Apr 29, 2011

Texas Budget Still Stalled in the Senate

TMA Legislative News Hotline

Friday, April 29, 2011



Sen. Steve Ogden
R-Bryan
BUDGET UPDATE
In spite of lots of controversy, the chief budget writer for the Senate is trying to keep the budget process moving in the upper chamber. Yesterday, Sen. Steve Ogden (R-Bryan) offered up several ideas to help cover the cost of the Senate’s spending plan. One that was approved by the full Senate would generate $184 million in additional revenue. It involves passing a temporary constitutional amendment that would increase the market value of the Permanent School Fund.

Senator Ogden also is going to take up the supplemental appropriations bill — House Bill 4 — in the Finance Committee. HB 4 authorizes additional spending to make up shortfalls in the current (2010-11) state budget. The measure passed in the House earlier this month.

UNDER THE ROTUNDA
Bills continue to move through the House and Senate chambers. Yesterday, the Senate passed these two bills:
  • Senate Bill 23 by Sen. Jane Nelson (R-Flower Mound). It creates about $500 million in cost savings, primarily in Medicaid and the Children’s Health Insurance program. The measure expands Medicaid managed care into South Texas for a savings of $290 million over the biennium. It requires most Medicaid patients to use medicines on a state formulary. And it ensures people with disabilities receiving home health care use a Medicaid contractor. Its companion is HB 1645 by Rep. John Zerwas, MD (R-Simonton).
  • SB 1580 by Senator Ogden would require the Health and Human Services Commission (HHSC) to study the cost-effectiveness of telemonitoring for diabetic Medicaid patients. SB 1580 also directs HHSC to study physician incentives to reduce Medicaid patients’ nonemergent use of emergency departments. Its companion legislation is HB 3666 by Representative Zerwas.


Rep. Garnet Coleman
D-Houston
 Today, several bills that TMA support are on the General House Calendar:
  • The committee substitute for HB 1700 by Rep. Garnet Coleman (D-Houston). This is TMA’s physician employment protection bill. HB 1700 would allow critical access hospitals, sole community hospitals, and hospitals in counties of 50,000 or fewer to employ physicians. Most of these hospitals are run by local governments. The bill contains many features that protect the physician’s clinical autonomy against the corporate practice of medicine. It:
    • Places the responsibility for all clinical matters — bylaws, credentialing, utilization review, and peer review — under the medical staff;
    • Guarantees physicians’ independent medical judgment;
    • States that all physicians — employed or independent — are subject to the same rights and responsibilities;
    • Allows employed physicians to participate in the selection of their liability insurance and have the right to consent to settle in a liability action; and
    • Requires the medical staff to designate a chief medical officer (CMO) who must be approved by the hospital board. The CMO has the duty to report to the Texas Medical Board (TMB) that the hospital is hiring physicians under this bill and that the CMO is the contact for TMB. The CMO has a duty to report instances of interference to TMB.
  • CSHB 300 by Rep. Lois Kolkhorst (R-Brenham). This is an attempt to strengthen state privacy law on top of the federal Health Information Portability and Accountability Act (HIPAA). The legislation would expand the entities and individuals who must comply with state privacy measures and also increases penalties for those who illegally disclose or sell data.
  • HB 1816 by Rep. Charlie Howard (R-Sugarland). It would require all first-time students at public and private or independent colleges to receive a bacterial meningitis vaccination. Its companion legislation is CSSB 1107 by Sen. Wendy Davis (R-Fort Worth). It’s on the Senate Local and Consent Calendar today.
WHAT WE'RE READING
Senate Approves Medicaid Savings Bill (Texas Tribune)
Two Lyme disease bills target gap in treatment in Texas
(Austin American

Apr 28, 2011

Dr. Dan McCoy Explains the Texas Budget Debate

>Get Adobe Flash player

Dan McCoy, MD, Chair of TMA's Council on Legislation, talks about why the Senate version of the Teas state budget is so much better than the House, why TMA is pushing for passage of the Senate bill, and what you can do to help.

What can you do? Contact your state senator today. Ask your senator to vote to bring the budget up for debate on the Senate floor ... and then to vote "Yes" on the Senate Finance Committee plan.

Apr 27, 2011

Senate Needs 21 Votes to Bring Up Better Budget Bill

TMA Legislative News Hotline

Wednesday, April 27, 2011


WHAT YOU CAN DO
Contact your senator today. The Senate needs 21 votes to bring up the Senate Finance Committee substitute to House Bill (CSHB) 1 — the state’s 2012-13 spending package. Please contact your senator today and ask him or her to vote to take up CSHB 1. This spending plan benefits you and your patients. Here is a comparison of the House and Senate budget bills. Compare the difference, then contact your senator and Lt. Gov. David Dewhurst to support the Senate version.

Here’s why: The Senate Finance Committee 2012-13 budget plan is $12 billion more generous than the House version, and restored funding for critical health care services. Finance Committee members did not slash physicians’ Medicaid and Children’s Health Insurance Program payments by 10 percent. They did not slash nursing home payments. They did not slash community-based mental health and hospital services for adults and children. They did not completely eliminate the Physician Education Loan Repayment Program or the state’s tobacco cessation program.

By no means does the Senate budget fully fund all of medicine’s top priorities, including funds to improve the physician workforce and essential public health services. This is still a very lean budget. That is why TMA will continue to work on these priorities. However, given the historic budget crisis facing Texas, we believe this budget goes a long way towards protecting Texas health care safety. Plus, if a budget bill does not pass in the next four weeks it will be decided in a special session. Health care definitely will not be funded quite as generously. Act now. Please send an e-mail through TMA’s Grassroots Action Center or call your senator today.

Sign up now for the last First Tuesdays at the Capitol. It’s your last chance to join hundreds of your colleagues to lobby on legislation that affects you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. International medical graduates especially are invited to take part. Register today.

BILL UPDATE
Great news: TMA-supported bills were passed in the House and Senate chambers yesterday. Bills that the full Senate passed include:
  • Senate Bill 224 by Sen. Jane Nelson (R-Flower Mound). It requires schools to report students’ fitness and academic scores to the Texas Education Agency.
  • SB 1177 by Senator Nelson. It requires health care facilities such as hospitals to develop and implement vaccination policies to protect patients from vaccine-preventable diseases. The policy would require health care workers to get vaccinations recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
These two bills were passed on second reading by the House:
  • HB 127 by Rep. Carol Alvarado (D-Houston). It would ban the sale of unhealthy sugary drinks to students in schools. A big shout-out to Reps. Susan King (R-Abilene), Garnet Coleman (R-Houston), Dianne Patrick (R-Arlington), Marc Veasey (D-Fort Worth), and Eddie Lucio III (D-Brownsville) who helped Representative Alvardo pass her important bill on the House floor. HB 127 is an important step to help fight childhood obesity. Like TMA member Marta Katalenas, MD, a Round Rock pediatrician, wrote on her blog recently, “Children are not hummingbirds; stop giving them sugary drinks.”
  • HB 273 by Rep. John Zerwas, MD (R-Simonton). It would create a committee to study the Interstate Health Care Compact.

