May 4, 2011

Senate Takes Another Crack at 2012-13 Budget

TMA Legislative News Hotline

Wednesday, May 4, 2011

Senate leaders failed to get the votes needed to bring up their state budget plan for 2012-13 Tuesday. In order to bring up the proposal, they need two-thirds of the Senate voting for the bill. To help get the votes, Sen. Steve Ogden (R-Bryan) took out a controversial provision that would tap the Rainy Day Fund for another $3 billion. To replace this money, Senator Ogden proposed making up the difference by bumping a $1.25 billion Medicaid payment into 2013 and enacting a 1.2 percent across-the-board cut for everything except schools and debt service. Senate leaders said they would add the money back into Medicaid if the state produces more revenue next year. This move still didn’t help muster the votes needed. However, the Senate plans to revise its rules today requiring only a simple majority to hear the bill. The budget bill then can be debated with only 16 senators voting in favor. The Senate spending plan is about $12 billion higher in state and federal funds than a bare-bones House budget plan. It cuts current spending by $11 billion, or 5.9 percent. Stay tuned.

Dallas physicians meet with Rep. Dan
Branch (R-Dallas) at First Tuesday
Thanks to all the physicians, medical students, and alliance members who participated in the last 2011 First Tuesday at the Capitol yesterday. TMA members spent the day visiting with state representatives and senators about legislation important to physicians and their patients. Legislators often comment that it makes a big difference when their constituents visit them in Austin.

The House was prepared to spend a long day taking up “fiscal matter” bills to find more money for its budget Tuesday. Instead, it spent the day tackling its backlog of bills. The fiscal matter bills are on the House Calendar today but will likely be brought up only after the Senate passes its version of the state budget. Here is a list of Senate and House bills that moved yesterday:
  • Senate Bill 894 by Sen. Robert Duncan (R-Lubbock) and Rep. Garnet Coleman (D-Houston) was tentatively approved. The bill now moves to final approval. This is TMA’s physician employment protection bill. SB 894 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.
Want to learn more about the physician employment bills moving through the legislative process? TMA has a description of each bill and how it protects a physicians’ clinical autonomy on our website.
  • House Bill 300 by Rep. Lois Kolkhorst (R-Brenham) was tentatively passed by the House. 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 1720 by Rep. John Davis (R-Houston) received tentative approve by the House. It would improve accountability in Medicaid and the Children’s Health Insurance Program.
  • HB 2599 by Rep. Allan Ritter (R-Nederland) also received tentative approval. It would place a tax on chewing tobacco and require better reporting of tobacco taxes.
  • HB 123 by Rep. Marc Veasey (D-Fort Worth) was passed by the House. The legislation would create a program to educate Texas adults on the importance of proper diet, nutrition, and physical activity in the prevention and management of diabetes in counties with populations of more than 100,000.

Physician workforce: HB 1380 by Rep. Vicki Truitt (R-Keller) was passed by the Senate Health and Human Services Committee Tuesday. It would allow international medical graduates to apply for licensure in Texas after two years of graduate medical education. Its companion legislation, SB 1022 by Sen. José Rodríquez (D-El Paso), is on the Senate Intent Calendar.

Immunizations: The committee substitute for SB 1107 by Sen. Wendy Davis (R-Fort Worth) was approved by the House Public Health Committee yesterday. It would require all first-time students at public and private or independent colleges to receive a bacterial meningitis vaccination. Its companion legislation, HB 1816 by Rep. Charlie Howard (R-Sugar Land), was scheduled to be heard on the House floor yesterday but was delayed in order for its Senate companion to catch up.

Dana Sprute, MD
The physician of the day at the capitol is Dana Sprute, MD, of Austin. Dr. Sprute has practiced family medicine for 15 years. She graduated from The University of Texas Health Science Center at San Antonio in 1993. Dr. Sprute is a member of TMA and the Travis County Medical Society. She served as a member on TMA’s Council of Public Health and Council on Science and Public Health.

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 2 edition.

House Gives Early OK to Rural Hospitals Hiring Docs
(Texas Tribune)
House Gives Early Endorsement to Patient Privacy Bill
(Texas Tribune)

Take-Aways from Tuesday's Senate Budget Fight (Texas Observer)

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