May 31, 2011

Health Care Issues Big in Legislature's Special Session

TMA Legislative News Hotline

Tuesday, May 31, 2011


Gov. Rick Perry calls Texas Legislature into special session
UNDER THE DOME
The 2011 legislative session roller coaster continues. After 140 days of the regular session, a few pieces critical to the budget puzzle were left unfinished. One is the school finance plan that would change the distribution formulae to the state’s public school districts to account for the $4 billion cut to public education funding. Another is legislation that would enact Medicaid cost savings of about $500 million primarily by expanding managed care statewide to include the Rio Grande Valley and requiring Texans with disabilities to get home health services through Medicaid first.

For this first special session, the “NEW” Senate Bill 7 includes elements of three bills considered during the regular session: SB 7, which related to general Medicaid and Children’s Health Insurance Program (CHIP) efficiencies and would have established a Quality-Based Payment Advisory Committee;  SB 8, which would have established a statewide plan for improving quality and increasing efficiency through performance-based measures, testing collaborative models between physicians and other health care providers (with TMA language to make sure physicians had equal representation in the governance); and SB 23, Medicaid payment reforms that specifically included the managed care expansion.

Sponsors for this bill are Sen. Jane Nelson (R-Flower Mound) and, in the House, Rep. John Zerwas, MD (R-Simonton).

During the regular session, SB 7 died early without being placed on a calendar for floor debate. SB 8 was on the floor Saturday evening when time ran out and was thereby defeated. SB 23 was so low on the House’s final calendar that it never came up on the floor for vote.

The NEW SB 7 will be laid out in the Senate Finance Committee on Thursday. It should be in the House early next week for consideration.

Gov. Rick Perry called lawmakers back to the state capitol today to finish their work on those these issues. Once these issues are solved, other measures could be added to the special session.

Parliamentary rules now change. During a special session, the two-thirds rule to pass legislation in the Senate no longer applies, which makes it easier to get bills passed. Stay tuned.

WHAT YOU CAN DO
Remember Eight, at Eight, on the Eighth: Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8 at 8 pm, you can learn what actions legislators took on medicine’s top eight issues.

TMA President C. Bruce Malone, MD, will call you at your home telephone number and invite you to stay on the line for TMA’s Tele-2011 Legislative Update. For the next 45 minutes, Dr. Malone and members of TMA’s Council on Legislation and TMA’s lobby team will discuss these eight issues:

1.    2012-13 state budget,
2.    Employment protections,
3.    Texas Medical Board reform,
4.    Scope of practice expansions,
5.    Health system reform,
6.    Workforce,
7.    Public health, and
8.    Health insurance reform.

You may ask questions after each topic and use your phone to participate in a survey. And, the best part: You will earn 1 AMA PRA Category 1 Credit™ for your time (providing you stay on the line for the entire program).

If you prefer that we call you on your cell or office telephone, please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by email by Friday, June 3, and let us know. We hope to talk to you on June 8.

WHAT WE'RE READING
Medicare Plan for Payments Irks Hospitals (New York Times)
Texas Senate convenes special session
(Houston Chronicle)
Gov. Perry: Loser Pays Lets Employers Spend Less Time in the Courtroom, More Time Creating Jobs
(Office of the Governor)

May 27, 2011

Budget Hung Up on School Finance Plan; Smoking Ban Snuffed

TMA Legislative News Hotline

Friday, May 27, 2011


BUDGET WATCH
With four (counting today) days left in the regular session, Texas lawmakers have a draft budget in place, but still have no way to pay for it all. The 2012-13 spending plan that budget negotiators approved yesterday will go to the full House and Senate for approval tomorrow. Still up in the air, though, is a bill that would change the state’s public school finance system to account for a $4 billion cut to public education. Several potential compromises appeared promising yesterday but fizzled out quickly. Stay tuned.

BILL UPDATE
Plenty of bills found new life yesterday as they were added by amendment to the few pieces of legislation still in play for the session. Others found that their lifeboats weren’t quite big enough. Texas Medical Association’s lobby team had one in each category:

Statewide smoking ban: Because it would save the state Medicaid program more than $31 million over the next two years, a measure that would have prohibited smoking in restaurants, bars, and other public facilities was tacked onto a broad revenue-raising bill last week. Yesterday, House-Senate negotiators on that bill — Senate Bill 1811 by Sen. Robert Duncan (R-Lubbock) — said the smoking ban had been snuffed out. TMA is working with supporters such as Rep. Myra Crownover (R-Lake Dallas) to find a new last-minute way to pass this important public health measure.

Women’s health: It looks like the controversial but highly cost-effective program that provides contraception and reproductive health screenings to tens of thousands of low-income women will survive. The program was slated to end this year without legislative action, and bills by Sen. Robert Deuell, MD (R-Greenville), and Rep. Garnet Coleman (D-Houston) didn’t make it through the end-of-session logjam. But yesterday, word leaked out that the final 2012-13 state budget document now includes an amendment that would keep the Women’s Health Program at least somewhat alive for the next two years. Advocates are praising the work of Senators Deuell, Steve Ogden (R-Bryan), and Leticia Van de Putte (D-San Antonio) for this maneuver.

Health care collaborative: SB 8 by Sen. Jane Nelson (R-Flower Mound) is in conference committee. It would establish a statewide plan for improving quality and increasing efficiency through performance-based measures, test collaborative models between physicians and other health care providers, and require public reporting of preventable readmissions and complications. TMA, the Texas Association of Health Plans, and the Texas Hospital Association have negotiated how the new paradigm in the bill would play out in the real world. As a result of these negotiations, three important provisions have been added 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.
  • They also would have due process protections and the ability to participate in more than one collaborative arrangement in their community.
  • The bill also protects Texas’ ban on the corporate practice of medicine.
The TMA team is working to ensure that good amendments stay in the bill and bad amendments get stripped off.

Medicaid savings: Also in conference committee is Senator Nelson’s SB 23, another critical piece of the budget puzzle. The bill would save about $500 million, primarily in Medicaid and the Children’s Health Insurance Program. A few ways it achieves the savings are by expanding Medicaid managed care into the Rio Grande Valley, requiring Medicaid patients to use medicines on a state preferred drug list, and requiring Texans with disabilities to get home health services through Medicaid first. On this bill as well, the TMA team is working to ensure that good amendments stay in and bad amendments get stripped off.

UNDER THE DOME
The regular session of the legislature must adjourn by midnight Monday. It already appears as if we might have a special session on several issues — school finance, sanctuary cities, congressional redistricting. And who knows whether the budget will make it through in time? Your TMA lobby team — and TMA Legislative News Hotline staff — will work through the holiday weekend to represent you and keep you informed.

