts recommend physicians use G-2211 when they have assumed or intend
(05:05):
to assume responsibility for the patient's ongoing medical care and they intend
to apply the code to office and outpatient E&M services.
Physicians should not use G-2211 when the associated office visit E&M service
is reported with modifier 25 appended and their visit with the patient are routine or time-limited.
(05:28):
For example, a physician who sees a patient for an acute concern should not
report G-2211 if they have not also assumed responsibility for the patient's
ongoing medical care or do not plan to take responsibility for subsequent billing care.
Additionally, TMA experts recommend practices update their electronic health
record and billing systems to reflect the 2024 Medicare Physician Fee Schedule
(05:52):
to verify G-2211 is added.
Practice management or billing and coding staff can help with this.
Physicians, also be aware that you cannot append Modifier 25 when billing for G-2211.
Also, CMS has not defined complex conditions, meaning you should create an internal
policy on what complex conditions mean to you.
(06:13):
And G-2211 claims should not include templates.
And document patient-specific details. For payment and coding help from TMA
experts who go to bat with payers for your practice, visit TMA's Physician Payment
Resource Center, linked in the episode description.
Moving on to association news, TMA debuts Leadership Development Program for
(06:34):
Physicians at every career stage.
The Lifelong Leadership Program is a self-paced 18-month program free to any TMA member physician.
Enrollees participate in a combination of in-person and on-demand courses and
activities centered on one of three concentrations, organized medicine,
practice leadership, or advocacy.
(06:55):
Along with the Leadership College and the Leadership Summit,
this program responds to members' requests for more career development opportunities
and similarly prepares graduates to leave in their practice,
organized medicine, and community.
It also builds on a successful foundation.
Beaumont Anesthesiologist Ray Callas, MD, is the first leadership college alumnus
(07:16):
installed at TMA President at TechSmith 2024.
He stands alongside other graduates who have gone on to hold a diverse array
of leadership roles in and outside of TMA, including elected office.
Dr. Callas encourages other physicians to seek out leadership opportunities
and to diversify their contributions, whether stepping up at work,
(07:37):
inside TMA or specialty societies, or in politics.
Doing so, he says, ensure physicians and their patients have an advocate at every level.
If you're not a voice for your patients, nobody else will be, said Dr. Callas.
The Lifelong Leadership Program complements TMA leadership development lineup
by serving several demographics, says Shannon Combs, MD, an obstetrician gynecologist
(08:01):
in Fort Worth and chair of TMA's council member experience.
That includes physicians who are new to Texas or to organized medicine,
Those who are busy building their practices or family during their early careers
and now have time for such training.
And leadership college alumni interested in more programming.
Dr. Combs counts herself in this last camp. She's an alumna of the class of
(08:23):
2018 and would like to further develop her skills.
She adds that lifelong leadership program will extend leadership college benefits,
including networking and community building across generations.
It was a great opportunity to engage and work through leadership opportunities,
but also to engage with different professions from all across Texas,
she said of the college. Dr.
(08:44):
Mathis, a 2020 Leadership College alumni and an assistant professor of family
medicine at the UTMB John Seeley School of Medicine,
where he serves as associate director of the Medical Student Education Program
and as director of the Integrative and Behavioral Medicine Fellowship,
is confident the lifelong leadership program will find a large audience.
(09:05):
Dr. Mathis says physicians are lifelong learners. Such a huge part of who we
are is to focus on learning and developing ourselves, keeping up with the latest medical information.
So the Lifelong Leadership Program taps into that natural inclination.
It is absolutely imperative that we provide leadership training to anyone who
is interested because TMA is made better and stronger when our membership is
(09:26):
actively engaged and involved across the generations.
The Lifelong Leadership Program also is more accessible given its rolling enrollment,
long duration, flexible pacing, and unlimited eligibility among TMA member physicians.
Melanie Fawcett, who manages TMA's leadership program, says this is by design
and the result of more than five years of development.