Rep. Rob Eissler
R-The Woodlands

UNDER THE ROTUNDA
Physician licensure: HB 527 by Rep. Rob Eissler (R-The Woodlands) will be taken up by the House Public Health Committee today. The bill would change the number of times a medical student could attempt to pass the U.S. Medical Licensure Exam. Currently a person can attempt to pass each component of the exam three times. This bill would change it so a person can attempt to pass each component six times.

Health insurance reform: The House Insurance Committee passed two TMA bills yesterday:
  • SB 822 by Sen. Kirk Watson (D-Austin) and HB 1333 by Representative Zerwas. These bills would allow physicians who work in an academic setting to treat patients as “in-network” physicians for claims purposes while their applications for credentialing and health plan network participation are being processed.
  • CSHB 1534 by Rep. Craig Eiland (D-Galveston).The committee substitute seeks to balance access to preferred provider organization networks while making their actions transparent when using a physician and other health care provider discount.   
Reconstructive surgery: Today the House Public Health Committee will take up HB 669 by Rep. James White (R-Hillister). TMA worked with the bill author on a committee substitute. The bill no longer mandates what a physician must say to a patient regarding reconstructive breast surgery. Now the bill simply fosters that dialogue. It allows the physician to use discretion as to what is appropriate. Debra Patt, MD, an Austin oncologist, will testify in support of CSHB 669.

Lyme disease: The House Public Health Committee also will take up HB 2975 by Rep. Todd Hunter (R-Corpus Christi). The legislation establishes a process of accredited continuing medical education (CME) programs for physicians by the Texas Medical Board (TMB). A TMB stakeholders group would develop accredited CME offerings regarding Lyme disease diagnosis, care, and treatment. Sen. Chris Harris (R-Arlington) is carrying the bill’s companion legislation, SB 1360.

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Mary Helen Morrow, MD, of North Zulch. Dr. Morrow has practiced family medicine for 15 years. She graduated from the University of Connecticut School of Medicine in 1991. Dr. Morrow is a member of the Brazos-Robertson County Medical Society.

WHAT WE'RE READING
Dewhurst says he disagrees with, and was surprised by, Finance Committee’s use of rainy day fund (Austin-American Statesman)
Perry: “No Faith” In LBB; Leave Rainy Day Fund Alone (Texas Tribune)

Apr 26, 2011

Contact Your Senator Today for a Better Budget Bill

TMA Legislative News Hotline

Tuesday, April 26, 2011



WHAT YOU CAN DO
Contact your senator today. TMA issued an action alert this morning asking members to contact their state senator today. Here’s why: Last week the Senate Finance Committee passed its 2012-13 budget plan. Its budget was $12 billion more generous than the House version, restoring funding for critical health care services. Finance Committee members did not slash physicians’ Medicaid and Children’s Health Insurance Program payments by 10 percent. They did not slash nursing home payments. They did not slash community-based mental health and hospital services for adults and children. They did not completely eliminate the Physician Education Loan Repayment Program or the state’s tobacco cessation program.

By no means does the Senate budget fully fund all of medicine’s top priorities, including funds to improve the physician workforce and essential public health services. This is still a very lean budget. That is why TMA will continue to work on these priorities.  However, given the historic budget crisis facing Texas, we believe this budget goes a long way towards protecting Texas health care safety.

It is critical to move the Senate proposal forward at this point to maximize the possibility of passing a budget during the regular session. If approved by the Senate, the next likely step is for both chambers to appoint a conference committee to work out differences between the two proposals. Act now. Please send an e-mail through TMA’s Grassroots Action Center or call your senator today.

Check out the TMA website for a comparison of the House and Senate budget bills.

Sign up now for the last First Tuesdays at the Capitol. It’s your last chance to join hundreds of your colleagues to lobby on legislation that affects you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. International medical graduates especially are invited to take part. Register today.

UNDER THE ROTUNDA
End of life: For the third week in a row, the House Human Services Committee will discuss how end-of-life decisions should be made and by whom. Today the committee is planning to take up House Bill 2483 by Rep. Aaron Peña (R-Edinburg). The restrictive measure would greatly limit a physician’s ability and willingness to execute a “do not resuscitate” order. It also would potentially criminalize the activity. It prioritizes the wishes of family members above those even of the patient and gives them near-absolute control over how long and what kind of care a terminally ill patient should receive while in the hospital, regardless of whether the care is medically appropriate. TMA submitted these comments in opposition to HB 2483.

Scope of practice: The Senate Health and Human Services Committee will take up Senate Bill 1084 by Sen. Jeff Wentworth (R-San Antonio) today. It would establish a definition of “complementary and alternative health care services” in state law and define which acts practitioners of these services are prohibited from doing, such as surgery, diagnostic testing, the exercise of prescriptive authority, and medical diagnosis but allow them to perform all other services. It would also require these practitioners to give each client in writing the services they are providing and the practitioner's related education, training, experience, or other qualifications to provide these services. TMA submitted these comments in opposition to the proposal.