James R. Brown, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is James R. Brown, MD, of Austin. Dr. Brown has practiced family medicine for 26 years. He graduated The University of Texas Health Science Center at Houston in 1982. Dr. Brown is a member of TMA and the Travis County Medical Society.

WHAT YOU CAN DO
Remember Eight, at Eight, on the Eighth: Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8 at 8 pm, you can learn what actions legislators took on medicine’s top eight issues.

TMA President C. Bruce Malone, MD, will call you at your home telephone number and invite you to stay on the line for TMA’s Tele-2011 Legislative Update. For the next 45 minutes, Dr. Malone and members of TMA’s Council on Legislation and TMA’s lobby team will discuss these eight issues:

1.    2012-13 state budget,
2.    Employment protections,
3.    Texas Medical Board reform,
4.    Scope of practice expansions,
5.    Health system reform,
6.    Workforce,
7.    Public health, and
8.    Health insurance reform.

You may ask questions after each topic and use your phone to participate in a survey. And, the best part: You will earn 1 AMA PRA Category 1 Credit™ for your time (providing you stay on the line for the entire program).

If you prefer that we call you on your cell or office telephone, please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by email by Friday, June 3, and let us know. We hope to talk to you on June 8.

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.

Read Action: Every two weeks, TMA publishes a web edition of Action. Action presents important and timely information about legal, economic, regulatory, and legislative affairs that Texas physicians need to know. Here is the May 18 edition.

WHAT WE'RE READING
Women's Health Program Stands, but Questions Remain (Texas Tribune)
Doctors tout Texas' brand of tort reform (Houston Chronicle)
Texas smoking ban snuffed out of spending bill (Houston Chronicle)

May 26, 2011

Budget on Slightly Less Wobbly Legs

TMA Legislative News Hotline

Thursday, May 26, 2011


BUDGET WATCH
Budget negotiators passed their final report for House Bill 1, the state’s next two-year budget, this morning. The budget approved by conferees cuts spending by $15 billion. The portion of the budget that Texas is responsible for totals $80.4 billion. The budget now must be approved by the House and Senate. However, for this budget to work, state leaders still need to resolve two critical pieces. They need to agree on how to alter the current school financing system to account for a $4 billion cut to public education. And they need pass Senate Bill 1811 by Sen. Steve Ogden (R-Bryan) that creates “nontax revenue” to help cover spending in the budget. Lawmakers need around $3.5 billion. One item SB 1811 conferees are hammering out is whether to approve a statewide smoking ban. The House added that provision to SB 1811 last Friday. A smoking ban would save $31 million in Texas Medicaid alone.

Lawmakers also made headway yesterday in solving the $4 billion deficit in the current state budget. Two major bills received final approval. One was HB 275 by Rep. Jim Pitts (R-Waxahachie), which would allow the state to use $3.2 billion from the Rainy Day Fund. This includes $81 million more than what the House originally approved. The extra money would pay for fighting West Texas wild fires. They also passed HB 4 by Representative Pitts, which authorizes the state to use these funds to help balance the current budget. The bills are headed to Gov. Rick Perry’s desk for his signature.

BILL UPDATE
Yesterday was the last day for the Senate to consider bills on the Senate Intent Calendar. The Texas House only has until midnight tonight to print and distribute Senate amendments. Amended bills then need approval by the original chamber. Those that are not approved then are assigned to a conference committee to work out differences between the House and Senate. The House approved these two bills yesterday:

Health care collaborative: The Texas House gave final approved to SB 8 by Sen. Jane Nelson (R-Flower Mound) last night. SB 8 would establish a statewide plan for improving quality and increasing efficiency through performance-based measures, test collaborative models between physicians and other health care providers, and require public reporting of preventable readmissions and complications. TMA, the Texas Association of Health Plans, and the Texas Hospital Association have negotiated how the new paradigm in the bill would play out in the real world. As a result of these negotiations, three important provisions have been added 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.
  • They also would have due process protections and the ability to participate in more than one collaborative arrangement in their community.
  • The bill also protects Texas’ ban on the corporate practice of medicine.
House members added several amendments to the bill last night. One included language from Rep. Lois Kolkhorst (R-Brenham) to allow Texas to join a multistate health care compact to help fund and administer Medicaid. Rep. Warren Chisum (R-Pampa) attached an amendment that would allow chiropractors to bill insurance companies for their services. And Rep. Jodie Laubenberg (R-Parker) made a change to an amendment that was added by Rep. John Zerwas, MD (R-Simonton), Tuesday. Representative Zerwas added language that would require hospitals and most other health care facilities to have vaccination policies in place to encourage their employees to get vaccinated against preventable but infectious diseases. Representative Laubenberg’s amendment would require facilities to exempt health care workers from vaccinations if they object for reasons of religion or conscience.

Food safety: The House also approved SB 81 by Senator Nelson, which would expand the number of food manufacturers, food wholesalers, and warehouse operators that must have a license from the Department State Health Services (DSHS). Representative Kolkhorst amended the bill to allow the sale of food and baked goods for producers in private homes with annual incomes less than $50,000. Her amendment also would require these producers to include their name and a statement that the food is not inspected. Rep. Eddie Rodriguez (D-Austin) added another amendment that would allow DSHS or a local health department to issue a temporary food establishment permit for sellers at farmers markets.

Jorge Duchicela, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Jorge Duchicela, MD, of Weimar. Dr. Duchicela has practiced family medicine for 23 years. He graduated from the University of Wisconsin Medical School in 1984. Dr. Duchicela is a member of TMA and the Colorado-Fayette County Medical Society.

WHAT YOU CAN DO
Remember Eight, at Eight, on the Eighth: Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8 at 8 pm, you can learn what actions legislators took on medicine’s top eight issues.

TMA President C. Bruce Malone, MD, will call you at your home telephone number and invite you to stay on the line for TMA’s Tele-2011 Legislative Update. For the next 45 minutes, Dr. Malone and members of TMA’s Council on Legislation and TMA’s lobby team will discuss these eight issues:

1.    2012-13 state budget,
2.    Employment protections,
3.    Texas Medical Board reform,
4.    Scope of practice expansions,
5.    Health system reform,
6.    Workforce,
7.    Public health, and
8.    Health insurance reform.

You may ask questions after each topic and use your phone to participate in a survey. And, the best part: You will earn 1 AMA PRA Category 1 Credit™ for your time (providing you stay on the line for the entire program).

If you prefer that we call you on your cell or office telephone, please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by email by Friday, June 3, and let us know. We hope to talk to you on June 8.

You also can learn more about the 2011 legislative session on TMA’s website.

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.