(09:48):
And our final story is fresh from TexMed 2024, TMA's annual premier conference
that was held earlier in May, where Dr.
Callas was installed as the Texas Medical Association's 159th president.
Dr. Callas said it's an honor and a privilege to to take care of patients,
and help lead physicians in the state of Texas.
(10:08):
Dr. Callas is a first alumnus of the TMA Leadership College to chair the association's
board of trustee and to now serve as TMA president.
A Beaumont anesthesiologist, Ray Callas, MD, didn't expect to become a physician,
let alone be elected president of what he unabashedly describes as the best
medical association in the world.
(10:28):
I never thought I would be that guy, he told Texas Medicine.
But after a few detours, including a stint playing college baseball and then
wartime military service, Dr.
Callas went on to launch a successful career as a physician and advocate.
His experience at TMA has prepared him to lead the association at a time when
Texas physicians faced the challenges of rapid industry consolidation,
(10:52):
declining payments, and mounting administrative hassles.
Also, when the state faces a record influx of new physicians and a physician
workforce shortage amid an exploding population.
Both are opportunities that put organized medicine in a unique position to offer
feasible solution, Dr. Callas says.
Physicians know Texas is a great place to practice medicine.
(11:13):
Texas is one of few states with medical liability reform, corporate practice
of medicine safeguards, and scope of practice protection, among other benefits, he said.
What physicians may not know, especially new physicians coming to Texas,
is the role TMA played in securing all those protections.
Having witnessed and participated in these and more of TMA's hard-fought wins
(11:34):
that make up for a healthy practice environment in Texas, Dr.
Callas's top priorities as president center on preventing scope of practice
creep, defending physician autonomy, and bolstering TMA membership.
Membership is the driving force of how strong our organization is going to be
and how strong medicine's voice is going to be around the state, he said.
(11:55):
Although Dr. Callas was drawn to medicine from a young age, his early career
path was nonlinear, including a failed first attempt at college.
He credits his parents with providing inspiration and instilling in him inclusive values.
His father, Gerald Callas a longtime anatomy professor at UTMB's School
of Medicine in Galveston, and his mother, Carolyn, co-owned and operated the
(12:17):
Carolyn Amen Dancing Academy for more than 50 years.
It was always cool to watch my dad carry a black bag back in the day and do
house calls, said Dr. Callas.
The respect that he generated as a physician, that was awesome. When Dr.
Callas' first foray into higher education didn't pan out, he enlisted in the
U.S. Navy, where he served as a submariner in Operation Desert Storm during the Gulf War.
(12:41):
The experience was formative and continues to influence him today.
It gives you a perspective that life is very, very fragile, he said.
Despite his pride in having served his country, Dr. Callas also learned that
a military career was not for him.
After being honorably discharged in 1992, he returned to his studies with newfound
(13:01):
resolve, completing his undergraduate studies at Texas A&M University in 1995
and earning his medical degree from UTMB in 2000.
It was improbable but not impossible, he said of his turnaround,
adding that receiving his medical school acceptance letter was one of the most
emotional moments of his life. Dr.
Callas stayed at UTMB for his residency in anesthesiology, which drew him in
(13:26):
with the promise of shift work and a balance between downtime and high-intensity situations.
This suits his personality, which also is high-intensity with moments of groundedness.
Each morning on his drive to work, Dr. Callas says he prays for the blessing
and decision-making to make sure his patients are safe.
During his residency and initial years in practice, Dr. Callas sought out mentorship
(13:48):
and other leadership development opportunities.
Which in turn cemented his passion for organized medicine. I was blessed to
have mentors who listened to me and gave me pearls, he said, citing a gift from Dr.
Kabbalah, the standard code of parliamentary procedure.
This push came at a pivotal moment when TMA was spearheading medical liability
reform and advocating for other legislation that would go on to rank among its
(14:11):
most significant victories.
Dr. Kala said, back in 2002-2003, when I was a brand new physician,
still in residency, getting ready to come out of the chute into private practice.
I remember getting involved in tort reform.
