May 17, 2011

Budget Negotiators Stick With Senate Medicaid Plan

TMA Legislative News Hotline

Tuesday, May 17, 2011

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.

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
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
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.

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)

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