Read Action: Every two weeks, TMA publishes a web edition of Action. Action presents important and timely information about legal, economic, regulatory, and legislative affairs that Texas physicians need to know. Here is the May 18 edition.

WHAT WE'RE READING
Bill restores some state funding for med school (El Paso Times)
Kolkhorst Keeps Health Care Compact Bill Alive
(Texas Tribune)
Kolkhorst Holding Nelson's Health Bill Hostage
(Texas Tribune)
Perry: ‘I can’t say I’m not tempted’ to run for president (Austin American-Statesman)

May 25, 2011

TMA For Medicare Private Contracting Bills

TMA joined the American Medical Association, 42 state medical associations, and 33 national specialty societies in asking House Speaker John Boehner to support and cosponsor the 'Medicare Patient Empowerment Act' (HR 1700) by U.S. Rep. Tom Price, MD, (R-Ga). Texas Reps. Michael Burgess, MD, Pete Sessions, and Sam Johnson are co-sponsors. Sen. Lisa Murkowski (R-Ak) introduced a similar bill (S. 1042) in the Senate.

Will Lawmakers Get Texas Budget Done in Time?

TMA Legislative News Hotline

Wednesday, May 25, 2011



BUDGET WATCH
State leaders and key budget negotiators are scrambling to find a last-minute solution for the school finance dilemma. The Texas House killed Senate Bill 1581 by Sen. Steve Ogden (R-Bryan) with a procedural maneuver Monday night. The legislation is a key piece of the state’s two-year budget puzzle. It would raise about $330 million for schools in the next two years through several mechanisms, including reducing the state’s contribution rate to the Teacher Retirement System. Lawmakers hope they can append the measure onto SB 1811, another revenue-generating budget bill that was sent to conference committee yesterday.  The conference committee consists of these 10 House and Senate members who ultimately will make the decision: Reps. Jim Pitts (R-Waxahachie), chair; Sylvester Turner (D-Houston); Myra Crownover (R-Keller); Rob Eissler (R-The Woodlands); and Charlie Geren (R-Fort Worth); and Sens. Robert Duncan (R-Lubbock); Tommy Williams (R-The Woodlands); Royce West (D-Dallas); Dan Patrick (R-Houston); and Robert Deuell, MD (R-Greenville). Stay tuned.


Sen. Jane Nelson
(R-Flower Mound)
 BILL UPDATE
Yesterday was the last day for bills on the House General Calendar to be passed. Today is the last day for the Senate to consider bills on the Senate Intent Calendar. Either the survivors are being sent to conference committee to work out differences between the two chambers or the changes are receiving concurrence from the originating chamber.  Bills are moving quickly through both the House and the Senate onto Gov. Rick Perry’s desk for signature. Here are a few bills approved over the past week:

Health care collaborative: The Texas House tentatively approved SB 8 by Sen. Jane Nelson (R-Flower Mound) yesterday. It would establish a statewide plan for improving quality and increasing efficiency through performance-based measures, test collaborative models between physicians and other health care providers, and require public reporting of preventable readmissions and complications. TMA, the Texas Association of Health Plans, and the Texas Hospital Association have negotiated how the new paradigm in the bill would play out in the real world. As a result of these negotiations, three important provisions have been added 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.
  • They also would have due process protections and the ability to participate in more than one collaborative arrangement in their community.
  • The bill also protects Texas’ ban on the corporate practice of medicine.
Thanks to Rep. John Zerwas, MD (R-Simonton), TMA was able to get SB 1177 added to the bill yesterday. The legislation would require health care facilities such as hospitals to develop and implement vaccination policies for employees. SB 1177 is important because health care workers, especially those who are not immunized against the flu and other preventable diseases, may unknowingly spread these diseases to the patients in their care. Also, Rep. Craig Eiland (D-Galveston) added his language on silent preferred provider organizations, which ensures that physicians and hospitals actually know who is accessing their contract rates.

Health insurance reform
  • SB 822 by Sen. Kirk Watson (D-Austin) was sent to the governor’s desk yesterday. It 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 reviewed and approved by the health plan’s credentialing committee.
  • The House approved House Bill 3017 by Rep. John Smithee (R-Amarillo) yesterday. It would put in statute what was adopted through rulemaking late last year after the Office of Public Insurance Counsel (OPIC) petitioned the Texas Department of Insurance to prohibit the use of discretionary clauses in insurance policies. TMA supported OPIC’s request and commented heavily during the rulemaking process over the past year.
Physician workforce: The House approved SB 189 by Senator Nelson Monday. It would affect international medical gradates (IMGs) who are not American citizens or permanent legal residents and who apply for a Texas medical license. It requires IMGs to practice at least three years in an underserved area as a condition of licensure.

Additional liability changes: The Senate approved HB 274 by Rep. Brandon Creighton (R-Conroe) yesterday. It would discourage the filing of obviously frivolous lawsuits and encourage more efficient and speedier resolution of most claims.

Medicaid cost savings: The Senate also passed HB 2636 by Rep. Lois Kolkhorst (R-Brenham) yesterday. It directs the Health and Human Services Commission to establish a commission to study neonatal intensive care units.

Workers’ compensation: HB 1774 by Rep. Larry Taylor (R-Friendswood) was sent to the governor’s desk. It would continue the functions of the Office of Injured Employee Counsel under the workers’ compensation program for six years, to coincide with the next Sunset Advisory Commission review of the division. The Senate sponsor was Sen. Joan Huffman (R-Southside Place).

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Elliott Trester, MD, of Austin. Dr. Trester has practiced family medicine for 30 years. He graduated from the Medical College of Ohio at Toledo in 1978. Dr. Trester is a member of TMA and the Travis County Medical Society.

WHAT YOU CAN DO
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.

Read Action: Every two weeks, TMA publishes a web edition of Action. Action presents important and timely information about legal, economic, regulatory, and legislative affairs that Texas physicians need to know. Here is the May 18 edition.

WHAT WE'RE READING
Texas Senate backs frivolous lawsuits legislation (Forbes)
State Efforts to Take Control of Medicaid Struggling
(Texas Tribune)
House Gives First OK to Dewhurst's Health Reform
(Texas Tribune)
Governor signs sonogram requirement for abortion
(Houston Chronicle)

TMA Wins Platinum

TMA's Communications Division received three Hermes Creative Awards from the Association of Marketing and Communication Professionals. Hermes Creative Awards is an international competition for creative professionals involved in the concept, writing, and design of traditional and emerging media.

May 23, 2011

State Budget Looks Good -- But What About Medical Education?