That's really where I cut my teeth and learned what it meant to be a physician advocate.
Soon after, he enrolled in leadership training, including the inaugural 2010
(14:31):
class of TMA's Leadership College, a pre-nine-month program that prepares scholars
to take on leadership roles in organized medicine, their practices, and their communities.
Dr. Callas certainly fulfilled his mandate. In addition to his many roles within
organized medicine, He is a leader
within his practice where he is board president and in his community,
(14:52):
serving as advisory director of the Beaumont Chamber of Commerce and board member
for the First Financial Bank.
Hooked on advocacy, Dr. Callas continued to grow in his role as TMA,
successfully urged Congress in 2015 to repeal the flawed sustainable growth
rate formula used by Medicare to calculate physician payments and the Texas
(15:13):
legislature in 2019 to enact surprise billing protection.
His faith and his family, his wife of more than 20 years and registered nurse
Lisa, and his daughters, Emery, McKenna, and Reagan, help him balance such a schedule.
Dr. Callas hopes to build on the association's strengths as envisioned in TMA's
five-year strategic plan, which he helped develop as 2023 Chair of TMA's Board of Trustees.
(15:38):
In carrying out that plan, one of Dr. Callas' top goals is maintaining TMA's
track record of stymieing scope of practice infringements on the practice of
medicine in the Texas legislature,
with more than 130 scope creep bills stopped in the 2023 session alone. loan.
He attributes the success to the inroads TMA has built with state leadership over decades.
(16:01):
We've created such a plethora of leader in Texas medicine that our voice is
very strong, said Dr. Callas.
With another legislative session set to kick off in January of 2025, Dr.
Callas plans to lean on these relationships in the year ahead and urges physicians
to do so locally with their lawmakers to preserve patients' access to high-quality
(16:22):
care, no matter where they live, and to dissuade future scope creep legislation.
This goal becomes especially important as evidenced in the 2023 legislative session.
Non-physician practitioners continue to bolster their argument that the scope
expansions are necessary given Texas's physician workforce shortage.
Dr. Callas said non-physician practitioners play a pivotal role on any health
(16:46):
care team, and I want to make sure we're all together. But rather than regulating
patients to a lower standard of care, that health care team has to be physician-led.
Dr. Callas is equally vigilant when it comes to encroachments on physicians'
autonomy by payers, hospital, venture capitalists, and other non-medical third parties.
They aren't going to overrun us, he said. That goes for whatever practice setting
(17:08):
or business model physicians may find themselves in.
And Dr. Callas wants to ensure physicians have options.
His tenure hits at a time when 34% of Texas physicians are in independent settings
and 66% are employed, whether by hospitals, health systems, or other corporate
entities, according to the Physicians Advocacy Institute.
(17:29):
I want to be the voice of the leader of all physicians, from independent practice
to private equity to hospital employee to academics, Dr. Kellis said.
Whatever you want to do as a physician, I'm 100% on board. With independent
practice becoming an increasingly rare choice, whether because of successive
Medicare physician pay cuts or other factors outside of the physician's control, Dr.
(17:52):
Callas, a staunch supporter of Medicare payment reform and other policy changes
that independent practices say are long overdue, understands his colleagues' plight.
I'm that small shop, says Dr. Callia, whose physician-owned Anesthesia Associates
is among the oldest independent medical group in Texas.
Wherever physicians find themselves on the membership spectrum,
(18:13):
as a medical student, resident, young physician starting out,
or those further along in their careers, Dr.
Callas wants them to feel represented and supported by TMA and the value it has to offer.
Having benefit himself, he hopes to pay it forward by being available to mentoring
as many of his physician colleagues as he can, particularly as TMA embarks this
(18:35):
year on its inaugural listening tour around the state.
Dr. Callas says, I'm your all-access type of president. I want to create more and more leaders.
And with those inspiring words, now you know the top stories you may have missed.
I hope you found this episode useful. Check the episode description for the link to these stories.