Rep. Linda Harper-Brown
R-Irving
Health insurance reform: The House Insurance Committee today will take up two bills TMA supports. These are:
  • House Bill 3291 by Rep. Linda Harper-Brown (R-Irving). It would prohibit insurers from making a false, misleading, or intimidating statement that would encourage a patient to fill prescriptions at a specific pharmacy.
  • HB 762 by Rep. Jose Manuel Lozano (D-Kingsville). It would require the state employee health plans (Employees Retirement System [ERS], Teacher Retirement System, The University of Texas System, and Texas A&M University System) to create voluntary pill-splitting programs with a pharmacy copay reduction as a participation incentive. The ERS Board of Trustees would adopt a list of eligible pills for the program and educational materials. It also would require individuals who choose to participate in the program to obtain a prescription from their physician for eligible drugs.
BILL UPDATE
TMA supports several bills on the Senate and House calendars. On the Senate Intent Calendar are these four, plus the committee substitute for HB 1 — the state budget bill discussed above:
  • SB 224 by Sen. Jane Nelson (R-Flower Mound) requires schools to report students’ fitness and academic scores to the Texas Education Agency.
  • SB 1177 by Senator Nelson requires health care facilities such as hospitals to develop and implement vaccination policies to protect patients from vaccine-preventable diseases. The policy would require health care workers to get vaccinations recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
  • SB 1022 by Sen. José Rodríquez (D-El Paso) would allow international medical graduates to apply for licensure in Texas after two years of graduate medical education.
  • SB 1533 by Sen. “Chuy” Hinojosa (D-McAllen) restricts the availability of foods served in Texas public schools with industrially produced trans fats.
On the General House Calendar up for a second reading today are these two bills:
  • HB 127 by Rep. Carol Alvarado (D-Houston) would ban the sale of unhealthy sugary drinks to students in schools.
  • HB 273 by Rep. John Zerwas, MD (R-Simonton), would create a committee to study the Interstate Health Care Compact.
Jeffrey Edwards, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Jeffrey Edwards, MD, of Stephenville. Dr. Edwards has practiced family medicine for six years. He graduated from the University of Washington School of Medicine in 1991. Dr. Edwards is a member of the Erath-Somervell-Comanche County Medical Society.

WHAT WE'RE READING
Video: Conservative Coalition Rolls Out Budget Ads (Texas Tribune)
Outside Groups Lobby Texas Budget Writers
(Texas Tribune)
Has Texas Patient Privacy Bill Hit a Snag?
(Texas Tribune)

Apr 25, 2011

Start The ICD-10 Switch Now

ICD-10 will replace ICD-9 in 2013. To use the new coding system in electronic transactions, you must convert to HIPAA Version 5010 software standards — or you won't get paid. But that’s not the only reason to upgrade to Version 5010.

Sign Up Now for May 3 First Tuesday at the Capitol

TMA Legislative News Hotline

Monday, April 25, 2011


Sen. Jane Nelson (R-Flower
Mound with Tarrant County
physicians and alliance
members at First Tuesday
WHAT YOU CAN DO
Sign up now for the last First Tuesdays at the Capitol. It’s your last chance to join hundreds of your colleagues to lobby on legislation that affects you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. International medical graduates especially are invited to take part. Register today.

UNDER THE ROTUNDA
With only 35 days left in the 2011 regular session, lawmakers have a lot of work to accomplish. When Senate members get back in Austin tomorrow, their top priority is to finalize the state’s 2012-13 budget plan. If it is approved, it is likely the House will not concur in the Senate changes, and a conference committee of five House members and five Senate members will be appointed to reconcile differences. In the lower chamber, the House is scheduled to take up the proposed redistricting plan on Wednesday. Upcoming legislative deadlines in both chambers start the second week of May.

BUDGET WATCH
Tomorrow, the full Senate could start the budget debate. It will take two-thirds of the Senate to bring the bill up for debate on the Senate floor. The budget plan passed by the Senate Finance Committee last week totals $176.5 billion, ($80.7 billion in general revenue). The budget reduces current spending by about $6 billion, but is $11 billion more than the House proposal. If the Senate musters the necessary votes to  pass its budget bill, the bill is sent back over to the House with the Senate language.  Then the House and Senate versions likely will need to be reconciled in conference committee. TMA will report the names of the 10 conference committee members as soon as they become available so you can be aware if your local legislator is serving on the committee. TMA staff also is preparing a side-by-side comparison of the two budget bills so you can better understand the differences and what’s in play. Stay tuned.

BILL UPDATE
A couple bills on the Senate Local and Consent Calendar that could be taken up this week are:
  • Senate Bill 224 by Sen. Jane Nelson (R-Flower Mound). It requires schools to report students’ fitness and academic scores to the Texas Education Agency.
  • SB 1177 by Senator Nelson. It requires health care facilities such as hospitals to develop and implement vaccination policies to protect patients from vaccine-preventable diseases. The policy would require health care workers to get vaccinations recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
WHAT WE'RE READING
Jails brace for influx of mentally ill (Houston Chronicle)
Hinojosa: Shapleigh walked away from the fight
(Rio Grande Guardian)

Medicaid ID Cards to Change

Starting in June, Texas Medicaid patients will carry credit-card-like identification to help physicians confirm that they are in the Medicaid program, the Texas Health and Human Services Commission (HHSC) said.

Apr 21, 2011

Texas Docs Pull All-Nighter at Capitol

TMA Legislative News Hotline

Thursday, April 21, 2011



Gary Floyd, MD
BIG SHOUT OUT TO TMA PHYSICIANS
A big shout out to TMA’s dedicated physicians and lobbyists who stayed up until 4 am this morning to testify before the House Public Health Committee. The committee took up more than 20 bills that ranged from allowing advanced practice nurses to practice independently of a physician, to expanding the sale of raw milk, to allowing physicians and physician assistants and APNs to provide care over the Internet without first doing an in-person exam. Thanks again to:
  • Gary Floyd, MD, a Fort Worth pediatrician, executive vice president of medical affairs at John Peter Smith Health Network and member of the TMA Council on Legislation;
  • Lloyd Van Winkle, MD, a Castroville family physician and past president of the Texas Academy of Family Physicians;
  • Tricia Elliott, MD, director of the family medicine residency program at The University of Texas Medical Branch at Galveston;
  • Jeff Jekot, MD, an anesthesiologist from Austin;
  • Russell Thomas, DO, an Eagle Lake family physician who formerly served on the Texas Medical Board and currently serves on the National Federation of State Medical Boards;
  • Debra Patt, MD, an Austin oncologist;
  • Kimberly Avila Edwards, MD, an Austin pediatrician and medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity at Dell Children’s Medical Center;
  • Greg Kronberg, MD, an Austin anesthesiologist and president the Texas Society of Anesthesiologists;
  • Sherid Zaafran, MD, a Houston anesthesiologist; and
  • Eddie Seade, MD, an Austin orthopedic surgeon.
 
We also want to thank Amy Arrant, MD, an Austin hospitalist and chief of staff of St. David’s South Austin Medical Center, and Mark Casanova, MD, a Dallas internist, for providing compelling testimony before the House Health and Human Services Committee yesterday. They testified on House Bill 3520 by Rep. Bryan Hughes (R-Mineola) that would force physicians and hospitals to provide medically unnecessary care indefinitely.

