TMA Legislative Hotline

Hotline is a daily electronic newsletter exclusively for TMA members that reports the legislature's latest actions on bills affecting Texas medicine.

Legislative Hotline: Prescription Monitoring and Professional Liability Bills Highlight Today’s Deliberations

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1.25 mental health

UNDER THE ROTUNDA

Today is the 130th day of the session. But who’s counting?

The House and Senate both have less than one week to vote on bills, which must be complete by midnight May 22.

Meanwhile, lawmakers are finalizing negotiations on the final 2020-21 state budget; the deadline for agreement between the two chambers is midnight May 26.

Here’s a status check on numerous bills that continue to move through the legislative process.

Prescription Monitoring Program/Opioids – TMA supports these three bills, which are scheduled for a hearing today in the Senate Health and Human Services Committee:

  • House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville), which would require electronic prescribing of opioids unless a waiver is granted, and establish an advisory committee to the State Board of Pharmacy.
  • House Bill 3285, also by Representative Sheffield, which would permit telehealth treatment for substance use, provide grants to law enforcement agencies to provide opioid antagonists, develop and implement an opioid misuse public awareness campaign, and collect and analyze data regarding opioid overdose deaths.                    
  • House Bill 2174, by Rep. John Zerwas, MD (R-Richmond) – which would help physicians address the opioid crisis by limiting the duration of opioid prescriptions, require electronic prescribing after Jan. 1, 2021, require opioid-related CME, and specify that prior authorization is prohibited for medication-assisted treatment for opioid use disorder.             

Professional Liability

  • House Bill 2362 by Rep. Joe Moody (D-El Paso) – which would create an exception to the willful and wanton emergency medical care standard if a physician or other health care provider negligently causes a stable patient to require emergency medical treatment – is set for a hearing today in the Senate State Affairs Committee. After extensive negotiation and revision, TMA supports the bill.

Insurance

  • Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio), which would require health plan directories to clearly identify which physician specialties are in network at network facilities, is set for final debate on today’s House Calendar. TMA testified in support of this bill.
  • House Bill 1832 by Rep. Julie Johnson (D-Carrollton) – which would prohibit health plan coverage of an emergency care claim dependent on utilization review, protecting the prudent layperson standard – was heard yesterday in the Senate Business and Commerce Committee and left pending. TMA supports this bill.
  • House Bill 3041 by Rep. Chris Turner (D-Grand Prairie) – which would allow for renewal of a prior authorization if it expires before the patient receives the medical service or procedure – was heard yesterday in the Senate Business and Commerce Committee and left pending. TMA supports this bill.

Maternal Health

  • Senate Bill 436 by Sen. Jane Nelson (R-Flower Mound), which directs the Department of State Health Services to develop and implement initiatives to assist pregnant and postpartum women with opioid use disorder and newborns with neonatal abstinence syndrome, is set on the House Calendar today. This bill is specifically referring to the TexasAIM Opioid Bundle that evolved out of the Maternal Mortality and Morbidity Task Force and is strongly supported by TMA.
  • House Bill 25 by Rep. Mary Gonzalez (D-Clint), which would create a pilot program to streamline nonemergent medical transportation services in Medicaid and allow children to accompany their pregnant mothers on doctor’s visits, was voted out of the Senate 30-1 yesterday. The House now must decide whether to accept the amendments the Senate made to the bill or ask for a conference committee to negotiate the differences. TMA testified in support of this bill last month.

Tobacco

  • Senate Bill 21 by Sen. Joan Huffman (R-Houston) – which would raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military – is eligible today for senators to consider the amendments representatives added to the bill. TMA testified in strong support of SB 21 earlier this session.

Telemedicine

  • House Bill 3345 by Rep. Four Price (R-Amarillo) – which would allow physicians to choose the best platform for providing telemedicine services, rather than having health plans dictate the platform – was heard in the Senate Business and Commerce Committee yesterday and left pending. TMA strongly supports this bill.

Scope of Practice

  • Senate Bill 2438 by Sen. Jose Rodriguez (D-El Paso), which would allow “full practice” authority for Advanced Practice Registered Nurses (APRNs), was heard in the Senate Business and Commerce Committee yesterday and left pending. TMA opposes this bill  .

Graduate Medical Education/Workforce

  • House Bill 80 by Rep. Lina Ortega (D-El Paso) would have the Texas Higher Education Coordinating Board (THECB) conduct a study and develop an inventory of existing doctoral-level health science education programs. THECB would then issue a report to the legislature with recommendations for establishing new programs and for expanding existing ones. HB 80 was voted out of the Senate 19-12 without amendments and should head next to Gov. Greg Abbott’s desk. TMA supports this bill.

TMA is watching each bill, committee substitute, and amendment for any changes, or for an opportunity to amend a stalled TMA-supported bill. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT.

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the regular legislative session and the quickly approaching interim.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador.

PHYSICIAN OF THE DAY

Today’s physician of the day is Banafsheh Moshiree Thomas, MD, of Grand Prairie. Dr. Thomas graduated from St. George’s University School of Medicine in Grenada and is a member of the Dallas County Medical Society.