Remember to like and follow TMA Practice Well to receive every episode.
(18:58):
Until next time, stay well.
Music.
Thank you for listening to TMA's Practice Well podcast.
TMA, helping you improve the health of all Texans.
Music.
TMA has a long, proud history of promoting patient rights, advocating for physicians,
(00:24):
and providing real solutions for your practice. us.
We can accomplish so much when we unite in one voice.
Call the TMA Knowledge Center at 1-800-880-7955 or visit textmed.org to find
out how you can join or renew your membership today. day.
Music.
(00:54):
Hi, I'm Cheryl Krhoviak. I produce the TMA Practice Well Podcast and manage the
TMA Education Center, where through on-demand webinars, PDF publications,
and CME2Go podcast episodes, We strive to help physicians thrive.
Texas Medical Association, TMA, provides several timely curated newsletters and magazine issues.
(01:16):
Delivered to your email daily, look for TMT, Texas Medicine Today,
for top stories and association news, and Medical News Roundup,
for mainstream news that affects Texas physicians.
Texas Medicine Magazine delivers timely information on public health,
medical legal issues, medical economics, science, medical education,
(01:37):
and legislative affairs affecting Texas physicians and their patients.
With the hundreds of things fighting for your attention at any given time,
it's easy to miss that negative information that could make your life easier
or keep you from being caught and aware.
So, in case you miss them, here are three recent stories that Texas physicians
found most interesting.
(01:58):
First up is two-payer update. Cigna to deny Deny claims without Z-code documentation.
Starting July 14th, Cigna Healthcare will deny certain claims that are billed
with the Z-code and without documentation.
Z-codes are used to document social, environmental, and personal circumstances
that influence a patient's health status but are not disease or injuries themselves. selves.
(02:20):
Cigna will deny claims when practices bill certain evaluation and management
codes known as E&M codes 99202 to 99215 with a preventative service code and
a supporting Z diagnosis code,
but not supplemental medical record documentation.
Physicians will need to refer to multiple policies by the payer to utilize both
(02:40):
preventative services and problem-oriented E&M services for new and established
patients on the same date of service.
Texas Medical Association Billing and Coding experts caution this could add to practices workload.
Moreover, these services will not be payable by Cigna when billed with a Z diagnosis code alone.
TMA experts recommend including supporting medical record documentation with
(03:05):
the diagnosis code for the problem E&M claim to identify why a preventative
service, like dietary counseling, for example, was performed.
Physicians can also check Cigna's preventative services policy for examples
of Z codes or refer to Cigna's E&M reimbursement policy for more payment information from the payer.
Aetna is set to pay Medicare Advantage G-2211 claim. The list of health plans
(03:30):
providing payment for Medicare's new add-on G-code continues to grow with Aetna
as the latest insurer to cover G-2211 for Medicare Advantage claims.
Aetna confirmed with Texas Medical Association coding experts that its Medicare
Advantage claims platform was updated in March to allow payment for the code
used to document the coordination of care for patients with complex or serious conditions.
(03:53):
For now, the plan's policy is only accessible through the physician's Aetna portal.
Previously, three other national payers had confirmed coverage of G-2211,
Cigna for Medicare Advantage only, Humana for Commercial and Medicare Advantage,
and UnitedHealthcare for Commercial and Medicare Advantage.
The 2024 Medicare Physician Fee Schedule allows physicians to list G-2211 in
(04:17):
addition to codes used in office or outpatient visits for new or established
patients, in other words, 99202 to 99215.
Physicians can also use it for telehealth visits. TMA continues to push for
increased code guidance from federal officials as confusion over its use persists.
The Center for Medicare and Medicaid Services does not restrict G-2211 to medical
(04:41):
professionals based on specialty.
It recommends physicians fill the code if they are a continuing focal point
for all needed services,
like a primary care practitioner, or are giving ongoing care for a single serious
condition or complex condition, like sickle cell disease or HIV.