BUDGET WATCH
Yes, it’s still rainy over at the capitol. That’s why the chief budget writer for the Senate asked his committee today to support drawing down $3 billion from the state’s Rainy Day Fund to balance its 2012-13 budget plan. The Senate Finance Committee spent most of the week substituting parts of the House budget plan with its more generous spending. This morning the committee passed the committee substitute for House Bill 1 on an 11-4 vote, with Senators Lucio, Patrick, Whitmire, and Zaffirini voting against the bill. The legislation likely will be heard in the full Senate late next week, and then the House and Senate versions will be reconciled in conference committee. TMA will report the names of the 10 conference committee members as soon as they become available so you can be aware if your local legislator is serving on the committee. TMA staff also is preparing a side-by-side comparison of both budget bills so you can better understand what’s in play. Stay tuned. On Tuesday TMA released a letter to Finance Committee Chair Steve Ogden (R-Bryan) explaining why Texas physicians prefer the Senate budget plan over the House version.

BILL UPDATE
With less than six weeks left of the session, lawmakers are moving quickly — through bills and through the budget. Yesterday was a big day under the rotunda. Here’s a brief list of legislation moving through the chambers that TMA is tracking:

Sen. Jane Nelson
R-Flower Mound
Medicaid cost savings: Senate Bill 7 by Sen. Jane Nelson (R-Flower Mound) was passed by the Senate. The measure now goes to the House. Rep. Lois Kolkhorst (R-Brenham), chair of the House Public Health Committee, will carry the legislation. SB 7 establishes a new Medicaid and Children’s Health Insurance Program (CHIP) Quality-Based Payment Advisory Committee that would:
  • Provide recommendations to the Texas Health and Human Services Commission to improve health outcomes and patient safety, and reduce the incidence of potentially preventable hospitalizations and readmissions;
  • Direct the state to test new payment and delivery systems that provide incentives to physicians and hospitals to develop more coordinated, evidence-driven, cost-effective care;
  • Tie a portion of Medicaid HMO premiums to improved health outcomes and quality; and
  • Implement copayments in Medicaid to reduce unnecessary emergency department use.
Health care collaborative: SB 8 by Senator Nelson also was passed by the Senate. It would establish a statewide plan for improving quality and increasing efficiency through performance-based measures, test collaborative models between physicians and health care providers, and require public reporting of preventable readmissions and complications. TMA was able to add these three important provisions to SB 8 to protect physicians in a collaborative arrangement:
  • Physicians would have an equal say and vote in a collaborative arrangement’s governing board.
  • Physicians would have due process protections and the ability to participate in more than one collaborative arrangement in their community.
  • The bill protects Texas’ ban on the corporate practice of medicine.

Rep. Lois Kolkhorst
R-Brenham
 Interstate compact: HB 5 by Representative Kolkhorst was passed by the House yesterday. The measure would authorize the state to participate in a multistate compact to help fund and administer Medicaid. If passed, the compact would be submitted to Congress for its consideration. If approved, member states could pursue waivers that would relieve the state of federal mandates regarding Medicaid; CHIP; and all other health care programs, such as mental health and public health services. If successful, Texas likely would receive a block grant of around $60 billion, based on 2010 state/federal health care spending. Texas would then create its own health care program to replace Medicaid, CHIP, and all the other public health services.

TMB reform bills: SB 190 and SB 191 by Senator Nelson were approved by the Senate. Both bills now go to the House Public Health Committee. SB 190 would allow physicians to tape the proceedings of a Texas Medical Board (TMB) informal settlement conference, which eliminates the truly anonymous complaints. It would provide a physician notice if an insurance company files a complaint. It would prohibit the granting of a license to an applicant who has had a medical license suspended or revoked by another state or country (originally, the bill named only the country of Canada). SB 191 would bind TMB to the ruling of an administrative law judge in a proceeding supervised by the State Office of Administrative Hearings. SB 227 by Senator Nelson was also passed by the Senate. It now needs to be referred to a committee in the House. SB 277 would provide discretion for TMB to waive a fine in lieu of a remedial action plan for a minor administrative violation.

Health insurance: SB 822 by Sen. Kirk Watson (D-Austin) was passed by the Senate. Rep. John Zerwas, MD (R-Simonton), will sponsor the legislation in the House. The measure now goes to the House Insurance Committee for consideration. It would allow physicians who work in an academic setting to treat patients as an “in-network” physician for claims purposes while their applications for credentialing and health plan network participation are being processed.

HB 1405 by Rep. John Smithee (R-Amarillo) has passed the House and now goes to the Senate State Affairs Committee. The legislation would require plans that utilize a formulary to continue prescription benefits until the next renewal period if the formulary changes in the middle of the plan year. More importantly, HB 1405 would allow patients with individual coverage the same appeal rights as patients with small- or large-group health coverage. This means that a refusal or denial of a prescription drug by the health plan or pharmacy benefit manager would be considered an adverse determination and subject to an independent review if the physician has determined the drug is medically necessary.

Graduate medical education: HB 2908 by Rep. Dan Branch (R-Dallas) passed the House on second reading today. The bill requires the Higher Education Coordinating Board to assess the number of graduate medical education (GME) slots in the state and whether this number meets the national standards relating to the ratio of GME slots to medical student slots, to make sure the state is maximizing its investment in medical education.

Obesity prevention: HB 127 by Rep. Carol Alvarado (D-Houston) is on the House Local and Consent Calendar today. The legislation would limit the availability of sugary drinks on public school campuses.

TMA ON THE MOVE
Stanley Wang, MD
Congratulations to three TMA members who were appointed by Gov. Rick Perry to TMB. The physicians are:
  • Stanley Wang, MD, an Austin cardiologist and director of legislative affairs for Austin Heart Hospital. He also is a vice chair of the TMA Political Action Committee Board of Directors. Dr. Wang is newly appointed to the board.
  • George Willeford III, MD, an Austin gastroenterologist and founding partner of Austin Gastroenterology. He was reappointed.
  • Irvin Zeitler, DO, a family physician from San Angelo and vice president of medical affairs at Shannon Medical Center. Dr. Zeitler was reappointed to the board and will continue to be the presiding officer.
PHYSICIAN OF THE DAY
The physician of the day at the capitol is James P. McCurdy, MD, of Marble Falls. Dr. McCurdy has practiced family medicine for 29 years. He graduated from The University of Texas Southwestern Medical Center in 1979. Dr. McCurdy is a member of TMA and the Burnet-Lampasas County Medical Society.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. Register today.

