Apr 7, 2011

TMA'S, TMB-REFORM BILLS MOVING

TMA Legislative News Hotline

Thursday, April 7, 2011


Sen. Jane Nelson
R-Flower Mound
TMA'S, TMB-REFORM BILLS MOVING
Good news. TMA’s bills to reform the Texas Medical Board (TMB) are moving. The Senate has passed Senate Bills 190 and 191 by Sen. Jane Nelson (R-Flower Mound). SB 190 would amend Texas’ Medical Practice Act to prohibit the granting of a license to an applicant who has had a medical license suspended or revoked by another state or country (previously, only country was Canada). It also allows physicians to tape the proceedings of an informal settlement conference, which eliminates the truly anonymous complaints, and provides a physician with a notice if an insurance company files a complaint. SB 191 binds TMB to the ruling of an administrative law judge in a proceeding supervised by the State Office of Administrative Hearings. And unlike any other licensing board, the board supports this fairness provision. Two other bills making their way through the Senate chamber are:
  • SB 177 by Sen. Joan Huffman (R-Houston) is waiting to be voted out of Senate Health and Human Services Committee. It requires the board to do all of the above.
  • SB 227 by Senator Nelson was passed by the Senate Health and Human Services Committee and is now waiting for a hearing in the Senate. SB 277 would provide some discretion by TMB to waive a fine in lieu of a remedial action plan for minor administrative violation.
Together, these four bills would provide real and fair reforms to TMB.

BILL UPDATE
Medicaid-Cost Savings: The House Public Health Committee took up more than a dozen bills aimed at cutting costs of Medicaid services yesterday. The committee heard bills that ranged from charging Medicaid patients a copay and making Medicaid the payer of last resort to forcing Federal Qualified Health Care clinics and other community clinics to treat patients until 10 pm. John Holcomb, MD, a San Antonio pulmonologist and member of TMA’s Ad Hoc Committee on Medicaid and the Uninsured, was on hand to testify on behalf of TMA.

Two bills that TMA supported in the hearing would extend the Women’s Health Program. Janet Realini, MD, MPH, a San Antonio family physician and a volunteer for the Healthy Futures Alliance (HFA), a community coalition dedicated to reducing teen and unplanned pregnancy, testified in strong support of HB 1478 by Rep. Beverly Woolley (R-Houston) and HB 1138 by Rep. Eddie Rodriguez (D-Austin).
A big shout out goes to Drs. Realini and Holcomb, who continually take the witness stand on behalf of TMA and Medicaid patients.

Physician Employment: The Senate Business and Commerce Committee yesterday passed SB 860 by Sen. José Rodriquez (D-El Paso). The measure would allow the El Paso County Hospital District to employ physicians and other health care professionals. Under this measure, the supervision of all matters related to the practice of medicine — by all physicians, employed or not — is the responsibility of the district’s medical executive board. The board would be made up of physicians and would establish the rules related to credentialing of physicians, peer review process, quality assurance programs, and any other function related to the clinical responsibilities of physicians practicing in district facilities. Most important, the bill results from a consensus achieved locally by the El Paso County Medical Society, the hospital district, and the Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. And, it helps fulfill the statutory mission of the district to provide indigent care.

Texas Medical Board: The House Public Health Committee also passed a Committee Substitute for HB 1013 by Rep. Fred Brown (R-College Station) that would weaken the board yesterday. Despite its portrayal as a “kinder, gentler version” of the original, CSHB 1013 still contains a number of objectionable provisions with unknown but significant costs, largely to be assessed to each licensed physician by an increase in their biennial license fee. TMA continues to oppose this bill. TMA believes that weakening the Texas Medical Board will drive complaints back to civil district courts, will place the liability reforms of 2003 at risk, and would create a new round of access-to-care problems for Texas patients. As stated above, TMA has four other bills in play that provide for real and fair reforms.

Brain Injury Prevention: The House passed HB 675 by Rep. Eddie Lucio III (D-Brownsville) yesterday. HB 675 would ensure that public schools track the number of years a football helmet is used and its condition. After 16 years, the helmet cannot be used any longer by student athletes.

BUDGET WATCH
The Senate Finance Subcommittee on Fiscal Matters is meeting today to discuss ways the Senate can find more money for its budget through nontax revenue. Today is the committees’ first official meeting. Two weeks ago, each member of the group received a specific assignment to start looking for additional money.