WHAT WE’RE READING

Texas House passed one of the nation’s toughest drug-pricing bills. Is it too good to be true? – Houston Chronicle

Texas Poised to Raise the Legal Smoking Age to 21 – U.S. News & World Report

Senate seeks to extend time in end-of-life hospital disputes – Austin American-Statesman

Voters happy with their healthcare, survey finds, highlighting risks of sweeping reform plans – Washington Examiner

White House Wants Patients to Know Health-Care Prices Up Front – The Wall Street Journal

Texas Health to build $128 million specialty center for women and infants in Denton – The Dallas Morning News

Hope still alive for Medicaid system fixes – The Dallas Morning News

US Birth Rate Continues to Fall – The Associated Press

‘I felt cheated. I felt robbed.’ Central Texas mothers share their experiences with postpartum mood – KVUE-TV

Texas Tech University Health Sciences Center of El Paso awarded telemedicine expansion grant – KVIA-TV


 

Legislative Hotline: Patient-Friendly Insurance Bills Top Today’s Calendar

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Capitol_Dome

UNDER THE ROTUNDA

Today is the 130th day of the 140-day session.

Time is quickly running out for bills to pass. Fortunately, physicians’ priority bills are still moving toward the finish line.

The House and Senate both have less than one week to vote on bills, which must be complete by midnight May 22.

Meanwhile, lawmakers will continue to negotiate the final 2020-21 state budget; the deadline for agreement between the two chambers is midnight May 26. The Texas Medical Association remains steadfast in its request for more funding for Medicaid, women’s health, mental health, and graduate medical education (GME), and will continue to vigorously plead our case.

Bills set on House and Senate calendars occasionally roll over to the next day if time runs out to debate them on the floor, and that happened again yesterday. Here’s a status check on numerous bills that continue to move through the legislative process.

Insurance

  • House Bill 1832 by Rep. Julie Johnson (D-Carrollton) – which would prohibit health plan coverage of an emergency care claim dependent on utilization review, protecting the prudent layperson standard – is set for a hearing today in the Senate Business and Commerce Committee. TMA supports this bill.
  • Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio) – which would require health plan directories to clearly identify which physician specialties are in network at network facilities – is set for floor debate on today’s House Calendar. TMA testified in support of this bill.

Maternal Health

  • House Bill 25 by Rep. Mary Gonzalez (D-Clint), which would create a pilot program to streamline nonemergent medical transportation services in Medicaid and allow children to accompany their pregnant mothers on doctor’s visits, is on today’s Senate Calendar. TMA testified in support of this bill last month.
  • House Bill 1111 by Rep. Sarah Davis (R-West University Place), which would direct the Health and Human Services Commission (HHSC) to establish new pregnancy medical home pilots in Texas, was heard in the Senate Health and Human Services Committee yesterday and left pending. TMA testified in support of this bill last month.  

Tobacco

  • Senate Bill 21 by Sen. Joan Huffman (R-Houston) – which would raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military – was voted out of the House yesterday 110-36. It now returns to the Senate for consideration of the amendments representatives added to the bill. TMA testified in strong support of SB 21 earlier this session.

Corporate Practice of Medicine

  • House Bill 1532 by Rep. Morgan Meyer (R-Dallas), which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference, was heard in the Senate Health and Human Services Committee yesterday and left pending. TMA testified in support of this bill in March.  

Graduate Medical Education/Workforce

  • House Bill 80 by Rep. Lina Ortega (D-El Paso) would have the Texas Higher Education Coordinating Board (THECB) conduct a study and develop an inventory of existing doctoral-level health science education programs. THECB would then issue a report to the legislature with recommendations for establishing new programs and for expanding existing ones. HB 80 is set on today’s Senate Calendar. TMA supports this bill.  

Telemedicine

  • Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway), which would require Medicaid to cover telemedicine services, is set on today’s Senate Items Eligible Calendar for consideration of amendments the House added to the bill. TMA supports this bill.
  • House Bill 871 by Rep. Four Price (R-Amarillo), which would expand the use of telemedicine to rural trauma hospitals, is set on today’s Senate Calendar. TMA supports this bill.

Prescription Monitoring Program/Opioids

  • House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville) –  which would require electronic prescribing of opioids unless a waiver is granted, and establish an advisory committee to the State Board of Pharmacy –  is set for a hearing tomorrow in the Senate Health and Human Services Committee. TMA supports this bill.
  • House Bill 2088 by Rep. Jay Dean (R-Longview), which would require health care professionals dispensing controlled substance prescriptions to provide written notice of the closest safe disposal location and other safe disposal methods available, was heard in the Senate Health and Human Services Committee yesterday and left pending. TMA supports this bill.

Long-Term Care/Immunizations

  • House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which would establish infection control programs in long-term care facilities, was heard in the Senate Health and Human Services Committee yesterday and left pending. TMA testified in support of HB 1848 in March and continues to support the bill.
  • House Bill 1256 by Rep. Dade Phelan (R-Beaumont), which would grant first responders and their employers access to first responders’ vaccination records on the statewide immunization registry during a disaster, passed in the yesterday and will now head to the governor. TMA testified in support of this bill last month.
  • House Bill 1418, also by Representative Phelan, which would provide first responders and emergency services personnel with their immunization status when they seek certification or recertification, also won Senate approval yesterday and will now head to the governor. TMA testified in support of this bill last month.

Professional Liability

  • House Bill 2362 by Rep. Joe Moody (D-El Paso) – which would create an exception to the willful and wanton emergency medical care standard if a physician or other health care provider negligently causes a stable patient to require emergency medical treatment – is set for a hearing tomorrow in the Senate State Affairs Committee. After extensive negotiation and revision, TMA supports the bill.

TMA is watching each bill, committee substitute, and amendment for any changes, or for an opportunity to amend a stalled TMA-supported bill. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the regular legislative session and the interim.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador

PHYSICIAN OF THE DAY

Today’s physician of the day is Joe Ventimiglia, MD, of Dallas. Dr. Ventimiglia graduated from the Duke University School of Medicine and is a member of both TMA and the Dallas County Medical Society.

