In 2005, about a dozen bills were filed to limit or prohibit
physician ownership of hospitals and other facilities. While no
bills to restrict physician ownership passed that year, opponents
of physician ownership vowed to try again in 2007.
In response, TMA organized an Ad Hoc Committee on
Physician/Hospital Relations to develop TMA policy guidance on the
issue. The committee outlined principles relating to "responsible
ownership," focusing not on who owns a facility, but whether the
facility - physician owned or not - provides high-quality,
cost-effective, safe, appropriate, and patient-centered care.
Despite expectations that physician ownership would consume much
of medicine's time during the session, the issue lost its 2005
momentum. Several stakeholders focused on other priorities,
including ensuring greater health plan transparency, reforming
Medicaid, and providing health insurance to more Texans. Only two
bills directly relating to ownership were filed. Both died.
Lawmakers at the federal and state levels remain interested in
physician ownership as do health plans, health policy think tanks
and organized medicine. Regardless of the venue, TMA will
continue to advocate vigorously in favor of responsible ownership
for all investors in the health care system.
Niche Hospital Bill
As filed, Senate Bill 290 by Sen. Jane Nelson (R-Lewisville) would
have, among other provisions, expanded physician disclosure of
ownership interests to include ambulatory surgical centers (ASCs)
and facilities, and required general hospitals, specialty
hospitals, and ASCs to report to the state regarding revenues,
costs, utilization, and investors. The Texas Department of State
Health Services (DSHS) would have been required to use data
collected from ASCs and specialty hospitals to examine their
respective impact on general community hospitals. TMA, the Texas
Hospital Association, and the Texas Ambulatory Surgical Center
Association raised serious concerns about the bill. The bill died
without having a hearing.
Imaging Center Disclosure and Reporting Bill
Senate Bill 1101 by Sen. Robert Duncan (R-Lubbock) related to the
reporting and disclosure of financial arrangements between
referring health care providers and diagnostic imaging providers.
As filed, the bill would have imposed costly and burdensome
reporting requirements on physicians - and their immediate and
extended family members. The bill required that they report to the
state all referrals made to a diagnostic imaging center, facility,
or office. Imaging centers also would have been required to report
referrals received and the investment interest, if any, of the
referring physician (or family member). Additionally, physicians
with investment interests would have been required not only to
disclose that interest, but also to obtain written consent from the
patient before making a referral to a facility in which the
physician had an ownership interest.
TMA, and most specialty societies, strongly opposed the bill,
arguing that provisions within Texas insurance law and the Medical
Practice Act already are sufficient to address any overutilization
of imaging services. However, the Texas College of Radiologists
strongly supported the bill. The bill passed out of Senate State
Affairs after the author modified the bill to address some of TMA's
concerns. Senator Duncan was successful in getting the bill to the
Senate floor, but it died on third reading after TMA and other
specialties issued an Action Alert urging members to call their
Senators in opposition to the bill.
Physician Ownership TMA Staff Team:
Legislative: Greg Herzog
Policy: Helen Kent Davis, Michael Reed, and Rich Johnson
Legal: Lee Spangler
Overview
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Managed Care/Insurance Reform
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Scope of Practice
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Retail Health Clinics
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Corporate Practice of Medicine
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Health Care Funding
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Medicaid, CHIP, and the
Uninsured
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Public Health
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Border Health
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Mental Health
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Emergency Medical Services and
Trauma Care
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Rural Health
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Medical Science and Quality
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Physician Workforce, Licensure,
and Discipline
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Health Information Technology
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Prescription Drugs
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Long-Term Care
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Workers' Compensation
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Abortion
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Franchise Tax Reform