The House Appropriations Committee also is taking a series of bills that could bring more money into the state, such as:
  • HB 1645 by Rep. John Zerwas, MD (R-Richmond), which looks at efficiencies and cost-savings in the health and human services agencies, including the state medical assistance and child health plan programs.
  • HB 3666 by Representative Zerwas, which requires the Health and Human Services Commission  to study cost-effectiveness of telemonitoring for diabetic Medicaid patients and if cost-effective, to consider expanding the program to additional patients.
Rick D. Edwards, MD
MEDICARE PAYMENTS CONTINUE
If the government shuts down, federal officials say, it won’t affect your Medicare services. The care you provide to Medicare patients would continue to be funded.

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Rick D. Edwards, MD, of Fort Worth. Dr. Edwards has practiced family medicine for 31 years. He graduated from The University of Texas Health Science Center at Houston in 1977. Dr. Edwards is a member of TMA and the Tarrant County Medical Society.

WHAT YOU CAN DO
Tell us your story. TMA wants to capture your story on video. Tell us why you decided to become a physician. What day did you leave your office or hospital and say to yourself, “Now, that’s why I became a physician”? Tell us what your profession means to you. Check out “physician moments” from some of your colleagues.
 
WHAT WE'RE READING
Duncan, Houston legislator clear hurdle to bill on hirings by rural hospitals (Lubbock Avalanche-Journal)
Could the federal health law survive without the individual mandate?
(Stateline)
Health care reform can't work without more doctors
(CNN)
Will Hospitals Be Taxed to Prop Up Medicaid?
(Texas Tribune)

2 comments:

Dr. Williams said...

HB1013 would finally stop some of the frivolous complaints by persons with other agendas than good patient care. Being a victim of a vindictive ex-wife and an embezzling office manager, I am appalled at the TMA’s objection to this bill. Our medical board is run by lawyers who have a seeming unlimited budget to destroy good physicians with limited resources over minor issues. STOP the Abuse! Pass the bill. I have canceled my membership with the TMA and I am Joining the AAPS.

TMA President Sue Bailey, MD said...

Thank you for your comment on the Texas Medical Association’s support for legislation that would improve the operation of the Texas Medical Board (TMB).

You have been badly, intentionally, misinformed by a scurrilous and fictitious attack on TMA from the proponents of House Bill 1013. Unlike what they would have you believe, that bill is not about making the TMB discipline process more fair for the average physician. It is a self-serving piece of legislation designed to remove legitimate oversight from those who practice outside the scientific basis of modern medicine.

Here is a quote, delivered under oath to the House Committee on Public Health, from the primary supporter of HB 1013:

“My opponents seem to think that anyone promoting this bill is a ‘snake-oil’ doctor. Well, what they really mean is that these doctors use natural approaches to health. They use vitamins, minerals, nutrients, bioidentical hormones. That’s what they’re doing. Food allergies. They’re using hocus pocus on people.”

TMA is not about hocus-pocus. We are not about bioidentical hormones. We are the place where ethical physicians want to be.

Even after we improved it, HB 1013 still contains a number of objectionable provisions with unknown but significant costs, largely to be assessed against each physician by an increase in your license fee. That is why we continue to oppose it.

We believe that weakening the TMB, as this bill’s supporters want, will drive physician complaints back to the courts and place our 2003 health care tort reforms at risk. If doctors are unable to police themselves through a strong and fair medical board, then today’s complaint is tomorrow’s lawsuit.

As you know, TMA has its own agenda of legislation to reform the TMB. Those bills already are making significantly more progress through the legislature than HB 1013.

• The Senate has passed Senate Bills 190 and 191 by Sen. Jane Nelson (R-Flower Mound). SB 190 would allow physicians to tape the proceedings of a TMB informal settlement conference, which eliminates the truly anonymous complaints. It would provide a physician with 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 (previously, the only country was 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 177 by Sen. Joan Huffman (R-Houston) is waiting to be voted out of the Senate Health and Human Services Committee. It requires the board to do all of the above.
• SB 227 by Senator Nelson was passed by the Senate Health and Human Services Committee and is now waiting for debate in the full Senate. SB 277 would provide discretion for TMB to waive a fine in lieu of a remedial action plan for a minor administrative violation.

I hope that I have adequately addressed your concerns about TMA’s position on this issue. Please let me know if you need more information.