TMA Legislative News Hotline: Monday, May 20, 2013

7 Days Remaining of 2013 Legislature

NEW STATE LAW 

On Saturday, Gov. Rick Perry signed into law the first of five TMA bills reducing red tape for physician practices. Senate Bill 166 by Sen. Robert Deuell, MD (R-Greenville), and Rep. Lyle Larson (R-San Antonio) allows physicians to check in patients using the electronic strip on the back of their Texas driver's license starting Sept. 1.   

SENATE ACTION 

The other big news is that Senate Bill 406 by Sen. Jane Nelson (R-Flower Mound) and Rep. Lois Kolkhorst (R-Brenham), which strengthens the physician-led medical team model, is now headed to the governor’s desk for signature. Senator Nelson today concurred with the agreed-to cleanup amendments placed on the bill in the House Friday.

ACTION IN THE HOUSE 

On Friday, the House gave preliminary approval to these bills, which likely will receive final approval later today:

  • Senate Bill 8 by Senator Nelson and Representative Kolkhorst validates the authority of the inspector general to detect and investigate fraud at all levels of the state health and human services system. If a physician or provider is found guilty of fraud or is disqualified from operating in another state due to fraud, he or she would be barred from operating in Texas. The bill also would move ambulance services to Medicaid HMOs and would reduce the use of ambulances for non-emergency transport.
  • Senate Bill 24 by Sen. Chuy Hinojosa (D-McAllen) and Rep. Rene Oliveira (D-Brownsville) establishes a new university in South Texas, including a medical school, within The University of Texas System.
  • Senate Bill 58 by Senator Nelson and Rep. John Zerwas, MD (R-Simonton), integrates behavioral health services, including mental health and substance abuse services and physical health services, under the Medicaid managed care program as opposed to having behavioral health "carve outs."
  • Senate Bill 978 by Senator Deuell and Rep. Sarah Davis (R-West University Place) would allow the Texas Medical Board to adopt rules regulating the use of local anesthesia and peripheral nerve blocks in an outpatient setting where only local anesthesia and peripheral nerve blocks are used.

Bills on today's House General Calendar important to TMA’s 2013 legislative agenda include these four red-tape reduction and Medicaid fraud and abuse reform bills:

  • Senate Bill 1216 by Sen. Kevin Eltife (R-Tyler) and Representative Davis requires the Texas Department of Insurance (TDI) to appoint a stakeholder workgroup to design a standard request form for prior authorization of health care services applicable to all payers.
  • Senate Bill 644 by Sen. Joan Huffman (R-Houston) and Representative Zerwas requires TDI to appoint a stakeholder workgroup to design a standard prescription drug prior-authorization form applicable across all payers, including Medicaid and the Children’s Health Insurance Program (CHIP).
  • Senate Bill 1221 by Sen. Ken Paxton (R-McKinney) and Rep. John Smithee (R-Amarillo) ensures physicians know when their discounted contract rates under Medicaid managed care or CHIP are applied to products other than Medicaid or CHIP. The bill ensures that managed care plans cannot apply physicians’ existing agreed-to discounts for their Medicaid/CHIP business to new commercial products in the health insurance exchange without notification and consent.
  • Senate Bill 1150 by Senator Hinojosa 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.”

Other bills on the House Calendar today of interest to medicine include these:

  • Senate Bill 227 by Sen. Tommy Williams (R-The Woodlands) and Representative Zerwas 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 imposes limits on pharmacy, non-brand drug substitutions. Biosimilars have similar properties to existing biologic products but are not identical. If 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.
  • Senate Bill 7 by Senator Nelson and Rep. Richard Raymond (D-Laredo) aims to save money in the Medicaid program by expanding Medicaid HMOs to people with intellectual and development disabilities and to nursing home residents. 

 PHYSICIAN OF THE DAY 

The physicians of the day at the Capitol are husband-and-wife team Rick Edwards, MD, and Barbara Estment, MD, of Fort Worth. Dr. Edwards graduated from The University of Texas Health Science Center in Houston in 1977, while Dr. Estment graduated from Texas Tech University Health Sciences Center in 1998. Both physicians are members of TMA and the Tarrant County Medical Society.

WHAT WE'RE READING 


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