TMA Legislative News Hotline

Monday, May 23, 2011



BUDGET WATCH
On Saturday, House members approved legislation that would raise some of the money needed to cover spending in the 2012-13 budget. The full House passed Senate Bill 1811 by Sen. Robert Duncan (R-Lubbock) with 47 amendments. The bill originally would have raised about $4 billion for the state budget. The Senate trimmed it back to $2.7 billion. However, after the House finished Friday night, it now raises only $400 million for the state budget. The bill now goes back to the Senate and on to conference committee for final negotiations. Here’s where the state budget stands at this point.


Last week state leaders agreed to a two-year budget that trimmed $15 billion in current spending. It authorizes spending to the tune of $80.6 billion. All sections of the budget had been approved, except two — education and general government spending. Negotiators today approved cuts to undergraduate and graduate medical education. Look for more details tomorrow. The Senate passed SB 1581 on Saturday that would raise around $330 million for schools. The House will take up this legislation today. Stay tuned.

New polling numbers from The University of Texas and Texas Tribune show voters still want lawmakers to cut the budget but oppose major cuts in health and human services and education.

Rep. Myra Crownover
R-Keller
BILL UPDATE
Tobacco prevention: Rep. Myra Crownover (R-Keller) successfully added legislation to ban smoking to SB 1811 on Saturday. The TMA-backed legislation saves money and lives. In fact, a smoking ban would save the state an estimated $31 million in Medicaid expenses alone. If the Senate agrees to keep this amendment attached to SB 1811, it’s one more step closer to becoming law.

Immunizations: House Bill 3336 by Rep. Garnet Coleman (D-Houston) is on the Senate Local and Uncontested Calendar today. This TMA-backed legislation would require that new moms receive information on pertussis (and the ability to get a Tdap vaccination if needed) before leaving the hospital.

Time is running out for TMA-supported SB 1177 by Sen. Jane Nelson (R-Flower Mound). It is on the House Calendar but could get caught in the end-of-session backlog. It would require health care facilities such as hospitals to develop and implement vaccination policies for employees. SB 1177 is important because health care workers, especially those who are not immunized against the flu and other preventable diseases, may unknowingly spread these diseases to the patients in their care. The House sponsor is Rep. John Zerwas, MD (R-Simonton).

Children’s health: SB 229 by Senator Nelson is on the House Local and Consent Calendar today. The measure would help guarantee all babies born in Texas have equal access to an important hearing screening. Another bill on this calendar today is SB 226 by Senator Nelson. It requires schools to report students’ fitness and academic scores to the Texas Education Agency.

Medical liability reform: The Senate State Affairs Committee passed HB 274 by Rep. Brandon Creighton (R-Conroe) Sunday. It would discourage the filing of obviously frivolous lawsuits and encourage more efficient and speedier resolution of most claims. TMA sent out a statement Saturday asking the Senate to pass HB 274. TMA President C. Bruce Malone, MD said, “This would be another blow against ‘jackpot justice’ in Texas. It also would allow our courts to focus on those patients who bring truly meritorious claims to trial.” The Senate sponsor is Sen. Joan Huffman (R-Southside Place).

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Harold Nachimson, MD, of Irving. Dr. Nachimson has practiced family medicine for 40 years. He graduated from The University of Texas Southwestern Medical Center in 1963. Dr. Nachimson is a member of TMA and the Harris County Medical Society.

WHAT YOU CAN DO
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.

Read Action: Every two weeks, TMA publishes a web edition of Action. Action presents important and timely information about legal, economic, regulatory, and legislative affairs that Texas physicians need to know. Here is the May 18 edition.

WHAT WE'RE READING
Budget decision puts off Medicaid problem to 2013 (Associated Press)
Texas Hospitals Face Dramatic Payment Overhaul
(Texas Tribune)
Smoking ban advances (Amarillo Globe-News)
Commentary: The doctor won't see you now
(Houston Chronicle)
Texas Senate committee approves revised 'loser pays' bill
(Southeast Texas Record)



May 20, 2011

What a Week for Texas Medicine!

TMA Legislative News Hotline

Week Ending May 20, 2011


TMA's LEGISLATIVE AGENDA
Great news! Six bills critical to TMA’s legislative agenda are almost completely through the legislative process and getting closer to the governor’s desk for signature. These bills provide physicians important employment protections, reform the Texas Medical Board, and help Texas shore up its physician workforce. Here’s the rundown:



Physician employment protections: Three bills that ensure physicians who choose to be employed can maintain their clinical autonomy are almost at the legislative finish line: These bills are:
  • Senate Bill 1661 by Sen. Robert Duncan (R-Lubbock), which will provide clinical protections for thousands of physicians employed in 501(a)s. It ensures physicians are able to retain independent medical judgment in doing what is best for their patients. The measure received approval yesterday by the Texas House. It already has passed the Senate. The bill was sponsored in the House by Rep. Todd Hunter (R-Corpus Christi).
  • SB 761 by Sen. Royce West (D-Dallas) and HB 2854 by Rep. Vicki Truitt (R-Keller), which received approval in the House yesterday. It would allow the Scottish Rite Hospital in Dallas to continue to employ physicians. Throughout its history, the hospital has been employing physicians because of its charitable mission. The physicians at this facility occupy a unique position at the intersection of academia, research, and charity care. Scottish Rite accepted amendments to ensure that the medical staff remains responsible for all aspects of the practice of medicine and have control of all clinical issues.
  • House Bill 2351 by Rep. Ruth Jones McClendon (D-San Antonio), sponsored in the Senate by Sen. Leticia Van de Putte (D-San Antonio), which was passed by the full Senate Tuesday. It would allow the Bexar County Hospital District to employ physicians with protections to meet its statutory mission of providing care to the indigent. The bill resulted from local consensus among the Bexar County Medical Society, the hospital district, and medical schools to develop an employment structure that protects a physician’s clinical autonomy and the patient-physician relationship. The framework of the employment arrangement constitutes a nonprofit health care corporation — a 501(a) — with a physician board of directors to oversee all the clinical issues related to physicians and the care they provide their patients.
Texas Medical Board (TMB) reform: TMA has three important bills in the legislative pipeline important for improving the TMB process. These two bills received approval yesterday in the Texas House. Both bills were sponsored in the House by Rep. Susan King (R-Abilene).
  • SB 191 by Sen. Jane Nelson (R-Flower Mound) 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 would provide discretion for TMB to waive a fine in lieu of a remedial action plan for a minor administrative violation.
However, one critical bill — SB 190 by Senator Nelson — was knocked off the House Local and Consent Calendar by special interests opposed to TMA. It now will be reassigned to the General House Calendar. SB 190 has many TMB reforms that TMA has worked to win over the past two sessions. These include:
  • Allowing physicians to tape the proceedings of a TMB informal settlement conference,
  • Increasing the time for a physician to respond to a notice from 30 days to 45 days,
  • Eliminating anonymous complaints,
  • Instituting a statute of limitations on bringing a disciplinary action, and
  • Prohibiting the granting of a license to an applicant who has had a medical license suspended or revoked by another state.
TMA will continue to work to ensure these needed reforms are achieved.

