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
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.

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

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.

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.

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.

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.

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

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