Listen to ReachMD XM 160: Sidney Ontai, MD, MBA, a Plainview, family physician and TMA physician is the first featured doctor in a new national radio franchise premiering this week. ReachMD, an award-winning network for professional medical news, information, and continuing medical education, premieres the new programming series “Voices From American Medicine.” The series features “physicians on the frontlines of medicine discussing their personal stories of triumph, tragedy, humanitarianism and innovation.” “Voices From American Medicine” is produced in cooperation with TMA and other medical associations and societies from across America.

WHAT WE'RE READING
Raw milk under scrutiny after North Texas illnesses (Dallas WFAA [ABC] 8)
Texas Tribune: El Paso Hospitals May Be Allowed to Hire Docs
(El Paso KVIA [ABC] 7)
A rainy-day fight?
(Houston Chronicle)
The good tax: We favor hiking the levy on cigarettes and banning workplace smoking. It's past time
(Houston Chronicle)

Apr 20, 2011

Physicians Stand Up for Patient Safety in the House

TMA Legislative News Hotline

Wednesday, April 20, 2011



TMA TESTIFIES
With so many white coats prepared to take the witness stand today, it almost looks like First Tuesdays at the Capitol. We have physicians from Austin, Fort Worth, Eagle Lake, and other parts of Texas in town to testify on behalf of TMA, the Texas Academy of Family Physicians (TAFP), Texas Pediatric Society, and Texas Orthopedic Society. Most of the physicians are testifying before the House Public Health Committee later today against these bills:

Gary Floyd, MD
APN scope expansion: Gary Floyd, MD, a Fort Worth pediatrician, executive vice-president of medical affairs at John Peter Smith Health Network and member of the TMA’s Council on Legislation; Lloyd Van Winkle, MD, a Castroville family physician and past president of TAFP; Tricia Elliott, MD, director of the family medicine residency program at The University of Texas Medical Branch at Galveston; and Jeff Jekot, MD, an anesthesiologist from Austin will testify against House Bill 708 by Rep. Kelly Hancock (R-North Richland Hills), HB 915 by Rep. Wayne Christian (R-Center), and HB 1266 by Garnet Coleman (D-Houston). All three bills have slight nuances. However, each would allow advanced practice nurses (APNs) to practice independently of physician supervision. The bills would apply to nurse practitioners, nurse anesthetists, and clinical nurse specialists. All would be allowed to (1) prescribe, (2) diagnose, and (3) order and prescribe therapeutic care independently of physician supervision. They would allow care to be provided to patients under the supervision of the Texas Board of Nursing, not the Texas Medical Board.

Telemedicine: Russell Thomas, DO, an Eagle Lake family physician who formerly served on the Texas Medical Board and currently serves on the National Federation of State Medical Boards, will testify against HB 2333 by Rep. Rick Hardcastle (R-Vernon). The legislation would allow a physician to diagnose and treat a patient via the Internet without first establishing a relationship in person or doing a physical exam on the patient. The bill also would allow a physician or telemedicine service to use an unlimited number of physician assistants and APNs to provide care to patients via the Internet.

Clinical autonomy: Debra Patt, MD, an Austin oncologist, will testify against HB 669 by Rep. James White (R-Hillister). The legislation would tell physicians what they must tell a woman facing breast surgery about their options for breast reconstruction. Physicians also would have to tell patients how much of the cost would be covered by their health plan. Dr. Patt will tell the committee that legislation should not dictate what physicians should discuss with their patients regarding their health care. She also will explain why it’s impossible for physicians to tell patients exactly how much of their medical care will be covered by their health plan.

Kimberly Avila Edwards, MD
Food safety: Kimberly Avila Edwards, MD, an Austin pediatrician and medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity at Dell Children’s Medical Center, will testify against HB 75 by Rep. Dan Flynn (R-Van). The bill would expand access to unpasteurized, raw milk. Dr. Edwards will explain to committee members why raw, unpasteurized milk is a health hazard.

Physical therapist scope expansion: Eddie Seade, MD, an Austin orthopedic surgeon will testify against HB 637 by Rep. Craig Eiland (D-Galveston). The measure would allow direct access to ALL physical therapists without a physician’s referral for all patients ― children and adults ― for all services. Dr. Seade is testifying on behalf of TMA and the Texas Orthopedic Society.

Other bills before the committee, which TMA supports are:
  • HB 1893 by Rep. John Zerwas, MD (R-Simonton), which calls for a physician to directly supervise anesthesiologist assistants.
  • HB 2414 by Rep. Borris Miles (D-Houston), which would extend the Healthy Food Advisory Committee that was established last session. This committee looks at the retail availability of fresh fruits and vegetables in lower income areas and directs the committee to find funding sources for promoting retail availability.
  • HB 2546 by Representative Zerwas, which would create the emergency and trauma care education partnership program. The partnership would consist of one or more hospitals and one or more nursing or medical education programs with the goal of increasing enrollment and graduation of physicians and registered nurses with training in emergency and trauma care.
Advance directives: Last week, the House Human Services Committee took up HB 3520 by Rep. Bryan Hughes (R-Mineola). The measure would force physicians and hospitals to provide medically unnecessary care indefinitely. Committee Chair Richard Peña Raymond (D-Laredo) formed a subcommittee to further explore end-of-life issues. Today, the subcommittee is revisiting HB 3520. Amy Arrant, MD, an Austin hospitalist and chief of staff of St. David’s South Austin Medical Center, and Mark Casanova, MD, a Dallas internist, will tell subcommittee members why the measure would cause terminally ill patients more pain and suffering.

BUDGET WATCH
Yesterday the Senate Finance Subcommittee on Fiscal Matters, chaired by Sen. Robert Duncan (R-Lubbock), unveiled its proposal — SB 1811, which outlines how the Senate could pay for part of its budget plan. The subcommittee recommendations added up to $4.8 billion. The list included mostly accounting maneuvers, including putting off certain payments until the 2014-15 budget, and accelerated tax collections on motor fuels, alcoholic beverages, corporate franchise, and sales. Physicians could be affected by the franchise tax speedup. Although details may change, one plan discussed would require businesses that pay more than $10,000 in franchise tax to make an early payment on their 2013 tax bill. Usually this payment is not due until spring the following year. The early payment amount would be equal to 25 percent of your 2012 tax. Here’s the complete list of recommendations. The committee will vote on SB 1811 this afternoon. Thursday, the senators will decide whether to use any of the state's Rainy Day Fund to pay for the rest of the spending plan and will vote on the 2012-13 budget. TMA yesterday released a letter to Finance Committee Chair Steve Ogden (R-Bryan) explaining why Texas physicians prefer the Senate budget plan over the House version.