Graduate medical education: The Senate passed a TMA-backed bill yesterday to examine graduate medical education (GME). House Bill 2908 by Rep. Dan Branch (R-Dallas) requires the Higher Education Coordinating Board to assess the number of GME slots in the state and determine whether this number meets the national standards for the ratio of GME slots to medical student slots, to make sure the state is maximizing its investment in medical education.

Earlier in the week the House agreed with Senate changes to HB 1380 by Representative Truitt and Sen. José Rodríquez (D-El Paso). HB 1380 allows international medical graduates (IMGs) in GME programs to apply for licensure in Texas after two years of residency training. The goal of this legislation is to facilitate board certification and retention of residents to practice in Texas. Without this change, IMGs often felt forced to leave Texas after GME for states with a two-year GME requirement to work around a board-exam scheduling problem. Those who remained in Texas typically had to wait at least half a year after residency to sit for their board exams. During the wait, they were unable to qualify for hospital or health plan credentialing and were unable to bill for their services.

Insurance reform: HB 438 by Rep. Senfronia Thompson (D-Houston) and Sen. John Carona (R-Dallas) is headed to the governor’s desk for his signature. The legislation would require health plans to cover orally administered anticancer medications at the same level as they provide coverage for other medical or surgical expenses. TMA strongly supported this legislation.

TMA TESTIFIES
Immunizations: Erica Swegler, MD, a Keller family medicine physician and chair of TMA’s Committee on Infectious Diseases, testified in support of SB 1177 Wednesday. The TMA-supported legislation by Senator Nelson and Rep. John Zerwas, MD (R-Simonton), would require health care facilities such as hospitals to develop and implement vaccination policies for employees. Dr. Swegler told House Public Health Committee members that SB 1177 is important because health care workers, especially those who are not immunized against the flu and other preventable diseases, may unknowingly spread these diseases to the patients in their care. Committee members passed the bill.

Newborn hearing screening: Alice Gong, MD, a San Antonio neonatal-perinatal specialist and a member of TMA’s Committee on Maternal and Perinatal Health, took the witness stand before the House Public Health Committee. Dr. Gong, a professor of pediatrics at The University of Texas Health Science Center in San Antonio, testified Wednesday in support of SB 229 by Senator Nelson. She told committee members that the legislation would help guarantee that all babies born in Texas have equal access to an important hearing screening. The bill was passed by the committee.

Food safety: TMA submitted a letter on the committee substitute for HB 3387 by Rep. Eddie Rodriguez (D-Austin). TMA took a neutral position on the bill Tuesday when it was taken up by the Senate Health and Human Services Committee. HB 3387 would regulate how food is prepared, stored, distributed, or sold at local farmers’ markets. It was left pending.

TMA submitted a letter in support of SB 1301 by Sen. Robert Deuell, MD (R-Greenville). The legislation would require that a bitter-tasting substance be added to antifreeze products that contain ethylene glycol. The goal is to deter children from drinking these poisonous products. The bill was passed by the House Public Health Committee Wednesday.

Student athletic safety: TMA also submitted written testimony in support of a committee substitute for HB 2038 by Rep. Four Price (R-Amarillo) Tuesday. The bill addresses the prevention, treatment, and management of concussions affecting young athletes participating in interscholastic events. The measure was passed by the Senate Health and Human Services Committee.

Health information technology: Matthew Murray MD, a Fort Worth pediatrician and vice chair of TMA’s Health Information Technology Ad Hoc Committee testified before the Senate Health and Human Services Committee. He testified Tuesday in support of a committee substitute for HB 300 by Rep. Lois Kolkhorst (R-Brenham). TMA has worked to achieve numerous changes in the bill so it won’t adversely affect physician practices. The legislation is an attempt to strengthen state privacy law on top of the federal Health Information Portability and Accountability Act (HIPAA). It would ban the sale of personal health information, for direct or indirect remuneration, but allow it for treatment, payment, or health care operations. It also sets up a process for notifying patients of, and obtaining consent for, the electronic transfer of their medical records. Physicians or other health care providers who willfully break the rules or are repeat offenders may be subject to disciplinary action by their licensing agency. The bill was approved by the committee.

BUDGET WATCH
The only legislative action lawmakers are mandated to do constitutionally is pass a state budget. With only a week left, lawmakers still have a lot of work to accomplish to get this job done by Memorial Day. And it all hinges on what happens today.

Three areas of contention between the House and Senate leaders must be decided today to prevent a special session. The first sticking point is how much money from the Rainy Day Fund to use to help balance the state’s current budget. Next, is how much money they want to spend on higher education. The final obstacle is passing Senate bills 1811 and 1581 that raise the money needed to balance the 2012-13 budget. SB 1811 could generate $2.5 billion to $4 billion depending upon what parts of the bill are approved. SB 1581 helps cover public and higher education spending. The Texas House has postponed taking up these bills all week. However, they both are on the House calendar again today.

The Texas House did approve SB 23 by Senator Nelson, another critical piece of the budget puzzle. The bill would save about $500 million, primarily in Medicaid and the Children’s Health Insurance Program. A few ways it achieves the savings are by expanding Medicaid managed care into the Rio Grande Valley, requiring Medicaid patients to use medicines on a state preferred drug list, and requiring Texans with disabilities to get home health services through Medicaid first. Nearly 40 amendments were approved. The measure now heads back to the Senate, and the two proposals must then be reconciled.

The House and Senate budgets were $4 billion apart on Wednesday. However, they have managed to close that gap, and there is a tenuous agreement. But it’s contingent on the passage of the state fiscal matter bills. Stay tuned.

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Erica Swegler, MD, of Keller. Dr. Swegler has practiced family medicine for 17 years. She graduated from The University of Health Science Center at Houston in 1983. Dr. Swegler is a member of TMA and the Tarrant County Medical Society. She also chairs TMA’s Committee on Infectious Diseases.

