By an overwhelming 392-27 vote, the U.S. House of Representatives this morning approved HR 2, the Medicare and CHIP Reauthorization Act, and sent it on to the Senate. The bill would eliminate the Medicare Sustainable Growth Rate (SGR) formula immediately, and extend funding for the Children’s Health Insurance Program (CHIP) for two years. “It is time to end the SGR,” said U.S. Rep. Michael Burgess, MD (R-Lewisville), the lead House author. “Let us never speak of this issue again.” Thanks to a strong grassroots expression of support from TMA members, 30 of Texas’ 36 House members voted for the measure. Voting against were U.S. Reps. Louis Gohmert (R-Tyler), Sam Johnson (R-Plano), Kenny Marchant, (R-Coppell), and John Ratcliffe (R-Heath). Rep. Ruben Hinojosa (D-Mercedes) was not present. Congress is scheduled to take its two-week Easter recess after Friday; thus passage in the Senate tomorrow is necessary to avoid the 22.4-percent physicians’ Medicare pay cut the SGR would exact beginning April 1. President Obama has said he will sign the bill should it reach his desk.
A bill banning texting while driving statewide earned final passage in the Texas House of Representatives today on a 104-39 vote. TMA and the Texas Public Health Coalition support House Bill 80 by Rep. Tom Craddick (R-Midland) and joint authors, Reps. Byron Cook (R-Corsicana), Patricia Harless (R-Spring), Eddie Lucio III (D-Harlingen), and Gene Wu (D-Houston). The bill now goes to the Senate. Forty-four states currently ban text messaging while driving. In Texas, 38 cities have local bans on texting while driving.
The Senate Business and Commerce Committee today approved Senate Bill 481 by Sen. Kelly Hancock (R-North Richland Hills). The bill would add assistant surgeons who are out of network to the definition of “facility-based physicians” for the purpose of using mediation to resolve claim disputes. It also removes the existing $1,000 balance threshold that makes a claim eligible for mediation; that balance is after the patient’s copays, coinsurance, and deductibles have been paid.
The Senate Finance Committee today added direction to its draft 2016-17 state budget on how to spend $60 million to pay for the graduate medical education (GME) expansion projects envisioned in Senate Bill 18 by Sen. Jane Nelson (R-Lewisville). The funding sustains some 2013 GME expansion programs while building other programs to improve access to care. Today’s decision includes $41 million for GME expansions; an additional $16 million for the family medicine residency program (a 125-percent increase above current funding); and $3 million to revitalize the Primary Care Preceptorship Program. Coauthors include Sens. Juan “Chuy” Hinojosa (D-McAllen) and Kel Seliger (R-Amarillo). House Bill 1445 by Rep. Ryan Guillen (D-Rio Grande City) is the companion legislation. TMA supports the bill.
TMA IN ACTION
Leslie Secrest, MD, a Dallas psychiatrist, and Robert Greenberg, MD, a Temple emergency medicine physician, urged passage of Senate Bill 359 by Sen. Royce West (D-Dallas). The bill would permit physicians to initiate a four-hour hold on patients who have voluntarily sought care at a hospital or freestanding emergency medical center but then want to leave, though the treating physician believes the patient is a danger to self or others. Currently if such a situation occurs, only law enforcement can initiate a detention, and only a court can issue an order of protective custody. This can pose problems in a hospital when no peace officer is available and the physician has no choice but to let the patient leave. The Senate Health and Human Services Committee heard testimony on the bill yesterday.
Houston emergency medicine physician Arlo Weltge, MD, testified yesterday at the House State Affairs Committee on House Bill 614 by Rep. Sarah Davis (R-West University Place), which would require the state to establish a registry in which patients could submit their advance directives. Dr. Weltge thanked Representative Davis for the legislation, saying the idea for creating such an advance directives registry, particularly for do-not-resuscitate orders, would be helpful in urgent-care situations during which timeliness and good information are critical. However, he expressed concerns about the prompt availability of such a registry, the reliability of its information, and liability of physicians providing care based on it.
PHYSICIAN OF THE DAY
The physician of the day at the Capitol is Rayford Mitchell, MD, of Karnes City. Dr. Mitchell graduated from The University of Texas Southwestern Medical School. He is a member of TMA and the Karnes-Wilson County Medical Society.
WHAT WE'RE READING
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