Legislative Hotline: Texas Medical Board Sunset and Tobacco 21 Bills Make Progress

(Budget, Health Insurance, Medicaid, Public Health, Texas Medical Board, Women’s Health) Permanent link

May_Runoff

UNDER THE ROTUNDA

Today is the 129th day of the session.

In the final 11 days of this session, much of the negotiations to pass or kill bills will happen behind the scenes. The calendar will run out of time, stranding many bills. The Texas Medical Association will keep fighting for physicians’ priority bills until the last minute.

The House and Senate both have one week to vote on bills, which must be complete by midnight May 22.

Meanwhile, lawmakers will continue to negotiate the final 2020-21 state budget; the deadline for agreement between the two chambers is midnight May 26. TMA remains steadfast in its request for more funding for Medicaid, women’s health, mental health, and graduate medical education (GME), and will vigorously plead our case, particularly after comptroller Glenn Hegar on Tuesday revised the state’s revenue estimate for the next two years. The new estimate will give lawmakers an additional $500 million to spend on public programs.

Bills set on House and Senate calendars occasionally roll over to the next day if time runs out to debate them on the floor, and that happened yesterday. Here’s a status check on numerous bills that continue to move through the legislative process.

TMB Sunset/Corporate Practice of Medicine

  • House Bill 1504 by Rep. Chris Paddie (R-Marshall), the Texas Medical Board (TMB) Sunset bill that would extend the TMB for another 12 years, was voted unanimously out of the Senate yesterday. The House must now decide whether to accept changes the Senate made to the bill or request a conference committee to negotiate the differences. TMA testified in support of this bill earlier this session.
  • House Bill 1532 by Rep. Morgan Meyer (R-Dallas), which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference, will be heard in the Senate Health and Human Services Committee today. TMA testified in support of this bill in March.  

Tobacco and Cancer

  • Senate Bill 21 by Sen. Joan Huffman (R-Houston) – which would raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military – passed out of the House with amendments today. The Senate must now decide whether to accept changes the House made to the bill or request a conference committee to negotiate the differences. TMA testified in strong support of SB 21 earlier this session and is optimistic the bill will pass.
  • House Bill 39 by Rep. John Zerwas, MD (R-Richmond), which would repeal the 2022 sunset date for the Cancer Prevention and Research Institute of Texas (CPRIT) and extend it by 10 years, was sent to the governer yesterday.
  • House Joint Resolution 12, also by Representative Zerwas, is the funding mechanism for HB 39. HJR 12 proposes a constitutional amendment authorizing the legislature to increase the maximum bond funding for CPRIT. The institute will exhaust its initial allotment of $3 billion by 2021; HJR 12 would replenish those funds, with voter approval. HJR 12 was filed with the Secretary of State yesterday to be placed on the November ballot. TMA strongly supports this measure.

Graduate Medical Education/Workforce

  • House Bill 1065 by Rep. Trent Ashby (R-Lufkin) – which would create a grant program to develop residency training tracks to prepare physicians for practice in rural, underserved settings – was voted out of the Senate 29-2 yesterday. It now returns to the House for consideration of amendments senators added to the bill. TMA submitted written testimony in support of this bill earlier this month.

House Bill 80 by Rep. Lina Ortega (D-El Paso) would have the Texas Higher Education Coordinating Board (THECB) conduct a study and develop an inventory of existing doctoral-level health science education programs. THECB would then issue a report to the legislature with recommendations for establishing new programs and for expanding existing ones. HB 80 is set on today’s Senate Calendar. TMA supports this bill.  

Maternal Health

  • House Bill 1111 by Rep. Sarah Davis (R-West University Place), which would direct the Health and Human Services Commission (HHSC) to establish new pregnancy medical home pilots in Texas, is set for a hearing in the Senate Health and Human Services Committee today. TMA testified in support of this bill last month.
  • House Bill 25 by Rep. Mary Gonzalez (D-Clint), which would create a pilot program to streamline nonemergent medical transportation services in Medicaid and allow children to accompany their pregnant mothers on doctor’s visits, is on today’s Senate Calendar. TMA testified in support of this bill last month.

Mental Health

  • House Bill 10 by Rep. Senfronia Thompson (D-Houston) would create the Texas Mental and Behavioral Health Research Institute, award grants to increase the number of psychiatric residency positions, and create a child and adolescent psychiatric nursing grant program. It is set on today’s Senate Calendar. TMA submitted written testimony in support of the bill.

Telemedicine

  • Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway), which would require Medicaid to cover telemedicine services, was voted out of the House 138-0 yesterday. It now returns to the Senate for consideration of amendments the House added to the bill. TMA supports this bill.
  • House Bill 871 by Rep. Four Price (R-Amarillo), which would expand the use of telemedicine to rural trauma hospitals, is set on today’s Senate Calendar. TMA supports this bill.
  • House Bill 1960, also by Representative Price – which would create a Governor’s Broadband Council that must include a medical advocacy representative – is on its way to Gov. Greg Abbott’s desk after the House agreed to Senate amendments yesterday. TMA supports this bill.

Prescription Monitoring Program/Opioids

  • House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville) –  which would require electronic prescribing of opioids unless a waiver is granted, and establish an advisory committee to the State Board of Pharmacy –  was referred to the Senate Health and Human Services Committee yesterday and awaits a hearing. TMA supports this bill.
  • House Bill 2088 by Rep. Jay Dean (R-Longview), which would require health care professionals dispensing controlled substance prescriptions to provide written notice of the closest safe disposal location and other safe disposal methods available, is set for a hearing in the Senate Health and Human Services Committee today. TMA supports this bill.