WHAT WE'RE READING
Texas House approves key Medicaid funding overhaul (Austin American-Statesman)
Feds Warn TX Medicaid Changes Could Harm Consumers
(Texas Tribune)
Health Premium Increases to Face New Scrutiny
(Wall Street Journal)
Perry signs physicians' bill into law
(Lubbock Avalanche-Journal)
Overshadowed, Med Schools Face Drastic Reductions
(Texas Tribune)
Rick Perry Presidential Push Quietly Gains Steam
(Real Clear Politics)
Most litigants unaffected by 'loser pays' reforms
(Houston Chronicle)
New Texas law mandates sonograms before abortion
(Reuters)

May 19, 2011

Bill Protecting Physicians Employed at 501a Corporations Passes

TMA Legislative News Hotline

REVISED Thursday, May 19, 2011


 
Sen. Jane Nelson
R-Flower Mound
BUDGET WATCH
Yesterday was anything but productive for budget writers. Instead, it was a day of closed-door meetings of state leaders, interruptions on the House floor to start and stop debate, and postponement of revenue-raising bills — Senate bills 1811, 1581 and 23, all of which are critical to helping balance the state budget. Without passage of SB 1811, the state budget is shy a couple billion dollars. SB 1581 is needed to shore up spending for education. SB 23 by Sen. Jane Nelson (R-Flower Mound) would save about $500 million, primarily in Medicaid and the Children’s Health Insurance Program. All three of these bills were packed with potential amendments yesterday. Amendments included ones that would lower the tax on chewing tobacco, repeal school-based fitness measurements and coordinated school health education from Texas schools bills, and ban smoking in public and work places. Discussions are still taking place to finalize a budget, but there is no deal yet. If a deal happens, these bills will need to pass to pay for the budget. Otherwise, the legislature will have to meet over the summer to hammer out a budget in special session. Stay tuned.

TMA's LEGISLATIVE AGENDA
Great news for physicians and medical students: The full Senate passed a TMA-backed bill this morning to examine graduate medical education (GME). House Bill 2908 by Rep. Dan Branch (R-Dallas) requires the Higher Education Coordinating Board to assess the number of GME slots in the state and determine whether this number meets the national standards for the ratio of GME slots to medical student slots, to make sure the state is maximizing its investment in medical education.

Three more bills critical to TMA’s legislative agenda landed on the House Local and Consent Calendar. And, the good news is all three were passed by the House this morning. The next stop is the governor’s desk. Here are the three bills and what they do for physicians:

Sen. Robert Duncan
R-Lubbock

Physician Protections: SB 1661 Sen. Robert Duncan (R-Lubbock) will provide clinical protections for thousands of physicians employed in [501(a)s]. It ensures physicians are able to retain independent medical judgment in doing what is best for their patients.

Texas Medical Board (TMB) reform: TMA has three important bills in the legislative pipeline important for improving the TMB process. These two bills were tentatively approved this morning.
  • SB 191 by Senator Nelson 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 would provide discretion for TMB to waive a fine in lieu of a remedial action plan for a minor administrative violation.
However, one critical bill — SB 190 by Senator Nelson — was knocked off the House Local and Consent Calendar by special interests opposed to TMA. It now will be reassigned to the General House Calendar. SB 190 has many TMB reforms that TMA has worked to win over the past two sessions. These include:
  • Allowing physicians to tape the proceedings of a TMB informal settlement conference;
  • Increasing the time for a physician to respond to a notice from 30 days to 45 days;
  • Eliminating anonymous complaints;
  • Instituting a statute of limitations on bringing a disciplinary action; and
  • Prohibiting the granting of a license to an applicant who has had a medical license suspended or revoked by another state.
TMA will continue to work to ensure that these needed reforms are achieved.

TMA TESTIFIES
Medicaid: TMA submitted a letter on HB 13 by Rep. Lois Kolkhorst (R-Brenham) today. The legislation calls for the development of an 1115 federal waiver to give Texas greater flexibility in the design and operation of the Medicaid program. The measure is before the Senate Health and Human Services Committee today.

BILL UPDATE
Immunizations: The House Public Health Committee approved the TMA-backed SB 1177. The measure by Senator Nelson and Rep. John Zerwas, MD, (R-Simonton) would require health care facilities such as hospitals to develop and implement vaccination policies for employees. The legislation is important because health care workers, especially those who are not immunized against the flu and other preventable diseases, may unknowingly spread these diseases to the patients in their care.

Medicaid cost-savings: The Senate passed two bills this morning to help save money in the Medicaid program. These include:
  • HB 2245 by Representative Zerwas and Senator Nelson. It would create physician incentive programs to reduce hospital emergency room use for non-emergent conditions by Medicaid patients.
  • HB 1983 by Representative Kolkhorst and Senator Nelson. It would direct the Health and Human Services Commission (HHSC) to implement evidence-based, tested quality and cost-savings measures to reduce the incidence of elective inductions or C-sections prior to the 39th week of gestation. It also directs HHSC to study the impact on infant health, the frequency of infant admissions to neonatal intensive care units, and readmission rates.
Obesity prevention: The Senate also passed HB 123 by Rep. Marc Veasey (D-Fort Worth) and Senator Nelson this morning. It would create adult diabetes education programs in counties with populations of more than 10,000.


PHYSICIAN OF THE DAY
The physician of the day at the capitol is Linton “Matt” Koger, MD, of Greenville. Dr. Koger has practiced family medicine for 11 years. He graduated from the UT Health Science Center at Houston in 1997. Dr. Koger is a member of TMA and the Hunt-Rockwall-Rains County Medical Society.

WHAT WE'RE READING
Deal on state health spending aids docs but leaves Medicaid hanging (Austin American-Statesman)
Report: Employers Face 8.5% Increase in Health-Care Costs in 2012
(Wall

May 18, 2011

TMA Leadership College - Class of 2011

Hear what the inagural class of the TMA Leadership College has to say about what their experiences in the eight-month training program for young physicians. These short videos (less than 3.5 minutes each) showcase lessons learned and how they used them in their practice, their organizations, and their community.

Budget Good News/Bad News Dance Continues in Austin

TMA Legislative News Hotline

Wednesday, May 18, 2011




State Comptroller Susan Combs

BUDGET WATCH
Budget conferees received some good news yesterday from Comptroller Susan Combs. She added $1.2 billion to her state revenue estimate, making that much more money available for the 2012-13 budget. These dollars, along with money created from the nontax revenue bills — better known as the “state fiscal matter” bills — are critical to helping balance the budget. Exactly how much money budget writers can count on from Senate bills 1811 and 1581, the state fiscal matter bills, will be determined in the Texas House today. SB 1811 could create $2.5 to $4 billion in nontax revenue. It all depends on which provisions are approved.

House members have a long, hard day ahead. More than 200 amendments have been filed for SBs 1811 and 1581. For example, TMA and members of the Texas Public Health Coalition are trying to keep an amendment off SB 1811 that would lower the tax on chewing tobacco. Another would repeal school-based fitness measurements and coordinated school health education from Texas schools. However, some amendments are good, such as those increasing taxes on tobacco products, placing additional requirements on facilities that allow smoking, providing tobacco cessation coverage for state employees, and maintaining Texas’ poison control centers.

