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.

TMA’s Top 10 Victories this Legislative Session

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


The Texas Medical Association scored on a wide range of goals to improve the state’s medical landscape during this year’s session of the Texas Legislature, which concluded in May. 

Which issues in health care and medicine did lawmakers address, and which were left undone? 

In public health, the House of Medicine convinced lawmakers that raising the age to purchase tobacco to 21 was the right thing for the state’s present and future. 

Medicine also successfully persuaded the legislature and Gov. Greg Abbott to improve insurance network adequacy and directories, which will help with surprise medical bills. Insurers’ prior authorization tactics took several damaging hits in the form of TMA-backed bills that became law. 

And the 2020-21 budget includes a number of vital funding increases, including a $68 million increase for women’s health programs, an added $60 million for graduate medical education (GME) slots, and $50 million more for community mental health services. 

TMA’s vice president of advocacy Darren Whitehurst tells us what we need to know about these victories in the TMA Legislative News Hotline’s Top 10 Issues videos. From maternal health improvements to health insurance reform, these brief videos report on progress achieved and opportunities missed this session. 

TMA’s Top 10:  

The Budget  

Surprise Billing Addressed   

Prior-Authorization Improvement Passes  

Efforts to Curb Opioid Abuse  

Scope of Practice  

Mental and Behavioral Health Legislation  

Maternal Health  

Governor Signs Tobacco Use Age Bill  

Volunteer Liability Protection  

TMB Sunset Bill 

And be sure to check out the entire playlist of legislative coverage of TMA physicians’ efforts to urge lawmakers to pass bills to benefit good patient care.

Legislative Hotline: Governor Signs Key Prior Authorization Bill

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



The work of the 86th Texas Legislature passed its final stage at midnight Sunday, the deadline for Gov. Greg Abbott to to sign, veto, or allow bills to become law without his signature.

Among those he signed this weekend was Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio). This bill requires greater transparency with prior authorizations and mandates that utilization reviews be conducted by a Texas-licensed physician in the same or similar specialty as the physician requesting the service or procedure. It also requires health plan directories to clearly identify which physician specialties are in-network at network facilities.

Thank you to our members who contacted the governor to urge him to sign SB 1742. Your advocacy worked.

The governor also signed House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville) which will delay the mandate to check the prescription monitoring program (PMP) until March 2020. The Texas Medical Association fought hard for the delay to give the PMP time to fully integrate with physicians’ electronic records systems. This reduces the hassle involved in using an important clinical tool. HB 3284 also requires electronic prescribing of opioids unless a waiver is granted. Electronic prescribing diminishes the chance of opioids being misused.

The Texas Medical Board (TMB) will not be a political football this year. Governor Abbott signed House Bill 1504 by Rep. Chris Paddie (R-Marshall), which extends the life of the TMB by 12 years – to 2031. In addition, HB 1504 includes provisions to ensure that dismissed or frivolous complaints or disciplinary actions are removed from physicians’ profiles as quickly as possible. It also allows expedited licensing for physicians who hold a full license and are in good standing in another state.

All told, 7,434 bills were filed during the session, which ended May 27. TMA monitored more than 1,900 bills, of which only a handful made it to Governor Abbott.

The outcome of numerous other bills important to medicine is listed below.


Governor Abbott vetoed two bills TMA supported: 

House Bill 448 by Rep. Chris Turner (D-Grand Prairie) would have required transporting a child younger than 2 in a rear-facing car seat unless the child meets certain height and weight thresholds. Governor Abbott vetoed this bill, saying it is overly prescriptive and micromanages parents.

House Bill 455 by Rep. Alma Allen (D-Dallas) would have directed the State Board of Education to develop recess policies that encourage outdoor play time and physical activity. While acknowledging the educational and health benefits of recess, Governor Abbott vetoed the bill, saying it’s another mandate and is bureaucracy for bureaucracy’s sake.


House Bill 1, by Rep. John Zerwas, MD (R-Richmond), is the $250 billion 2020-21 biennial budget. Governor Abbott signed HB 1 with no line-item vetoes. 

The budget does not include any physician rate increases for Medicaid, and it requires the state to find $350 million in Medicaid savings. 