BILL UPDATE
Physician employment protections: The Senate Intergovernmental Relations Committee will take up two bills today that provide physicians protections if they choose to be employed by the Harris and/or Bexar county hospital districts. Both bills already were approved by the Texas House.
  • SB 1263 by Sen. Leticia Van de Putte (D-San Antonio) would allow the Bexar County Hospital District to employ physicians to meet its statutory mission of providing care to the indigent. TMA, the Bexar County Medical Society, and the hospital district worked together to develop an employment structure that protects a physician’s clinical autonomy and the patient-physician relationship. The framework of the employment arrangement is a nonprofit healthcare corporation — a 501(a) — with a physician board of directors to oversee all clinical issues related to physicians and the care they provide their patients.
  • SB 1795 by Sen. Mario Gallegos (D-Houston) would put responsibility for supervising all clinical issues related to the practice of medicine at the Harris County Hospital District in a medical executive board (MEB). It uses the existing MEB as a physician-led group in charge of the practice of medicine by all physicians — employed or medical-school affiliated — providing care in district facilities. Most importantly, it is the product of local discussions, facilitated by TMA, that included the district; the Harris County Medical Society; and both medical schools, The University of Texas Medical School at Houston and Baylor College of Medicine. It, too, helps the district meet its statutory mission to provide care to the indigent.
Interstate compact: HB 5 by Rep. Lois Kolkhorst (R-Brenham) is before the full House today. The measure would authorize the state to participate in a multistate compact to help fund and administer Medicaid. If passed, the compact would be submitted to Congress for its consideration. If approved, member states could pursue waivers that would relieve the state of federal mandates regarding Medicaid; the Children’s Health Insurance Program (CHIP); and all other health care programs, such as mental health and public health services. If successful, Texas likely would receive a block grant of around $60 billion, based on 2010 state/federal health care spending. Texas would then create its own health care program to replace Medicaid, CHIP, and all the other public health services. TMA submitted comments and questions in March.

Daniel Voss, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Daniel Voss, MD, of Jarrell. Dr. Voss has practiced family medicine for 23 years. He graduated from The University of Texas Medical Branch in 1985. Dr. Voss is a member of TMA and the Williamson County Medical Society.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. Register today.

Listen to ReachMD XM 160: Sidney Ontai, MD, MBA, a Plainview, family physician and TMA physician is the first featured doctor in a new national radio franchise premiering this week. ReachMD, an award-winning network for professional medical news, information, and continuing medical education, premieres the new programming series “Voices From American Medicine.” The series features “physicians on the frontlines of medicine discussing their personal stories of triumph, tragedy, humanitarianism and innovation.” “Voices From American Medicine” is produced in cooperation with TMA and other medical associations and societies from across America.

WHAT WE'RE READING 
Physical Therapists Fight Mandatory Referrals
(Texas Tribune)
Senate bill would ease El Paso doctor shortages
(El Paso Times)
Senate Approves Health Payment Reform
(Texas Tribune)
Obama Panel to Curb Medicare Finds Foes in Both Parties
(New York Times)

Apr 19, 2011

Why the Senate Has a Better Budget Plan

TMA Legislative News Hotline

Tuesday, April 19, 2011



Sen. Steve Ogden
R-Bryan
BUDGET WATCH
The budget debate between the House and Senate starts this week. Today the Senate Finance Committee will discuss which nontax revenue options it will use to pay for its more generous budget. Then tomorrow, the committee will discuss using money out of the Rainy Day Fund. On Thursday, the committee is expected to vote the budget out of committee and hand it over to the full Senate for debate. TMA sent a letter today to Sen. Steve Ogden (R-Bryan), chief budget writer for the Senate, supporting the Senate’s budget plan. Here’s why:
  • The House bill eliminated more than $100 million in state and federal funds for community-based mental health and hospital services for adults and children. The Senate plan restores that money.
  • The House bill cut Medicaid and Children’s Health Insurance Program (CHIP) physicians’ fees by10 percent. The Senate plan restores that money.
  • The House bill cut almost all of the state’s $21 million tobacco cessation program. The Senate plan restores half of that money — and uses the rest to help children’s hospitals.
  • The House bill provides absolutely no funding for either of our physician education loan repayment programs — that’s a cut of $58 million. The Senate plan provides $17.5 million for the biennium for the underserved-area loan repayment program.
  • The Senate plan invests $6 million in significant efforts to improve birth outcomes and reduce preventable hospitalizations and readmissions.
UNDER THE ROTUNDA
Health insurance reform: Several bills TMA supports are before the House Insurance Committee and ready for the full House to take up on its next Local and Consent Calendar:
  • House Bill 2101 by Rep. Luna Hernandez (D-Houston) would require certain health plans to provide coverage for supplemental breast cancer screenings.
  • HB 3266 by Rep. Sid Miller (R-Stephenville) requires state auditors to audit pharmacy claims for Employees Retirement System of Texas and Teachers Retirement System of Texas members. The goal of the bill is to verify parity between retail and mail-order pharmacies.
  • Senate Bill 822 by Sen. Kirk Watson (D-Austin) allows physicians who work in an academic setting to treat patients as “in-network” physicians for claims purposes while their applications for credentialing and health plan network participation are still pending. Rep. John Zerwas, MD (R-Simonton), is carrying the House version of this bill — HB 1333.
  • HB 438 by Rep. Senfronia Thompson (D-Houston) is on the House Local and Consent Calendar today. The bill would require health plans to cover orally administered anticancer medications at the same level as they provide coverage for other medical or surgical expenses.

Rep. Garnet Coleman
D-Houston
 Immunizations: Two TMA-supported bills are on House and Senate calendars.
  • HB 3336 by Rep. Garnet Coleman (D-Houston) is on today’s House Local and Consent Calendar. The measure would require that new moms receive information on pertussis (and the ability to get a Tdap vaccination if needed) before leaving the hospital.
  • SB 1177 by Sen. Jane Nelson (R-Flower Mound) is on the Senate Intent Calendar. The bill requires health care facilities such as hospitals to develop and implement vaccination policies to protect patients from vaccine-preventable diseases. The policy would require health care workers to get vaccinations recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
Physician workforce: TMA’s graduate medical education bill, HB 2908 by Rep. Dan Branch (R-Dallas), is on the House Local and Consent Calendar today. The bill directs the Higher Education Coordinating Board to determine how many graduate medical education slots Texas needs to keep up with the number of medical school graduates.