Today is a critical one for the budget process. If the House doesn’t pass the fiscal matter bills, then the budget likely will have to be settled in a special session. Stay tuned.


Erika Sweggler, MD
 TMA TESTIFIES
Immunizations: Erica Swegler, MD, a Keller family medicine physician and chair of TMA’s Committee on Infectious Diseases, testified in support of SB 1177. The TMA-supported legislation by Sen. Jane Nelson (R-Flower Mound) and Rep. John Zerwas, MD (R-Simonton), would require health care facilities such as hospitals to develop and implement vaccination policies for employees. Dr. Swegler told House Public Health Committee members that SB 1177 is important because health care workers, especially those who are not immunized against the flu and other preventable diseases, may unknowingly spread these diseases to the patients in their care. The bill was left pending.

Newborn hearing screening: Alice Gong, MD, a San Antonio neonatal-perinatal specialist and a member of TMA’s Committee on Maternal and Perinatal Health, took the witness stand before the House Public Health Committee. Dr. Gong, a professor of pediatrics at The University of Texas Health Science Center in San Antonio, testified this morning in support of SB 229 by Senator Nelson. She told committee members that the legislation would help guarantee that all babies born in Texas have equal access to an important hearing screening. The bill was left pending.

Food safety: TMA submitted a letter in support of SB 1301 by Sen. Robert Deuell, MD (R-Greenville). The legislation would require that a bitter-tasting substance be added to antifreeze products that contain ethylene glycol. The goal is to deter children from drinking these poisonous products. The bill was taken up today in the House Public Health Committee. No action was taken on the measure.

PHYSICIAN OF THE DAY
The physician of the day at the capitol is Love D. Paul, MD, of Austin. Dr. Paul has practiced family medicine for 32 years. He graduated from the Government Medical College Maharishi in India in 1976. Dr. Paul is a member of TMA and the Travis County Medical Society.

WHAT WE'RE READING
Overshadowed, Med Schools Face Drastic Reductions (Texas Tribune)
Rick Perry Presidential Push Quietly Gains Steam
(Real Clear Politics)
$1.2 billion in additional revenue available for Texas budget
(Fort Worth Star-Telegram)
Confusion Over Texas Fiscal Bills Leads to Delay
(Texas Tribune)
Most litigants unaffected by 'loser pays' reforms (Houston Chronicle)

Political Prognosis: Legislature Tunes Up for Big Finale; Encore Possible

TMA Vice President for Advocacy Darren Whitehurst likes to say that the end of a legislative session is like the final crescendo of a great orchestra – either the musicians come together and make beautiful music or the whole thing falls apart.

May 17, 2011

Counting Down to June E-Prescribe Penalty

Texas physicians have until June 30 to e-prescribe to avoid penalties in 2012 (1 percent of Medicare Part B claims).

If you are not already e-prescribing in your office, act immediately to avoid this penalty. If you are not already on an electronic health record (EHR) with e-prescribing capabilities, you can install a standalone e-prescribing system and still meet the approaching deadline. Physicians can even use a free e-prescribing service to avoid the penalty.

Budget Negotiators Stick With Senate Medicaid Plan

TMA Legislative News Hotline

Tuesday, May 17, 2011



BUDGET WATCH
Big news. House and Senate budget conferees reached an agreement on many of the sections of the state 2012-13 budget yesterday. The only sticking points remaining are public and higher education funding and what nontax revenue to use to cover spending in the two-year budget. Unfortunately, those are big sticking points.

The good news is that budget conferees agreed to use the Senate version of the budget for health and human services. Medicaid payments to physicians and nursing homes were not slashed by 10 percent as proposed in the House’s bare-bones budget. The Senate’s budget doesn’t cut physicians’ Medicaid payments. It also included funding mental health and other public health services. However, the budget still is short $4.8 billion to fund expected growth in Medicaid caseloads, use of services, and medical inflation. More details on the budget should be released today.

Tomorrow, the Texas House is scheduled to take up the nontax revenue bills that will help cover around $4 billion in spending. The legislation is Senate bills 1811 and 1581 by Sen. Robert Duncan (R-Lubbock). The House likely will substitute the bills with its language. The bills then go to conference committee, where House and Senate differences are resolved.

Another item left for the House and Senate to iron out is how much money they will draw down from the Rainy Day Fund to help balance the current budget. There currently is around a $900 million difference between the two chambers. The House agreed to draw down $3.1 billion from the fund in March. Yesterday, the full Senate approved using almost $4 billion. Stay tuned.

BILL UPDATE
Workforce: Another TMA-supported bill is headed to the governor’s desk. House Bill 1380 by Rep. Vicki Truitt (R-Keller)/Sen. José Rodríquez (D-El Paso) will allow international medical graduates (IMGs) in graduate medical education (GME) programs to apply for licensure in Texas after two years of residency training. The goal of this legislation is to facilitate board certification and retention of residents to practice in Texas. Without this change, IMGs often felt forced to leave Texas after GME for states with a two-year GME requirement to work around a board-exam scheduling problem. Those who remained in Texas typically had to wait at least half a year after residency to sit for their board exams. During the wait, they were unable to qualify for hospital or health plan credentialing and were unable to bill for their services.

Matthew Murray, MD
TMA TESTIFIES
Health information technology: Matthew Murray MD, a Fort Worth pediatrician and vice chair of TMA’s Health Information Technology Ad Hoc Committee testified before the Senate Health and Human Services Committee. He testified this morning in support of a committee substitute for HB 300 by Rep. Lois Kolkhorst (R-Brenham). TMA has worked to achieve numerous changes on the bill so it won’t adversely affect physician practices. The legislation is an attempt to strengthen state privacy law on top of the federal Health Information Portability and Accountability Act (HIPAA). It would ban the sale of personal health information, for direct or indirect remuneration, but allow it for treatment, payment, or health care operations. It also sets up a process for notifying patients of, and obtaining consent for, the electronic transfer of their medical records. Physicians or other health care providers who willfully break the rules or are repeat offenders may be subject to disciplinary action by their licensing agency. The bill was left pending.

Food safety: TMA submitted a letter on the committee substitute for HB 3387 by Rep. Eddie Rodriguez (D-Austin). TMA took a neutral position on the bill today when it was taken up by the Senate Health and Human Services Committee. HB 3387 would regulate how food is prepared, stored, distributed, or sold at local farmers’ markets. It was left pending.

Student athletic safety: TMA also submitted written testimony in support of a committee substitute for HB 2038 by Rep. Four Price (R-Amarillo). The bill addresses the prevention, treatment, and management of concussions affecting young athletes participating in interscholastic events. The measure was approved this morning by the Senate Health and Human Services Committee.

