Jun 16, 2011

Health Care Compact Bill #2 Up for House Vote Today

TMA Legislative News Hotline

Thursday, June 16, 2011

Interstate compact: The Texas House gave tentative approval to House Bill 5 by Rep. Lois Kolkhorst (R-Brenham) yesterday. The legislation would allow Texas to participate in a multistate compact to help fund and administer Medicaid and Medicare. HB 5 is slated for a final House vote today. Earlier this week the House approved HB 13 also by Representative Kolkhorst that would allow the state to apply for a federal waiver to help fund Medicaid.

Medicaid cost savings: House conferees for Senate Bill 7 by Sen. Jane Nelson (R-Flower Mound) were named yesterday. They are Reps. John Zerwas, MD (R-Simonton), chair; Jim Pitts (R-Waxahachie); John Davis (R-Houston); Veronica Gonzales (D-McAllen); and Kolkhorst. The House conferees join Senator Nelson and Sens. Robert Deuell, MD (R-Greenville); Juan “Chuy” Hinojosa (D-McAllen); Florence Shapiro (R-Plano); and John Carona (R-Dallas). These 10 lawmakers will decide which amendments stay on SB 7 and which ones don’t.

The omnibus health care bill is a combination of three bills heard during the regular session ― SBs 7 and 23 regarding Medicaid organization and cost containment, and SB 8, which establishes health care collaboratives in Texas. Taken together this huge bill would:
  • Ensure physicians would have an equal say and vote in a collaborative’s governing board, and due process protections and the ability to participate in more than one collaborative arrangement in their community;
  • Establish a statewide plan to improve quality and increase efficiency by forming and regulating health care collaboratives;
  • Create a new Medicaid and Children’s Health Insurance Program Quality-Based Payment Advisory Committee and program that would tie a portion of Medicaid HMO premiums to improved health outcomes and quality, and implement copayments in Medicaid to reduce unnecessary emergency department use;
  • Create more than $460 million for Medicaid by placing a premium tax on Medicaid managed care companies that are expanding to the Rio Grande Valley;
  • Protect patients from vaccine-preventable diseases in health care facilities by requiring health care workers to be properly immunized;
  • Establish the Texas Emergency and Trauma Care Education Partnership Program to ensure support of the trauma infrastructure in Texas;
  • Require the disclosure of physician discounts by any company that applies them to a patient claim;
  • Establish criminal penalties for physicians who fail to fill out appropriate paperwork for women who have received services related to an abortion; and
  • Allow Texas to participate in a multistate compact to help fund and administer Medicaid and Medicare.
Medicare payments: Physician’s Medicare payments could be cut almost 30 percent Jan. 1, 2012, if Congress does not address the flawed Sustainable Growth Rate (SGR) funding formula. Congress currently is exploring different ways to fix the formula, but each has a hefty price tag. The Congressional Budget Office estimated the 10-year cost of different solutions range from $21.5 billion, which includes a 35-percent payment cut in 2013, to $388.5 billion, which includes an annual 2-percent increase through 2021 after resetting the SGR or forgiving all over-target spending that accrued cumulatively up to Dec. 31, 2010. Another option would use the same resetting formula and link updates to the Medicare Economic Index. That option has been projected to cost $358.1 billion from 2012 through 2021.

Obesity prevention: U.S. Reps. Michael C. Burgess, MD (R-Texas), and Eliot Engel (D-New York) reintroduced legislation yesterday designed to lower gestational diabetes and prevent affected women and their children from later developing Type 2 diabetes. If passed the legislation would:
  • Develop a multisite gestational diabetes research project within the Centers for Disease Control and Prevention diabetes program to enhance surveillance and public health research on gestational diabetes;
  • Provide demonstration grants to focus on reducing the incidence of gestational diabetes; and
  • Expand basic, clinical, and public health research investigating gestational diabetes and current treatments and therapies available.
TMA’s Tele-2011 Legislative Update
In case you missed the Tele-2011 Legislative Update by TMA President C. Bruce Malone, MD, and physician leaders from TMA’s Council on Legislation — Gary Floyd, MD, and Dan McCoy, MD —you still can hear and see what they discussed. An audio recording and video are available on the TMA website.

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