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Nejla S. Shami, MD, of Hamilton. She has practiced family medicine for nine years. Dr. Shami graduated from The University of Texas Health Science Center at San Antonio in 2000. She is a member of TMA and the Travis County Medical Society.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. Register today.


Get your daily dose of TMA’s legislative news via RSS feed. To subscribe, see the RSS Feeds page of the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases; Texas Medicine magazine; TMA Practice E-Tips; and Blogged Arteries, the feed for our Action newsletter.

WHAT WE'RE READING
Key factors make Texas budget problem tougher to solve (Austin-American Statesman)
Ogden Revives Key Piece of Federal Health Reform
(Texas Tribune)

Apr 18, 2011

Finance Committee Wrapping Up Better Senate Budget Bill

TMA Legislative News Hotline

Monday, April 18, 2011



Sen. Steve Ogden
R-Bryan
BUDGET WATCH
The only task lawmakers have to accomplish each session is to complete a two-year state budget. Both chambers now have only six weeks left to decide how they’re going to shave $27 billion off state spending while not devastating our health care infrastructure.

The Senate is scheduled to spend a great deal of its time on the subject this week. Sen. Steve Ogden (R-Bryan), chief budget writer for the Senate, put the finishing touches on the upper chamber’s plan late last week. The next step is for the Senate Finance Committee to vote the bill out of committee. Then, the budget plan goes to the full Senate for debate.

The Senate budget spends additional dollars over the House budget on state infrastructure needs, principally related to health and human services and education. The good news is that Senate plan does not cut physicians’ Medicaid payments by 10 percent. The Senate version also includes funding for Medicaid caseload growth and restores funding for a number of important TMA priorities, including community-based and crisis mental health service, and tobacco cessation and prevention programs. Senators also added back some of the funding for primary care residencies administered by the Texas Higher Education Coordinating Board.

The question remains, however, how the Senate will pay for its more generous budget. That matter lies with Senate Finance Subcommittee on Fiscal Matters. The subcommittee is trying to find nontax revenue within the state coffers to help pay for Senate spending. Some of the ideas the subcommittee has come up with so far include liquidating part of the tobacco endowment and permanent public health fund, selling state property, and determining whether to extend the small business exemption from the franchise tax.

On Thursday, the full Senate is scheduled to take up the two-year budget plan. They will debate the Senate Finance Committee’s version of House Bill 1. As passed by the Texas House, HB 1 is a $164.5 billion, bare-bones budget that includes a 10-percent cut in physician Medicaid and Children’s Health Insurance Program fees, deep cuts in the state’s mental and public health safety programs, and reductions in funding for programs designed to recruit and retain physicians. Stay tuned.

How Does the Final House Budget (HB 1) Affect Your County?
If you want to find out how the proposed Medicaid cuts in the final House version of the budget could affect your county, check out this chart.

Monte Horne, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Monte Horne, MD, of Hamilton. Dr. Horne has practiced family medicine for nine years. He graduated from The University of Texas Medical Branch in 1998. Dr. Horne is a member of TMA and the Bosque-Hamilton County Medical Society, and is a CMS delegate.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. Register today.

Get your daily dose of TMA’s legislative news via RSS feed. To subscribe, see the RSS Feeds page of the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases; Texas Medicine magazine; TMA Practice E-Tips; and Blogged Arteries, the feed for our Action newsletter.

WHAT WE'RE READING
Senate budget writers consider proposed hospital tax to recover costs of illegal immigrants’ charity care (Dallas Morning News)
1 in 6 Texans get Medicaid health insurance program, whose costs in Texas are projected to grow $3 billion every year
(Texas Watchdog)
Proposed budget cuts carve into Medicaid
(Tyler Morning-Telegraph)

Apr 15, 2011

Major Win for TMA in Chiropractic Bill

TMA Legislative News Hotline

Friday, April 15, 2011


TMA IN ACTION
Major chiro win for TMA: Thanks to the hundreds of physicians, medical students, and TMA Alliance members who contacted their senators this week and aggressive advocacy by TMA’s lobby team, the association won a major scope battle.

It started on Monday when the Senate Business and Commerce Committee approved legislation that essentially gave the Texas Board of Chiropractic Examiners carte blanche authority to do whatever it wants — by rulemaking — without having to worry about legal action from another state health licensure agency. Working with the bill author, however, by Friday TMA was able to remove all of the objectionable provisions.

As approved by the committee Monday, Senate Bill 1001 by Sen. John Carona (R-Dallas) would have prevented the Texas Medical Board from taking legal action to stop an individual chiropractor from violating the Medical Practice Act if the chiropractic board said the chiropractor was practicing within his or her scope.

The bill also would have circumvented current insurance code provisions concerning nondiscrimination against nonphysicians, which would allow more than 30 nonphysician health care groups to get paid for more services and also would increase utilization. And lastly, the bill would have allowed a number of these groups to create partnerships and other professional structures with physicians, circumventing current law that sets out how these organizations are established.

Under the compromise bill agreed to and passed by the Senate on Thursday, the measure requires fair payment and nondiscrimination in payment by health plans for services that chiropractors are authorized to provide. It also allows chiropractors and physicians to establish business relationships as long as the physician affirmatively reports and updates those relationships to TMB.

The Texas Tribune reported, “After a fierce fight, the state’s leading physician groups won a change in legislation backed predominantly by Texas chiropractors that could have prevented one health care licensing agency from challenging the ruling of another in court. The bill reached final passage on the Senate floor today after addition of an amendment added by Sen. John Carona, R-Dallas, who authored the bill, reflecting a compromise between the Texas Medical Association and the Texas Chiropractic Association.”

Its House companion bill — House Bill 3441 by Rep. Warren Chisum (R-Pampa) — was heard in the House Licensing and Administrative Procedures Committee on Monday. Sara Austin, MD, an Austin neurologist and member of TMA’s Council on Legislation, testified against the measure, which was left pending in committee.

TMA may be calling on you again next week, when the House Public Health Committee takes up a whole host of scope bills by advanced practices nurses and other health care practitioners. Stay tuned.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 3. Register today.

TMA’s Message: Want to know where TMA stands on issues before House and Senate committees this session? All the testimonies presented by TMA leaders are on the TMA website. You can also find letters TMA has sent to our state leaders.

