Medicaid Provider Rate Updates
Prescription Drug Coverage
Nursing Shortage Relief
Long-Term Care Quality
Teacher Health Insurance
Early legislative forecasts predicted that the state's tight
budget would derail substantial health care reform. However,
prognosticators proved wrong. Vigorous advocacy by TMA and other
health care providers, combined with skillful negotiations and
budget writing finesse by the Senate Finance and House
Appropriations committees, resulted in the legislature dedicating
$34.9 billion (state and federal funds) to health and human
services, a 17-percent increase from the previous session. The
lion's share of these monies - approximately 72 percent - will be
dedicated to Medicaid. The Medicaid dollars will pay not only for
caseload growth and costs associated with medical inflation, but
also TMA-backed Medicaid rate increases for physicians, hospitals,
and long-term care facilities and simplification of the enrollment
and eligibility process for children's Medicaid.
In addition to substantial Medicaid funding, the legislature
provided dollars for many other less visible, but equally
important, health-related measures TMA supported, such as new
monies for immunizations, telemedicine, low-income students
entering medical school, and numerous public health measures.
Lastly, health care coverage for teachers also received
substantial funding - $1.8 billion over the next two
Below are highlights of the 2002-03 health care budget; items
are organized by issue area. Unless otherwise indicated, dollar
amounts refer to state funding only.
MEDICAID PROVIDER RATE UPDATES
$197 million to update Medicaid rates for physicians,
hospitals, and other health care providers. (See below for
$190 million to increase funding for nursing home and
$104 million to reduce waiting lists for community based
$3.4 million (state and federal funds) to expand the use and
availability of telemedicine within Medicaid. The monies will
implement a TMA-backed bill, SB 789. For a complete description of
the bill, go to the
"Medicaid - Telemedicine"
section below. Additionally, the Texas Department of Health
received $212,000 to fund telemedicine pilot projects aimed at
expanding prenatal care and other services to low-income women. One
pilot must be located in an urban area and the other in a rural
Breast and Cervical Cancer Coverage
$3.6 million (state and federal funds) to implement SB 532,
extending Medicaid coverage to women diagnosed with breast or
cervical cancer. Currently, low-income, uninsured women are
eligible to participate in the National Breast and Cervical Cancer
Early Detection Program. However, if a woman is diagnosed with
cancer, monies are not available for treatment. Enactment and
funding of SB 532 will allow Texas to extend Medicaid coverage to
these women, benefiting about 200 women each year. The federal
government pays three-fourths of the new program's costs.
Coverage for Psychotropic Medications and HIV/AIDS
SB 1 included several riders directing the Health and Human
Services Commission (HHSC) to pursue federal waivers that would
bring additional federal dollars to Texas to expand Medicaid
services to designated populations. HHSC is directed within SB 1 to
specifically pursue waivers allowing the state to establish
prescription drug and related medical service coverage pilots for
patients with behavioral health disorders and HIV/AIDS.
On June 17, Gov. Rick Perry vetoed the statutory component of
these riders, SB 1156. (See below for details.) However, pursuit of
the waivers is not necessarily contingent upon legislation. Thus,
HHSC has the authority to initiate waivers to implement these
$122.6 million to simplify the enrollment and eligibility
process for children's Medicaid.
$263 million to continue funding for the Children's Health
Insurance Program (CHIP) plus $65 million to pay for caseload
growth and provider rate increases. The state expects to
enroll nearly 500,000 children in the program by the end of
$437,000 to study extending Medicaid and CHIP coverage to
children of Texas' migrant and seasonal agricultural workers.
If the study indicates that extension of coverage is
cost-effective, the state may develop a pilot health care coverage
program for this population.
$800,000 to fund hepatitis A vaccinations for preschoolers and
adolescents living in counties with high incidences of the disease,
including Dallas, Harris (Houston), and numerous border
$300,000 to fund SB 55, which establishes a statewide education
program to prevent infant mortality.
PRESCRIPTION DRUG COVERAGE
$35 million to implement a prescription drug benefit plan for
low-income senior citizens and to establish a bulk-purchasing
program for prescription drugs offered through Texas' public health
care programs, including Medicaid, employee and teacher retirement
systems, and prison health care.
NURSING SHORTAGE RELIEF
$1.44 million to provide additional funding for registered nurse
educational programs. The monies will allow nursing programs to
hire more faculty and secure more classroom and training space to
accommodate more students.
LONG-TERM CARE QUALITY
In response to physicians' and patients' concerns about health
care quality within nursing homes, the legislature allocated
$180,000 in state funds to survey nursing facility residents about
their quality of care and quality of life. Another $500,000 was
allocated to perform on-site case reviews of nursing home
residents' care. The survey and on-site reviews will be conducted
by the Department of Human Services, which is required to report
its findings to the legislature by January 2003.
TEACHER HEALTH INSURANCE
To fund health care coverage for teachers, the legislature
allocated $1.8 billion over the biennium. Funding begins in the
second half of the biennium, starting in September 2002.
Long-Term Care and End-of-Life
Market Fairness/Managed Care
Medical Licensure and
Public Health and Science
Scope of Practice
Tort Reform/Medical Liability