TMA experts recommend physicians use G-2211 when they have assumed or intend
(05:05):
to assume responsibility for the patient's ongoing medical care and they intend
to apply the code to office and outpatient E&M services.
Physicians should not use G-2211 when the associated office visit E&M service
is reported with modifier 25 appended and their visit with the patient are routine or time-limited.
(05:28):
For example, a physician who sees a patient for an acute concern should not
report G-2211 if they have not also assumed responsibility for the patient's
ongoing medical care or do not plan to take responsibility for subsequent billing care.
Additionally, TMA experts recommend practices update their electronic health
record and billing systems to reflect the 2024 Medicare Physician Fee Schedule
(05:52):
to verify G-2211 is added.
Practice management or billing and coding staff can help with this.
Physicians, also be aware that you cannot append Modifier 25 when billing for G-2211.
Also, CMS has not defined complex conditions, meaning you should create an internal
policy on what complex conditions mean to you.
(06:13):
And G-2211 claims should not include templates.
And document patient-specific details. For payment and coding help from TMA
experts who go to bat with payers for your practice, visit TMA's Physician Payment
Resource Center, linked in the episode description.
Moving on to association news, TMA debuts Leadership Development Program for
(06:34):
Physicians at every career stage.
The Lifelong Leadership Program is a self-paced 18-month program free to any TMA member physician.
Enrollees participate in a combination of in-person and on-demand courses and
activities centered on one of three concentrations, organized medicine,
practice leadership, or advocacy.
(06:55):
Along with the Leadership College and the Leadership Summit,
this program responds to members' requests for more career development opportunities
and similarly prepares graduates to leave in their practice,
organized medicine, and community.
It also builds on a successful foundation.
Beaumont Anesthesiologist Ray Callas, MD, is the first leadership college alumnus
(07:16):
installed at TMA President at TechSmith 2024.
He stands alongside other graduates who have gone on to hold a diverse array
of leadership roles in and outside of TMA, including elected office.
Dr. Callas encourages other physicians to seek out leadership opportunities
and to diversify their contributions, whether stepping up at work,
(07:37):
inside TMA or specialty societies, or in politics.
Doing so, he says, ensure physicians and their patients have an advocate at every level.
If you're not a voice for your patients, nobody else will be, said Dr. Callas.
The Lifelong Leadership Program complements TMA leadership development lineup
by serving several demographics, says Shannon Combs, MD, an obstetrician gynecologist
(08:01):
in Fort Worth and chair of TMA's council member experience.
That includes physicians who are new to Texas or to organized medicine,
Those who are busy building their practices or family during their early careers
and now have time for such training.
And leadership college alumni interested in more programming.
Dr. Combs counts herself in this last camp. She's an alumna of the class of
(08:23):
2018 and would like to further develop her skills.
She adds that lifelong leadership program will extend leadership college benefits,
including networking and community building across generations.
It was a great opportunity to engage and work through leadership opportunities,
but also to engage with different professions from all across Texas,
she said of the college. Dr.
(08:44):
Mathis, a 2020 Leadership College alumni and an assistant professor of family
medicine at the UTMB John Seeley School of Medicine,
where he serves as associate director of the Medical Student Education Program
and as director of the Integrative and Behavioral Medicine Fellowship,
is confident the lifelong leadership program will find a large audience.
(09:05):
Dr. Mathis says physicians are lifelong learners. Such a huge part of who we
are is to focus on learning and developing ourselves, keeping up with the latest medical information.
So the Lifelong Leadership Program taps into that natural inclination.
It is absolutely imperative that we provide leadership training to anyone who
is interested because TMA is made better and stronger when our membership is
(09:26):
actively engaged and involved across the generations.
The Lifelong Leadership Program also is more accessible given its rolling enrollment,
long duration, flexible pacing, and unlimited eligibility among TMA member physicians.
Melanie Fawcett, who manages TMA's leadership program, says this is by design
and the result of more than five years of development.
(09:48):
And our final story is fresh from TexMed 2024, TMA's annual premier conference
that was held earlier in May, where Dr.