Long-Term Care/Immunizations

  • House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which would establish infection control programs in long-term care facilities, is set for a hearing in the Senate Health and Human Services Committee today. TMA testified in support of HB 1848 in March and continues to support the bill.
  • Senate Bill 1519 by Senator Kolkhorst, which would establish a statewide council on long-term care facilities, was voted out of the House Human Services Committee yesterday and awaits debate on the House floor. TMA submitted written testimony in support of the bill last month.
  • House Bill 1256 by Rep. Dade Phelan (R-Beaumont), which would grant first responders and their employers access to first responders’ vaccination records on the statewide immunization registry during a disaster, is set on today’s Senate Local and Uncontested Calendar, meaning it faces no opposition. TMA testified in support of this bill last month.
  • House Bill 1418, also by Representative Phelan,  which would provide first responders and emergency services personnel with their immunization status when they seek certification or recertification, also is set on today’s Senate Local and Uncontested Calendar. TMA testified in support of this bill last month.

Insurance

  • Senate Bill 1037 by Sen. Larry Taylor (R-Friendswood) – which would prohibit a credit reporting agency from including on a credit report a collection account for health care services if (1) a consumer was covered by a health benefit plan at the time the out-of-network health care service was incurred; (2) the service was performed by an emergency care provider or facility-based provider; and (3) the collection was for an outstanding balance due to that provider after any applicable copayments, deductibles, and coinsurance – passed 141-0 on the House Local Calendar yesterday. Taking patients out of surprise billing scenarios would render moot the issue of credit reporting for health care. TMA testified against this bill last month.
  • House Bill 1941 by Representative Phelan – which would prohibit free-standing emergency facilities from charging “unconscionable” rates, defined as 200 percent or more of the average charge for the same or substantially similar treatment at a hospital emergency room – was voted out of the Senate Business and Commerce Committee yesterday and awaits debate on Senate floor. TMA supports this bill.

End of Life

  • Senate Bill 2089 by Sen. Bryan Hughes (R-Mineola) – which would require hospitals, physicians, nurses, and other health care professionals to provide what physicians believe amounts to medically inappropriate and potentially harmful care for an unlimited period of time – was voted out of the Senate 22-8-1 yesterday. SB 2089 now heads to the House to await committee referral. TMA continues to vehemently oppose this bill.

Professional Liability

  • House Bill 2362 by Rep. Joe Moody (D-El Paso) – which would create an exception to the willful and wanton emergency medical care standard if a physician or other health care provider negligently causes a stable patient to require emergency medical treatment – yesterday was referred to the Senate State Affairs Committee, where it awaits a hearing. After extensive negotiation and revision, TMA supports the bill.

TMA is watching each bill, committee substitute, and amendment for any changes, or for an opportunity to amend a stalled TMA-supported bill. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the regular legislative session and the interim.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador

PHYSICIAN OF THE DAY

Today’s physician of the day is Dana Sprute, MD, of Austin. Dr. Sprute graduated from the UT Health San Antonio Long School of Medicine and is a member of both TMA and the Travis County Medical Society.

WHAT WE’RE READING

The Potentially Lifesaving Difference in How a Gun Is Stored – The New York Times

With cancer rates rising worldwide, oncologist shortage predicted – Reuters  

Rate of type-2 diabetes in children in skyrocketing – KENS-TV

State shouldn’t punish people for being poor [Opinion] – Beaumont Enterprise

Health care’s payment model needs changing before the medical system will improve – Houston Business Journal

Tarrant County Named on Most At Risk List for Measles Outbreaks – KXAS-TV

 

Legislative Hotline: Insurance Bills In the Spotlight Today

(Budget, Health Insurance, Liability Reform, Medicaid, Public Health, Scope of Practice, Texas Medical Board, Women’s Health) Permanent link

state-capitol

UNDER THE ROTUNDA

Today is the 128th day of the session.

In the waning days of this session, it is important to remember that it is much easier to stop a bill than to pass one, and frequently bills pass incrementally over several sessions. Perfect must not be the enemy of the good as the calendar winds down.

Having said that, medicine is strategically working every angle to salvage important bills that have stalled in the legislative process.

This week Senate bills will move in the House and vice-versa; the House must hear all Senate bills by midnight May 22. Meanwhile, lawmakers will continue to negotiate the final 2020-21 state budget until the last possible moment. The House and Senate must concur on the budget by midnight May 26.

The Texas Medical Association remains steadfast in its request for more funding for Medicaid, women’s health, mental health, and graduate medical education (GME). We will report developments as they happen.

Bills on House and Senate calendars occasionally roll over to the next day if time runs out to debate them on the floor. Here’s a status check of several bills that continue to move through the legislative process.

Insurance

  • House Bill 2041 by Rep. Tom Oliverson, MD (R-Cypress) – which would require freestanding emergency room facilities to post conspicuous notices that the facility or the physician might be out of network, along with written disclosure of possible observation and facility fees – was heard in the Senate Business and Commerce Committee today and left pending. TMA continues to support this bill.
  • House Bill 2099 by Rep. Stan Lambert (R-Abilene), which would prohibit a health plan from changing a patient’s drug coverage upon plan renewal if the patient has been stable on that drug, also was heard in the Senate Business and Commerce Committee today  and left pending. TMA submitted written testimony in support of this bill in March.
  • House Bill 2327 by Rep. Greg Bonnen, MD (R-Friendswood), which would require both greater prior authorization transparency and that utilization reviews be conducted by a licensed Texas physician, was heard in the Senate Business and Commerce Committee today and left pending. Austin oncologist Debra Patt, MD, testified in support of this bill today.
  • House Bill 3911 by Rep. Hubert Vo (D-Houston) – which would require the Texas Department of Insurance to examine the network adequacy of preferred provider organizations and exclusive provider organizations at least once every three years – was heard in the Senate Business and Commerce Committee today  and left pending. TMA testified in support of HB 3911 last month.
  • Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills) – which would require baseball-style arbitration for most surprise medical bills, removing the patient from the billing dispute and resolution process – was voted out of the House Insurance Committee yesterday and awaits a debate on the House floor. SB 1264 continues to be a work in progress as it moves through the legislative process. TMA supports the revised bill and is working with the bill’s authors on improvements to the language.