Julie Graves Moy, MD
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Julie Graves Moy, MD, of Austin. Dr. Moy has practiced family medicine for 22 years. She graduated from The University of Texas Southwestern Medical Center at Dallas in 1983. Dr. Moy is a member of TMA and the Travis County Medical Society.


WHAT WE'RE READING
Senate Votes $4 Billion From Rainy Day Fund for Deficit (Texas Tribune)
TX Health Care Industry Watches Austin for Possible Medicaid Cuts
(KUHF Houston)
House Passes Bill on Indigent Care for Immigrants
(Texas Tribune)
Got Health Insurance? Pray You Won't Get "Purged"
(Huffington Post)
Rural communities to get assistance to recruit physicians
(Gonzales Inquirer)
Education funding may force special session of state Legislature
(Fort Worth Star-Telegram)

Remember Eight, at Eight, on the Eighth

Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8, at 8 pm (CDT), you can learn what actions legislators took on medicine's top eight issues.

Important: TMB to Resume Death Registration Fines

On June 1, the Texas Medical Board (TMB) will resume disciplining physicians who do not use the Texas Electronic Registrar (TER) Death Registration system to register patient deaths, TMB Executive Director Mari Robinson, JD, told the TMA Patient-Physician Advocacy Committee at TexMed 2011. The fine is $500.

May 16, 2011

State Budget Hitting Session Time Crunch

TMA Legislative News Hotline

Monday, May 16, 2011


BUDGET WATCH
With only two weeks left in the 2011 legislative session, lawmakers still have a lot of work to accomplish if they plan to pass a state budget by Memorial Day. Legislators are under pressure from outside groups to approve a budget that dramatically cuts state spending. A robo-call went out last week asking lawmakers to keep the state living within its means by cutting spending, protecting the Rainy Day Fund, and saying “no” to any new taxes or revenue schemes.

What’s in the works this week: The budget negotiators spent last week ironing out House and Senate differences in the 2012-13 budget. We should see their final product early this week. Meanwhile, Senate Bill 1811 by Sen. Robert Duncan (R-Lubbock) that would help cover some of the spending in the budget will be taken up by the Texas House. The legislation, known as the “fiscal matter” bill, would generate nontax revenue money. The House likely will substitute SB 1811 with its language. The bill then goes to conference committee, where House and Senate differences are resolved. The big sticking point stalling the budget process is how to pay for public schools. This issue is before the full Senate. Either or both of these issues could hang up the budget.

BILL UPDATE
Here a few more bills that received Senate approval last week:
  • House Bill 1380 by Rep. Vicki Truitt (R-Keller) and SB 1022 by Sen. José Rodríquez (D-El Paso). It would allow international medical graduates to apply for licensure in Texas after two (rather than three) years of graduate medical education.
  • SB 270 by Sen. Carlos Uresti (D-San Antonio). It helps ensure more newborns receive hearing screenings. It also adds follow-up care for newborns with abnormal hearing screening results.
  • SB 1360 by Sen. Chris Harris (R-Arlington) and 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.

The Texas House passed HB 677 by Rep. Eddie Lucio III (D-Brownsville) last week. It would require a neurocognitive or cognitive-linguistic assessment of young athletes before they could participate in athletic events after sustaining a concussion.

Good news: HB 438 by Rep. Senfronia Thompson (D-Houston) and Sen. John Carona (R-Dallas) is headed to the governor’s desk for his signature. The legislation would require health plans to cover orally administered anticancer medications at the same level as they provide coverage for other medical or surgical expenses. TMA strongly supported this legislation.

Thomas Shima, DO
PHYSICIAN OF THE DAY
The physician of the day at the capitol is Thomas Shima, DO, of Dallas. Dr. Shima has practiced family medicine for 10 years. He graduated from Kansas City University of Medicine and Biosciences in 1998. Dr. Shima is a member of the Dallas County Medical Society.

WHAT WE'RE READING
Perry signs physicians' bill into law (Lubbock Avalanche-Journal)
Trauma center chiefs beg for usual funding
(Houston Chronicle)
Medicare to Run Dry in 2024
(MedPage Today)
AMA unveils SGR replacement plans
(American Medical News)
House approves concussion bill for school sports (Houston Chronicle)

Farewell Address of Past TMA President Sue Bailey, MD



One year ago, when I proudly accepted this position, I told you that the theme ... the agenda ... the challenge of my presidency would be "Taking Advantage of Change." With the passage of the Affordable Care Act only one month before, with the nonstop threats to our Medicare payments, with the prospect of a nasty 2011 session of the Texas Legislature ... there was no question what changes we were talking about.


But I also told you that if any medical society is prepared to help its members through these seismic changes ... through advocacy, education, and engagement ... it's our Texas Medical Association. And I pledged that TMA would help Texas physicians take advantage of this change all around us.


Here we are, one year later. I can report that we've come so far ... but we still have a long way to go. I can tell you that we've done so much ... but we still have so much to do.


(Houston, TX -- May 13, 2011)

Installation Address of TMA President Bruce Malone, MD



C. Bruce Malone III, MD, of Austin became TMA’s 146th president in an installation ceremony at TexMed 2011 in Houston ON May 14, 2011.


“In this time of disruptive change, we cannot just say ‘no,’” Dr. Malone, an orthopedic surgeon, said in his installation address. “We have to help create a reorganized medical marketplace that creates value for the consumer and gives us a right to practice in the public system while having the option to privately contract with patients who want more.”

May 13, 2011

Leaders Earn Honors at TexMed 2011

Congratulations to the TMA leaders who took home honors today at the annual meeting of the House of Delegates at TexMed 2011 in Houston:

Medical Student Section Awards
Chapter of the Year
Texas College of Osteopathic Medicine. The chapter continued its efforts to provide community service and educational opportunities for students in 2010. The Class of 2013 logged more than 4,700 hours of service last year, and the Class of 2014 chalked up more than 2,700 hours in only one semester. Student of the Year Kim Hawthorne, The University of Texas Medical School at Houston. She was cited for service and leadership to the chapter. The student nominating her said Ms. Hawthorne "is reliable, effective, and passionate. Her name continues to be raised during discussions about future TMA leaders."
C. Frank Webber Award
Angela Siler-Fisher, MD, FACEP, Houston. Dr. Siler-Fisher, an emergency physician, was honored for being a strong advocate for student involvement in TMA.

Young Physician Section Awards
Young at Heart Award
William W. Hinchey, MD. He received the award for his commitment to organized medicine, his willingness and openness to bringing young physicians up the ranks.

PLUS: Last night at the TEXPAC 300 Club reception, Linda Swan Atkins of Houston received the June Bratcher Award for Political Action. Way to go, all!