Callas was installed as the Texas Medical Association's 159th president.
Dr. Callas said it's an honor and a privilege to to take care of patients,
and help lead physicians in the state of Texas.
(10:08):
Dr. Callas is a first alumnus of the TMA Leadership College to chair the association's
board of trustee and to now serve as TMA president.
A Beaumont anesthesiologist, Ray Callas, MD, didn't expect to become a physician,
let alone be elected president of what he unabashedly describes as the best
medical association in the world.
(10:28):
I never thought I would be that guy, he told Texas Medicine.
But after a few detours, including a stint playing college baseball and then
wartime military service, Dr.
Callas went on to launch a successful career as a physician and advocate.
His experience at TMA has prepared him to lead the association at a time when
Texas physicians faced the challenges of rapid industry consolidation,
(10:52):
declining payments, and mounting administrative hassles.
Also, when the state faces a record influx of new physicians and a physician
workforce shortage amid an exploding population.
Both are opportunities that put organized medicine in a unique position to offer
feasible solution, Dr. Callas says.
Physicians know Texas is a great place to practice medicine.
(11:13):
Texas is one of few states with medical liability reform, corporate practice
of medicine safeguards, and scope of practice protection, among other benefits, he said.
What physicians may not know, especially new physicians coming to Texas,
is the role TMA played in securing all those protections.
Having witnessed and participated in these and more of TMA's hard-fought wins
(11:34):
that make up for a healthy practice environment in Texas, Dr.
Callas's top priorities as president center on preventing scope of practice
creep, defending physician autonomy, and bolstering TMA membership.
Membership is the driving force of how strong our organization is going to be
and how strong medicine's voice is going to be around the state, he said.
(11:55):
Although Dr. Callas was drawn to medicine from a young age, his early career
path was nonlinear, including a failed first attempt at college.
He credits his parents with providing inspiration and instilling in him inclusive values.
His father, Gerald Callas a longtime anatomy professor at UTMB's School
of Medicine in Galveston, and his mother, Carolyn, co-owned and operated the
(12:17):
Carolyn Amen Dancing Academy for more than 50 years.
It was always cool to watch my dad carry a black bag back in the day and do
house calls, said Dr. Callas.
The respect that he generated as a physician, that was awesome. When Dr.
Callas' first foray into higher education didn't pan out, he enlisted in the
U.S. Navy, where he served as a submariner in Operation Desert Storm during the Gulf War.
(12:41):
The experience was formative and continues to influence him today.
It gives you a perspective that life is very, very fragile, he said.
Despite his pride in having served his country, Dr. Callas also learned that
a military career was not for him.
After being honorably discharged in 1992, he returned to his studies with newfound
(13:01):
resolve, completing his undergraduate studies at Texas A&M University in 1995
and earning his medical degree from UTMB in 2000.
It was improbable but not impossible, he said of his turnaround,
adding that receiving his medical school acceptance letter was one of the most
emotional moments of his life. Dr.
Callas stayed at UTMB for his residency in anesthesiology, which drew him in
(13:26):
with the promise of shift work and a balance between downtime and high-intensity situations.
This suits his personality, which also is high-intensity with moments of groundedness.
Each morning on his drive to work, Dr. Callas says he prays for the blessing
and decision-making to make sure his patients are safe.
During his residency and initial years in practice, Dr. Callas sought out mentorship
(13:48):
and other leadership development opportunities.
Which in turn cemented his passion for organized medicine. I was blessed to
have mentors who listened to me and gave me pearls, he said, citing a gift from Dr.
Kabbalah, the standard code of parliamentary procedure.
This push came at a pivotal moment when TMA was spearheading medical liability
reform and advocating for other legislation that would go on to rank among its
(14:11):
most significant victories.
Dr. Kala said, back in 2002-2003, when I was a brand new physician,
still in residency, getting ready to come out of the chute into private practice.
I remember getting involved in tort reform.
That's really where I cut my teeth and learned what it meant to be a physician advocate.