TMB Sunset/Corporate Practice of Medicine

  • House Bill 1504 by Rep. Chris Paddie (R-Marshall), the Texas Medical Board (TMB) Sunset bill that would extend the TMB for another 12 years, is on the Senate Calendar for today. TMA testified in support of this bill earlier this session.
  • House Bill 1532 by Rep. Morgan Meyer (R-Dallas), which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference, will be heard in the Senate Health and Human Services Committee tomorrow. TMA testified in support of this bill in March.  

Tobacco

  • Senate Bill 21 by Sen. Joan Huffman (R-Houston) – which would raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military – is set for debate in the House today. TMA testified in strong support of SB 21 earlier this session and is cautiously optimistic the bill will pass.

Maternal Health

  • House Bill 1111 by Rep. Sarah Davis (R-West University Place), which would direct the Health and Human Services Commission (HHSC) to establish new pregnancy medical home pilots in Texas, is set for a hearing in the Senate Health and Human Services Committee tomorrow. TMA testified in support of this bill last month. 
  • Senate Bill 750 by Sen. Lois Kolkhorst (R-Brenham), which would improve maternal access to postpartum care through the Healthy Texas Women Program, was voted out of the House Public Health Committee yesterday and awaits debate on the House floor. TMA testified in support of this bill earlier this session.
  • Senate Bill 436 by Sen. Jane Nelson (R-Flower Mound), which directs the Department of State Health Services (DSHS) to develop and implement initiatives to assist pregnant and postpartum women with opioid-use disorder and newborns with neonatal-abstinence syndrome, was voted out of the House Public Health Committee yesterday and awaits debate on the House floor. This bill specifically refers to the TexasAIM Opioid Bundle that evolved out of the Maternal Mortality and Morbidity Task Force and is strongly supported by TMA.

Mental Health

  • House Bill 10 by Rep. Senfronia Thompson (D-Houston) would create the Texas Mental and Behavioral Health Research Institute, award grants to increase the number of psychiatric residency positions, and create a child and adolescent psychiatric nursing grant program. It was voted out of the Senate Health and Human Services Committee yesterday and awaits debate on the Senate floor. TMA submitted written testimony in support of the bill .
  • House Joint Resolution 5, also by Representative Thompson, is the funding mechanism for HB 10. HJR 5 would allocate $100 million in each fiscal year to the Texas mental and behavioral health research fund that HB 10 would establish, as long as the state collects more than $30.5 billion in sales, excise, and use tax revenue in that fiscal year. HJR 5 was heard in the Senate Finance Committee yesterday and left pending. If HJR 5 passes, Texans will vote on the constitutional amendment in November. TMA supports this bill.
  • Senate Bill 10 by Senator Nelson – which would create the Texas Mental Health Care Consortium, a collaboration of health-related institutions of higher education and the Statewide Behavioral Health Coordinating Council to improve the effectiveness of and access to behavioral health care for Texas youth – was voted out of the House Public Health Committee yesterday and awaits a debate on the House floor. TMA testified in support of this bill in early May.

Telemedicine

  • Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway), which would require Medicaid to cover telemedicine services, won preliminary approval in the House yesterday and awaits a final vote today. TMA supports this bill.

Prescription Monitoring Program

  • House Bill 3285 by Rep. J.D. Sheffield, DO (R-Gatesville) would permit telehealth treatment for substance use, provide grants to law enforcement agencies to provide opioid antagonists, develop and implement an opioid misuse public awareness campaign, and collect and analyze data regarding opioid overdose deaths. HB 3285 was voted out of the House 119-18 late last week and awaits committee referral in the Senate. TMA supports this bill.

Long-Term Care

  • House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which would establish infection control programs in long-term care facilities, is set for a hearing in the Senate Health and Human Services Committee tomorrow. TMA testified in support of HB 1848 in March and continues to support the bill.
  • Senate Bill 1519 by Senator Kolkhorst, which would establish a statewide council on long-term care facilities, is set for a hearing in the House Human Services Committee today. TMA submitted written testimony in support of the bill last month.

Graduate Medical Education

  • House Bill 1065 by Rep. Trent Ashby (R-Lufkin) – which would create a grant program to develop residency training tracks to prepare physicians for practice in rural, underserved settings – is on today’s Senate Calendar. TMA submitted written testimony in support of this bill earlier this month.
  • Senate Bill 1378 by Senator Buckingham, which would require new medical schools to account for peak class sizes – and not merely inaugural class sizes – when planning residency slots, has been sent to the governor. TMA supported this bill.

TMA is watching each bill, committee substitute, and amendment for any changes, or for an opportunity to amend a stalled TMA-supported bill. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the regular legislative session and the interim.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador

PHYSICIAN OF THE DAY

Today’s physician of the day is Sylvia Garcia-Beach, MD, of  Austin. Dr. Garcia-Beach graduated from the University of Illinois at Chicago College of Medicine and is a member of both TMA and the Travis County Medical Society.

