TMA Wants Women's Health Rules Changed

Unless modified, proposed changes to the state's Women's Health Program (WHP) rules [PDF] "will deter many privately practicing physicians from participating in WHP, thereby making it more difficult for low-income women to avail themselves of the much needed and cost-effective family planning and wellness services provided through the program," TMA and four specialty societies told the Texas Health and Human Services Commission (HHSC). The program provides low-income women with family planning examinations, related health screenings, and birth control through Texas Medicaid. The program does not provide abortions.

Among the groups' other concerns are the rules' definitions of a health clinic and the term "promote," and their prohibition of contracts with certain providers.

Besides TMA, the Texas Association of Obstetricians and Gynecologists, the Texas chapter of the American College of Obstetricians and Gynecologists, the Texas Academy of Family Practice, and the Texas Pediatric Society signed the letter.

The letter recommends several changes:  

  1. Exclude physician practices from the definition of a health clinic to make the rules more easily understood. 
  2. Revise the definition of "promotes" elective abortions so it will not interfere with the patient-physician relationship and prevent candid conversations between doctors and patients during an examination or treatment. "Physicians must be able to have frank and accurate discussions with their patients when either asked by the patient about abortion or when the patient's medical condition warrants discussion of the procedure, such as when continuation of the pregnancy may be life threatening," the letter says. "It may violate the principles of medical ethics for a physician to fail to respond to patient questions regarding her condition or to withhold information reasonably related to her condition."
  3. Remove the provision that HHSC cannot admit a Medicaid physician to the WHP if he or she "performs services for a corporate entity that performs or promotes elective abortions…" The letter says the exclusion is "exceedingly broad" and will "limit the number of private practicing physicians available to participate in WHP, thus making it more difficult for women to obtain WHP services and defeating the state's intent to lower Medicaid costs by helping women better plan and space their pregnancies. HHSC currently allows physicians who practice in a group to enroll in WHP as individual providers. This avoids the problem of excluding the entire group if one member provides elective abortions. We strongly encourage HHSC to maintain the existing provider enrollment policy." 

Action, Oct. 4, 2011


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