Soon after, he enrolled in leadership training, including the inaugural 2010
(14:31):
class of TMA's Leadership College, a pre-nine-month program that prepares scholars
to take on leadership roles in organized medicine, their practices, and their communities.
Dr. Callas certainly fulfilled his mandate. In addition to his many roles within
organized medicine, He is a leader
within his practice where he is board president and in his community,
(14:52):
serving as advisory director of the Beaumont Chamber of Commerce and board member
for the First Financial Bank.
Hooked on advocacy, Dr. Callas continued to grow in his role as TMA,
successfully urged Congress in 2015 to repeal the flawed sustainable growth
rate formula used by Medicare to calculate physician payments and the Texas
(15:13):
legislature in 2019 to enact surprise billing protection.
His faith and his family, his wife of more than 20 years and registered nurse
Lisa, and his daughters, Emery, McKenna, and Reagan, help him balance such a schedule.
Dr. Callas hopes to build on the association's strengths as envisioned in TMA's
five-year strategic plan, which he helped develop as 2023 Chair of TMA's Board of Trustees.
(15:38):
In carrying out that plan, one of Dr. Callas' top goals is maintaining TMA's
track record of stymieing scope of practice infringements on the practice of
medicine in the Texas legislature,
with more than 130 scope creep bills stopped in the 2023 session alone. loan.
He attributes the success to the inroads TMA has built with state leadership over decades.
(16:01):
We've created such a plethora of leader in Texas medicine that our voice is
very strong, said Dr. Callas.
With another legislative session set to kick off in January of 2025, Dr.
Callas plans to lean on these relationships in the year ahead and urges physicians
to do so locally with their lawmakers to preserve patients' access to high-quality
(16:22):
care, no matter where they live, and to dissuade future scope creep legislation.
This goal becomes especially important as evidenced in the 2023 legislative session.
Non-physician practitioners continue to bolster their argument that the scope
expansions are necessary given Texas's physician workforce shortage.
Dr. Callas said non-physician practitioners play a pivotal role on any health
(16:46):
care team, and I want to make sure we're all together. But rather than regulating
patients to a lower standard of care, that health care team has to be physician-led.
Dr. Callas is equally vigilant when it comes to encroachments on physicians'
autonomy by payers, hospital, venture capitalists, and other non-medical third parties.
They aren't going to overrun us, he said. That goes for whatever practice setting
(17:08):
or business model physicians may find themselves in.
And Dr. Callas wants to ensure physicians have options.
His tenure hits at a time when 34% of Texas physicians are in independent settings
and 66% are employed, whether by hospitals, health systems, or other corporate
entities, according to the Physicians Advocacy Institute.
(17:29):
I want to be the voice of the leader of all physicians, from independent practice
to private equity to hospital employee to academics, Dr. Kellis said.
Whatever you want to do as a physician, I'm 100% on board. With independent
practice becoming an increasingly rare choice, whether because of successive
Medicare physician pay cuts or other factors outside of the physician's control, Dr.
(17:52):
Callas, a staunch supporter of Medicare payment reform and other policy changes
that independent practices say are long overdue, understands his colleagues' plight.
I'm that small shop, says Dr. Callia, whose physician-owned Anesthesia Associates
is among the oldest independent medical group in Texas.
Wherever physicians find themselves on the membership spectrum,
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as a medical student, resident, young physician starting out,
or those further along in their careers, Dr.
Callas wants them to feel represented and supported by TMA and the value it has to offer.
Having benefit himself, he hopes to pay it forward by being available to mentoring
as many of his physician colleagues as he can, particularly as TMA embarks this
(18:35):
year on its inaugural listening tour around the state.
Dr. Callas says, I'm your all-access type of president. I want to create more and more leaders.
And with those inspiring words, now you know the top stories you may have missed.
I hope you found this episode useful. Check the episode description for the link to these stories.
Remember to like and follow TMA Practice Well to receive every episode.
(18:58):
Until next time, stay well.
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