WHAT WE’RE READING

Legislature extends cancer agency; issue is now up to voters – Houston Chronicle

50,000 Texas children a year lose Medicaid over paperwork. A bill to change that died. – Houston Chronicle 

A Republican legislator’s tirade gives a misleading impression of the vaccine choice movement [Opinion]Houston Chronicle

MAPPED: See which Texas districts and private schools have high vaccine exemption rates – KXAN-TV

Leave health care decisions to patient and doctor, not cost-cutting insurance industry [Opinion]  – Fort Worth Star-Telegram

Commentary: Let’s give new Texas moms a lifeline [Opinion] – Austin American-Statesman

Why Racial Gaps In Maternal Mortality Persist – NPR

Health industry to clash over surprise medical bills – The Hill

Report shows costs of medical procedures all over the map – San Antonio Express-News

44 states accuse drug companies of price-fixing – The Hill

 

Legislative Hotline: Insurance, Public Health, Opioids, and Sunset Bills Still Alive With Two Weeks Left in Session

(Budget, End-of-Life Care, Liability Reform, Medicaid, Public Health, Scope of Practice, Texas Medical Board, Women’s Health) Permanent link

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UNDER THE ROTUNDA

Today is the 126th day of this session; fourteen days remain. This week Senate bills will move in the House and vice-versa. Meanwhile, lawmakers will continue to negotiate the final 2020-21 state budget until the last possible moment. 

The Texas Medical Association remains steadfast in its request for more funding for Medicaid, women’s health, mental health, and graduate medical education (GME.) We will report developments as they happen.

Friday at midnight was the deadline for House bills to receive final approval in the House, and many bills medicine is tracking are still in the game. Here’s a status check of several bills that continue to move through the legislative process.

TMB Sunset/Corporate Practice of Medicine

  • House Bill 1504 by Rep. Chris Paddie (R-Marshall), the Texas Medical Board (TMB) Sunset bill that would extend the TMB for another 12 years, is on the Senate Calendar for today. TMA testified in support of this bill earlier this session.  

Maternal Health

  • House Bill 744 by Rep. Toni Rose (D-Dallas), which would allow continued Medicaid coverage for eligible women up to 12 months postpartum, was voted out of the House 87-43 and now heads to the Senate. Medicaid coverage currently expires 60 days after delivery, but the vast majority of maternal deaths occur from 61 to 365 days postpartum. TMA supports this bill.
  • Senate Bill 749 by Sen. Lois Kolkhorst (R-Brenham), which would establish level of care designations for hospitals that provide maternal and neonatal care, was voted out of the House Public Health Committee and awaits initial debate on the House floor. TMA supports this bill.  

Mental Health

  • House Bill 10 by Rep. Senfronia Thompson (D-Houston) – which would create the Texas Behavioral Health Research Institute, award grants to increase the number of psychiatric residency positions, and create a child and adolescent psychiatric nursing grant program – was voted out of the Senate Health and Human Services Committee and awaits debate on the Senate floor. TMA submitted written testimony in support of the bill.

Tobacco

  • Senate Bill 21 by Sen. Joan Huffman (R-Houston ) – which would raise the minimum age to purchase tobacco and vape products to 21 years, excluding active duty military – is set for debate on the House floor tomorrow. TMA testified in strong support of SB 21 earlier this session.

Insurance

  • House Bill 1880 by Rep. Sarah Davis (R-West University Place), which would establish time limits for corrections and updates to be made to insurers’ online network directories, was voted out of the House 116-18 Friday and heads to the Senate. TMA supports this bill.
  • House Bill 2041 by Rep. Tom Oliverson, MD (R-Cypress ) – which would require freestanding emergency room facilities to post conspicuous notices that the facility or the physician might be out of network, along with written disclosure of possible observation and facility fees – is set for a hearing in the Senate Business and Commerce Committee tomorrow. TMA continues to support this bill.
  • House Bill 2099 by Rep. Stan Lambert (R-Abilene), which would prohibit a health plan from changing a patient’s drug coverage upon plan renewal if the patient has been stable on that drug, is set for debate in the Senate Business and Commerce Committee tomorrow. TMA submitted written testimony in support of this bill in March.
  • House Bill 2327 by Rep. Greg Bonnen, MD (R-Friendswood), which would require both greater prior authorization transparency and that utilization reviews be conducted by a licensed Texas physician, is set for a hearing in the Senate Business and Commerce Committee tomorrow. TMA testified in support of this bill last month.
  • House Bill 3911 by Rep. Hubert Vo (D-Houston), which would require the Texas Department of Insurance to examine the network adequacy of preferred provider organizations and exclusive provider organizations at least once every three years – is set for debate in the Senate Business and Commerce Committee tomorrow. TMA testified in support of HB 3911 last month.
  • Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills) – which would require baseball-style arbitration for most surprise medical bills, removing the patient from the billing dispute and resolution process – continues to be a work in progress as it moves through the legislative process. TMA supports the revised bill and is working with the bill’s authors on improvements to the language.

Telemedicine

  • Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway), which would require Medicaid to cover telemedicine services, is set for debate on the House floor today. TMA supports this bill.

Prescription Monitoring Program

  • House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville ) – which would require electronic prescribing of opioids, unless a waiver is granted, and establish an advisory committee to the State Board of Pharmacy – was voted out of the House 136-3 and heads to the Senate. TMA supports this bill.
  • Senate Bill 2316 by Sen. Juan “Chuy” Hinojosa (D-McAllen) would delay the mandate to check the Prescription Drug Monitoring Program (PMP) until March 1, 2020, to allow time for integration of the PMP into physicians’ electronic health records. The bill also would create an advisory committee to the Board of Pharmacy. TMA supports this bill, which was voted out of the House Public Health Committee and awaits debate on the House floor. 

