12 Days Remaining in 2013 Legislature
TMA IN ACTION
Cynthia Jumper, MD, a Lubbock internist and member of TMA’s Council on Medical Education, testifies before the House Higher Education Committee today in support of Senate Bill 301. The measure by Sen. Judith Zaffirini (D-Laredo) prevents offshore medical schools from buying clinical clerkships for their students. Dr. Jumper will tell committee members Texas clerkships are limited and must be reserved for Texas medical students. TMA does not support jeopardizing the accreditation of our own medical schools by allowing offshore medical schools to use Texas’ clerkships. U.S. medical school accreditation standards specify the parent medical school must provide core clinical training.
Lee Spangler, TMA vice president of Medical Economics, is testifying in support of two bills that provide physicians’ practices some flexibility in complying with the state privacy law's training requirements and other provisions. The bills are Senate bills 1609 and 1610 by Sen. Charles Schwertner, MD (R-Georgetown). They offer targeted amendments that maintain the strength of the state's privacy law protections. SBs 1609 and 1610 set a single Texas standard for the elements for compliance. They eliminate the daunting task of complying with multiple, constantly changing laws passed in other states when notifying patients of a breach of their medical records.
The Budget Conference Committee is making progress on the state’s 2014-15 spending plan. The conferees finished hammering out the details on the section of the budget dealing with health and human services spending known as Article II. The good news is that it includes more than $225 million in new funding for mental health services. The proposed budget makes significant strides toward upgrading a mental health system that has barely kept pace with rapid population growth. Lawmakers took particular care to ensure new funds targeted specific initiatives across Texans’ myriad mental health needs, including prevention, early identification, community-based services, and inpatient hospital care. These are some of the new mental health initiatives slated for improvement by the legislature:
- $4 million to improve mental health services for veterans, such as peer-to-peer counseling,
- $5 million to enhance prevention and early identification of mental illness in school-aged children,
- $25 million for additional crisis services to be provided by local mental health authorities, and
- $25 million to promote public-private partnerships to improve mental health care delivery and services.
The committee is taking up spending plans for public and higher education today. Look for another budget update tomorrow.
ACTION IN THE HOUSE
Two TMA bills received preliminary approval from the Texas House yesterday. These include:
- Senate Bill 406 by Sen. Jane Nelson (R-Flowermound) and Rep. Lois Kolkhorst (R-Brenham) would strengthen the physician-led medical team model. SB 406 establishes a more collaborative, delegated practice that allows members of the health care team to practice to their level of education and training. Physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) are natural partners in the delivery of appropriate and compassionate patient care. SB 406 strengthens that partnership. TMA, the Texas Academy of Family Physicians, APRNs, and PAs support the bill. Read The Texas Tribune story.
- Senate Bill 64 by Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Simonton), would require licensed child care facilities to develop and implement an immunization policy for their employees to protect the children in their care from vaccine-preventable diseases.
Medicaid Reforms: The House Human Services Committee approved a bill critical to TMA’s Medicaid reform agenda. Senate Bill 1150 by Sen. Chuy Hinojosa (R-McAllen) and Rep. Bobby Guerra (R-McAllen), requires the Health and Human Services Commission (HHSC) to implement a “provider protection plan” under Medicaid HMO or other arrangements and incorporate the plan into the contracts between HHSC and the plans. Plans must pay claims properly and promptly. The bill imposes penalties on plans that engage in low-pay, slow-pay, no-pay activity.
The committee also approved Senate Bill 1542 by Sen. Leticia Van de Putte (D-San Antonio) and Representative Zerwas that requires HHSC to establish a Medicaid quality improvement process to assess and recommend clinical initiatives that could improve quality or save money in the Medicaid program. It directs HHSC to analyze initiatives that:
- Require hospitals to implement evidence-based protocols for treatment of sepsis and severe septicemia, and
- Provide blood-based allergy testing for patients with persistent asthma to develop a treatment strategy to minimize exposure to allergens.
Prescription Drugs: The House Public Health Committee approved several bills dealing with controlled substances and prescription drugs yesterday. Three of the bills were by Sen. Tommy Williams (R-The Woodlands) — Senate bills 1643, 1646, and 227. SB 1643 creates an Interagency Prescription Monitoring Work Group to evaluate the effectiveness of prescription monitoring for controlled substances. SB 1646 clarifies that owning and operating a pain management clinic is the practice of medicine and provides for the Board of Nursing to adopt rules relating to pain management services. SB 227 would allow physicians to dispense aesthetic pharmaceuticals in excess of the patient’s immediate needs without a pharmacist license. Drugs include bimatoprost for growing eyelashes; hydroquinone, a skin whitener; retinoid for improving skin; and metronidazole to treat rosacea.
Senate Bill 190 by Senator Huffman and Representative Zerwas also was approved. The bill imposes limits on pharmacy, non-brand drug substitutions. Biosimilars have similar properties to existing biologic products but are not identical. As part of the federal health care reform legislation, Congress authorized a legal pathway for approving biosimilars, but a formal regulatory process is still being established by the U.S. Food and Drug Administration (FDA). This bill allows the FDA to determine if a biosimilar biological product is interchangeable with the reference biological product. But when a pharmacist chooses to substitute a prescription with a biosimilar, the physician must be notified. And, if a physician certifies that a specific prescribed product is medically necessary, the pharmacist must dispense the prescription as written.
Advertising: The Senate Health and Human Services Committee approved House Bill 1376 by Representative Kolkhorst yesterday. The bill would prohibit a freestanding emergency department (ED) affiliated with a hospital from advertising or holding itself out to be a medical office, facility, or entity other than an ED, if the facility charges rates comparable to hospital ED rates.
PHYSICIAN OF THE DAY
The physician of the day at the Capitol is Daniel Voss, MD, of Jarrell. Dr. Voss graduated from The University of Texas Medical Branch in 1985. He is a member of TMA and the Williamson County Medical Society. Dr. Voss will be accompanied by Texas A&M University Medical School medical student Haoyu Lee.
WHAT WE'RE READING