Table of Contents: December 2017

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Volume 113, Number 12 — December 2017

COVER STORY (pages 22–28)

Closing the Gap
Balance billing was one of TMA's biggest legislative wins this year. Senate Bill 507 will expand mediation for out-of-network bills, but nasty financial surprises for patients won't end when it takes effect on Jan. 1. By Joey Berlin


Expecting the Unexpected
Hurricane Harvey showed many Texas physicians how vulnerable their practices can be to natural disasters and other calamities. Recovering from setbacks can be difficult, but there are steps physicians can take to prepare for recovery. By Sean Price

LAW (pages 37–42) 

Difficult Situations
A Harris County judge rejected a constitutional challenge to the state’s Advance Directives Act in September, siding with TMA and other organizations in Houston Methodist Hospital’s dispute over whether to withdraw lifesaving treatment. By Joey Berlin

ECONOMICS (pages 43–47)

For Future Reference
Reference pricing allows a payer or employer to set a standard, maximum price for a procedure regardless of whether the physician is in or out of network, allowing patients to shop for care. That ability to shop, though, introduces some consequences. By Joey Berlin 

PUBLIC HEALTH (pages 49–54)

Bad Medicine
How can physicians safely get rid of old medications and encourage patients to do the same? For generations, people have flushed old prescriptions down the toilet or have held on to them. But these methods can lead to a potentially dangerous situation. By Sean Price

JOURNAL (page 55)

Cancer Incidence Among Texas Publicly Funded Substance Abuse Treatment Clients 

By Robert J. Reynolds, MPH, PhD; Steven M. Day, PhD; Alan Shafer, PhD; and Emilie Becker, MD


Editor's Note (page 7)
Fact (page 9)
Focus On: Fruit, Vegetable Consumption (page 11)
Commentary: A Chance to Live Better: Integrating Palliative and Supportive Care By Gerard J. Voorhees, MD (pages 13–14)
Commentary: "The American Sickness": A Clinical Perspective By Larry Buxton, MD; Eduardo Garcia, MD; and John Pettigrove, MD (pages 15–17)
Rounds (pages 19-21)
Tip (page 56)

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