Long-Term Care

  • House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which would establish infection control programs in long-term care facilities, is set for debate in the Senate Health and Human Services Committee tomorrow. TMA testified in support of HB 1848 in March and continues to support the bill.

Graduate Medical Education

  • House Bill 1065 by Rep. Trent Ashby (R-Lufkin ) – which would create a grant program to develop residency training tracks to prepare physicians for practice in rural, underserved settings – is on today’s Senate Calendar. TMA submitted written testimony in support of this bill earlier this month.
  • Senate Bill 1378 by Senator Buckingham, which would require new medical schools to account for peak class sizes – and not merely inaugural class sizes – when planning residency slots, has been sent to the governor. TMA strongly supports this bill.  

Medical Liability

  • House Bill 1693 by Rep. John Smithee (R-Amarillo), which would revise timelines established to submit medical expense affidavits in legal cases, was set for debate in the Senate State Affairs Committee today. TMA supports this bill.  

Bills that didn’t get passed by the deadline on their own can be proposed as amendments to legislation that is moving, a strategy that is not always successful. Conventional wisdom among legislators is that if a bill couldn’t get out of committee, it must not be worthy to be an amendment.

The next major hurdle: the House must consider Senate bills for their initial debate on the House floor by midnight, Tuesday, May 21 – next week.

TMA is watching each bill, committee substitute, and amendment for any changes. It is not uncommon for revised legislation to prompt a revised position from TMA, particularly when bad bills become better bills through rewriting or amendments. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador

PHYSICIAN OF THE DAY

Today’s physician of the day is Jocelyn Wilson, MD, of Temple. Dr. Wilson graduated from the Quillen College of Medicine at East Tennessee State University and is a member of both TMA and the Bell County Medical Society.

WHAT WE’RE READING

Travis County among the riskiest locations for measles outbreak, UT study says – KVUE-TV

Many Hospitals Charge Double or Even Triple What Medicare Would Pay – The New York Times

Trump calls on Congress to end ‘surprise medical bills’ – The Associated Press

Mumps cases confirmed in Cameron County – Valley Morning Star

CDC: Hepatitis A Cases Quadruple in 5 Years – MedPage Today

Texas House OKs death penalty ban for severely mentally ill – Austin American-Statesman

 

Legislative Hotline: First Bill-Killing Deadline Passes, Leaving Mass Casualties

(Health Insurance, Medicaid, Public Health, Texas Medical Board, Women’s Health) Permanent link

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UNDER THE ROTUNDA

Today is the 123rd day of this session; 17 days remain. Those 17 days will be a flurry of activity and behind-the-scenes maneuvering to keep bills moving toward passage.

Yesterday was a marathon floor session in the House, and today will be more of the same as bills live or die by the clock. Here’s a status check of several bills important to medicine that continue to move through the legislative process:

  • House Bill 744 by Rep. Toni Rose (D-Dallas), which would allow continued Medicaid coverage for eligible women up to 12 months postpartum, received preliminary approval on the House floor yesterday and awaits a final vote in the House today. Medicaid coverage currently expires 60 days after delivery, but the vast majority of maternal deaths occur from 61 to 365 days postpartum. TMA supports this bill.
  • House Bill 1504 by Rep. Chris Paddie (R-Marshall), the Texas Medical Board (TMB) sunset bill that would extend TMB for another 12 years, is on the Senate Calendar for today. TMA testified in support of this bill earlier this session.
  • House Bill 1880 by Rep. Sarah Davis (R-West University Place), which would establish time limits for corrections and updates to be made to insurers’ online network directories, received preliminary approval by the House yesterday and awaits final debate. TMA supports this bill.
  • House Bill 1065 by Rep. Trent Ashby (R-Lufkin), which would create a grant program to develop residency training tracks to prepare physicians for practice in rural, underserved settings, is on today’s Senate Calendar. TMA submitted written testimony in support of this bill earlier this month.
  • House Bill 39 by Rep. John Zerwas, MD (R-Richmond), which would repeal the 2022 sunset date for the Cancer Prevention and Research Institute of Texas (CPRIT) and extend it by 10 years, was voted out of the Senate 29-2 and now heads to the governor. TMA strongly supports this bill.
  • House Joint Resolution 12 also by Representative Zerwas is the funding mechanism for HB 39. HJR 12 proposes a constitutional amendment authorizing the legislature to increase the maximum bond funding for CPRIT. The institute will exhaust its initial allotment of $3 billion by 2021; HJR 12 would replenish those funds, with voter approval. HJR 12 won unanimous approval in the Senate today and will appear on the Nov. 5 general election ballot. TMA strongly supports this measure.
  • Senate Bill 2089 by Sen. Bryan Hughes (R-Mineola), which would require hospitals, physicians, nurses, and other health care professionals to provide what physicians believe amounts to medically inappropriate and potentially harmful care for an unlimited period of time, is set on today’s Senate Intent Calendar. TMA vehemently opposes this bill and encourages you to let your senator know you oppose it, too, by sending a message through TMA’s Grassroots Action Center.
  • Senate Bill 1742 by Sen. José Menéndez (D-San Antonio), which would require health plan directories to clearly identify which physician specialties are in network at network facilities, was voted out of the House Insurance Committee and awaits debate on the House floor. SB 1742’s companion, House Bill 2630 by Rep. Julie Johnson (D-Carrollton), awaits debate in the Senate Business and Commerce Committee.  