WHAT WE'RE READING
Doctors, Chiropractors Square Off Over Bill (Texas Tribune)
Many Texas schoolchildren fail fitness evaluation
(Austin-American Statesman)
Court unlikely to hear Obama healthcare law now
(Reuters)
Obama lifts 1099 tax reporting burden
(The Hill)

Apr 14, 2011

We Couldn't Have Done it Without You

Thanks to everyone who called their senators to block SB 1001 from reaching the Senate floor. Due to your interest and hard work, we won tremendous concessions and turned a bad bill into one we could support.


Here's the lead from an article on the bill from the Texas Tribune, which covers Texas politics and the legislature: "After a fierce fight, the state’s leading physician groups won a change in legislation backed predominantly by Texas chiropractors that could have prevented one health care licensing agency from challenging the ruling of another in court."

Thanks again for joining us in that "fierce fight."

Finance Committee Plan Adds Dollars for GME

TMA Legislative News Hotline

Thursday, April 14, 2011



BUDGET WATCH
The Senate Finance subcommittees are still hammering out their budget recommendations for the upper chamber. The Senate Finance Subcommittee on Higher Education met on Tuesday and approved these medical education recommendations.
  • Liquidate a $430 million endowment created with part of the state’s tobacco lawsuit settlement and disperse the money to health-related schools that already benefit from the trust fund. Every two years, the institutions receive approximately $45 million from the endowment. The proposal would allow the institutions to either spend the money or create their own endowments. The reason for the funding is to help the schools continue to meet the patient demand in their communities. If approved by the full Senate, the plan would require separate legislation to take effect. According to a committee document, the fund is estimated to be divided in this way in 2012-13 if the action becomes final:
    • The University of Texas (UT) Southwestern Medical Center at Dallas, $60 million;
    • UT Medical Branch at Galveston, $47 million;
    • UT Health Science Center at Houston, $47 million;
    • UT Health Science Center at San Antonio, $43 million;
    • M.D. Anderson Cancer Center, $49 million;
    • UT Health Science Center at Tyler, $31 million;
    • Texas A&M Health Science Center, $33 million;
    • University of North Texas Health Science Center at Fort Worth, $32 million;
    • Texas Tech University Health Sciences Center, $38 million; and
    • Baylor College of Medicine, $49 million;
  • Increase the Family Medicine Residency Program by $1.37 million;
  • Eliminate funding ($2.75 million) for the primary care residency program; and
  • Increase graduate medical education (GME) program funding by $142,500, which brings the total funding up to 2010-11 levels of $570,000. This program provides GME formula funding to independent programs that are not eligible for state GME funding, which is reserved by law solely for medical school-related GME.
How does the final House budget (House Bill 1) affect your county?
If you want to find out how the proposed Medicaid cuts in the final House version of the budget could affect your county, check out this chart.

Sen. John Carona
R-Dallas
BILL UPDATE
Chiropractor legislation: Yesterday, TMA and Sen. John Carona (R-Dallas) came to an agreement on a committee substitute for Senate Bill 1001. Senator Carona agreed to remove much of the language expanding scope of practice for chiropractors and other health care practitioners. The bill now consists of the following provisions that TMA supports: fair payment and nondiscrimination in payment to chiropractors for services they provide, and allowing chiropractors and physicians to establish business relationships as long as the physician affirmatively reports and updates these relationships with the Texas Medical Board.

Health insurance reform: Monday in the House Insurance Committee, TMA supported these two bills, both of which were left pending in committee:
  • HB 758 by Rep. Craig Eiland (D-Galveston), which would allow coverage for medical services due to ingestion of narcotics or intoxicants. It is known nationally as the Uniform Policy Provision Law and is supported by the National Association of Insurance Commissioners.
  • HB 1534 by Representative Eiland, which would regulate certain health care provider network contract arrangements. More commonly referred to as the “silent PPO legislation,” this is the third session it has been filed. TMA, the Texas Hospital Association, the Texas Association of Health Plans, and the American Association of Preferred Provider Organizations have met over the past couple of months and reached a compromise on language for the substitute.
TMA-supported bills are moving. Here are just a few on the list:
  • SB 229 by Sen. Jane Nelson (R-Flower Mound), which would help guarantee that all newborns in Texas get a hearing screening, was passed by the Senate. The bill now goes to the House chamber.
  • SB 226 by Senator Nelson is set on the Local and Consent Calendar. The measure would enhance data gathered through the Fitnessgram. It’s a program required under current law for children in grades 3 through 12 that measures a child’s aerobic capacity, muscular strength, muscular endurance, flexibility, and body composition.
  • SB 622 by Senator Nelson was approved by the Senate and now moves to the House chamber. The measure would protect a patient’s health information and personal information.
  • SB 1177 by Senator Nelson was approved by the Senate Health and Human Services Committee. It requires health care facilities such as hospitals to develop and implement vaccination policies to protect patients from vaccine-preventable diseases. The policy would require health care workers to get vaccinations recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
  • HB 2636 by Rep. Lois Kolkhorst (R-Brenham) was approved by the House Public Health Committee yesterday and moves to the full House for debate. It directs the Texas Health and Human Services Commission to establish a commission to study neonatal intensive care units.
  • SB 1545 by Sen. Dan Patrick (R-Houston) is on the Senate Local and Consent Calendar. The measure would provide immunity to physicians when they perform a student athlete physical examination or medical screening.
Monique Cortez, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Monique Cortez, MD, of Austin. Dr. Cortez has practiced family medicine for 10 years. She graduated from UT Health Science Center at Houston in 1999. Dr. Cortez is a member of TMA and the Travis County Medical Society.

WHAT YOU CAN DO
Needed in Austin: patient advocates. Join hundreds of your colleagues and make a difference in legislation affecting you and your patients. Sign up now to attend First Tuesdays at the Capitol on May 1. Register today.

Get your daily dose of TMA’s legislative news via RSS feed. To subscribe, see the RSS Feeds page of the TMA website. Once there, you can download an RSS reader, such as Feedreader, Sharpreader, Sage, or NetNewsWire Lite. You also can subscribe to the RSS feeds for TMA news releases; Texas Medicine magazine; TMA Practice E-Tips; and Blogged Arteries, the feed for our Action newsletter.

WHAT WE'RE READING
Doctors, Chiropractors Square Off Over Bill (Texas Tribune)
State cuts to mental health funding could burden police, jails
(Austin American-Statesman)
What ‘Big Medicine’ Means for Doctors and Patients
(New York Times)
Senate Panel OKs Expanding Managed Care to Valley
(Texas Tribune)
Texas chiropractors seek expanded scope of practice
(Fort Worth Star-Telegram)