If a House bill hadn’t had its initial debate on the House floor by midnight yesterday, it is dead for this session. Among yesterday’s casualties:

  • House Bill 2732 by Rep. Dustin Burrows (R-Lubbock) would have required physicians to receive from patients a signed disclosure form with an itemized statement of the amounts to be billed for nonemergency medical services before those services are provided. Otherwise, the physician would be prohibited from sending an unpaid bill to a credit reporting agency. TMA opposed this bill.
  • House Bill 4013 by Rep. Rick Miller (R-Sugar Land) would have created a new retail tax on e-cigarettes and vape products. The proceeds of the tax would have been dedicated to improving enforcement of current law that prohibits minors from buying these products. TMA and the Texas Public Health Coalition supported this bill.  

Bills that didn’t get passed by the deadline on their own, however, can be proposed as amendments to legislation that is moving, a strategy that is not always successful. Conventional wisdom among legislators is that if a bill couldn’t get out of committee, it must not be worthy to be an amendment.

The next major hurdle: The House must consider most House bills and House Consent Calendar bills for their final debate by midnight, Friday, May 10 – tonight.

The Senate deadlines come later this month.

TMA is watching each bill, committee substitute, and amendment for any changes. It is not uncommon for revised legislation to prompt a revised position from TMA, particularly when bad bills become better bills through rewriting or amendments. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT.

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador

PHYSICIAN OF THE DAY

Today’s physician of the day is Larry Kravitz, MD, of Austin. Dr. Kravitz graduated from the George Washington University School of Medicine and is a member of both TMA and the Travis County Medical Society.

WHAT WE’RE READING

HB 1110 may expand Medicaid for women to a year after delivery [Opinion] – San Antonio Express-News

Bill taxing e-cigs, vapes dies in Texas House after Big Tobacco, Gov. Greg Abbott push late changes – The Dallas Morning News

Report: Reluctance To Vaccinate Hurting Texas’ Ability To Respond To Public Health Threats – Houston Public Media

Why so many primary-care doctors across America are closing their doors – MarketWatch

Texas House to debate bills tackling opioid crisis – KXAN-TV

Texas Mulls Telehealth Pilot for Early Childhood Intervention Services – mHealthIntelligence

CDC: 1.1 million more Americans lost health insurance coverage in 2018 – USA TODAY

Walmart raises age to buy tobacco to 21The Hill

Vaccines are ‘sorcery’? How one Texas legislator is hurting public health [Opinion] – The Dallas Morning News

Trump pushes to end surprise medical billing for hospital care – The Washington Post

Texas Physicians Fight End-of-Life Bill With Passion

(TAKE ACTION NOW, End-of-Life Care) Permanent link

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When the Texas Medical Association urged members to ask their state senators to vote “no” on a key bill regarding treatment disputes at the end of life, they didn’t hold back.

“I believe the whole thing is motivated by a lack of faith in physicians and a desire to impose one group's political will on everyone else without their say so,” Mary Elizabeth Paulk, MD, wrote in an email to Sen. Nathan Johnson (D-Dallas). “This is just wrong.”

Dr. Paulk wasn’t alone. Hundreds of Texas physicians took up the call, using TMA’s Grassroots Action enter to share very personal and passionate messages with their senators.

The outpouring came in response to a TMA action alert against Senate Bill 2089. That bill would require hospitals, physicians, nurses, and other health care professionals to provide medically inappropriate and potentially harmful care for an unlimited period of time.

“Deciding how to spend the final days and hours of life is a highly personal decision, and it’s one we encourage our patients to make long before the need arises,” TMA President Doug Curran, MD, wrote in the alert. “Requiring care in perpetuity would prolong the dying process, exacerbate suffering for both patients and loved ones, and violate the standard of care to do no harm.”

When writing their lawmakers, some physicians shared personal stories of their experiences; excerpts of some of those emails are below:

“SB 2089 takes decisionmaking about dying patients out of the hands of ethicists and physicians who have spent their lives dedicated to training and study so that we understand how best to provide care in exactly these kinds of situations. … When I think of the amount of suffering this bill is going to cause for patients, families, hospitals, and our health system as a whole, I am overwhelmed with sadness.”

- Faith Holmes, MD, to Sen. Donna Campbell (R-New Braunfels) 

“In all honesty there isn't going to be another physician who will accept the transfer. So the patient will be on life support indefinitely without the physician in the current hospital being able to withdraw care. In effect, the first physician could not withdraw care, but a second physician will not likely accept, and therefore, the first physician will be legally obligated to continue care for the patient on life support indefinitely.”

- Amber van den Raadt, DO, to Lt. Gov. Dan Patrick  

“During my intern year, I had a patient with metastatic breast cancer who was only in her 50s. Unfortunately, her cancer was so aggressive that she had now begun to develop fluid buildup (ascites) due to liver failure and later developed renal failure. Because of this, she also had a tremendous amount of acid build-up in her body. She had a husband and two children, and we went above and beyond extraordinary measures trying to save her life as they continued to want aggressive care. Throughout the final stages of our aggressive treatment, I felt sick to my stomach, because it was obvious our interventions were doing more harm than good, and the patient was clearly suffering.”

- Nitya Kumar, MD, to Sen. Borris Miles (D-Houston)

“End-of-life issues are not something that can be legislated in the fashion proposed in SB 2089. These things have to be individualized by patients, families, and their physicians. … It is foolhardy for legislators to presume to know what is correct on an individual basis from a global perspective. Perhaps God can do that but not the Texas Senate. Please keep the state rational and vote against this bill and any others like it that see the light of day.”

- Vik Wall, MD, to Sen. Kel Seliger (R-Amarillo)

TMA is vehemently opposed to SB 2089 by Sen. Bryan Hughes (R-Mineola), which is currently poised for debate on the Senate floor. TMA continues to encourage you to help stop it from making any further progress.

Please contact your state senator today and ask him or her to oppose SB 2089.