“Physician services have not had any change in payment for 20 years,” TMA Past-President Doug Curran, MD, said. “That’s so wrong. It’s wrong for the patients, it’s wrong for the physicians, and it just makes it impossible for the doctor to continue to see these people that need our help and care.” 

However, the budget does increase funding for programs and initiatives that will help improve maternal health, behavioral health, and graduate medical education. 

Professional Liability

House Bill 2362 by Rep. Joe Moody (D-El Paso) ensures that physicians working in emergency rooms who face high-risk obstetrical cases requiring immediate and difficult decions are protected from unwarranted lawsuits. Notable exceptions to the willful and wanton protection include instances in which the patient’s treatment is unrelated to a medical emergency, and for any physician whose negligent act or omission causes a stable patient to require emergency medical care. Governor Abbott signed HB 2362.

Mothers and Children

House Bill 170 by Rep. Diego Bernal (D-San Antonio) will require health plans to cover diagnostic mammograms at 100%, the same as screening mammograms. The governor signed this bill.

Senate Bill 355 by Sen. Royce West (D-Dallas) directs the Department of Family and Protective Services to create a strategic plan so Texas can access new federal matching funds for services to help children at risk of entering foster care. SB 355 was filed without Governor Abbott’s signature, meaning the bill becomes law.

Senate Bill 952 by Sen. Kirk Watson (D-Austin) will require that child care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards. Governor Abbott filed SB 952 without his signature. 


Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills) will require baseball-style arbitration for most surprise medical bills, effectively removing patients from the billing dispute resolution process. Patients who elect to go out-of-network for health care are not covered by this arbitration process. Governor Abbott signed this bill.

House Bill 1941 by Rep. Dade Phelan (R-Beaumont) will prohibit free-standing emergency facilities from charging “unconscionable” rates, defined as 200% or more of the average charge for the same or substantially similar treatment at a hospital emergency room. HB 1941 will financially protect patients seeking care in an emergency. Governor Abbott signed this bill.

House Bill 3911 by Rep. Hubert Vo (D-Houston) will require the Texas Department of Insurance to examine the network adequacy of preferred provider organizations (PPOs) and exclusive provider organizations (EPOs) at least once every three years. Inadequate or narrow networks contribute to higher costs for patients and frustration for physicians. Governor Abbott signed this bill.

House Bill 1584 by Rep. Senfronia Thompson (D-Houston) will prohibit step therapy protocols for stage-4 metastatic breast cancer. HB 1584 was filed without signature by the governor.

House Bill 1576 by Representative Phelan will allow Medicaid to contract with a transportation network company, such as Uber or Lyft, for nonemergency transportation to or from a medical appointment. Making it easier to get to the doctor will improve patient compliance with prescriptions and other remedies prescribed by the physician. Governor Abbott signed this bill.

House Bill 2536 by Rep. Tom Oliverson, MD (R-Cypress) will require vastly improved transparency regarding prescription drug costs, including posting drug price information on the Health and Human Services Commission’s website and explaining cost increases of greater than 40%. Governor Abbott signed this bill.

House Bill 2041 by Representative Oliverson will 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. Pricing transparency will help patients make more prudent choices for emergency health care. The governor signed this bill.


House Bill 2174 by Representative Zerwas limits the duration of opioid prescriptions, requires electronic prescribing beginning on Jan. 1, 2021, requires opioid-related CME, and prohibits prior authorization for medication-assisted treatment for opioid-use disorder. HB 2174 will help prevent “doctor shopping” by patients seeking opioids for non-therapeutic uses. Governor Abbott signed this bill.

House Bill 3285 by Representative Sheffield will permit telehealth treatment for substance-use disorder, develop and implement an opioid misuse public awareness campaign, and collect and analyze data regarding opioid overdose deaths. Governor Abbott signed this bill. 

Graduate Medical Education/Workforce

House Bill 2261 by Rep. Armando Walle (D-Houston) will increase the Physician Education Loan Repayment Program’s allowable repayment assistance amounts by $5,000 each year, bringing the total amount of repayment assistance available to $180,000. The repayment program is designed to encourage new physicians to start their careers in underserved communities by helping them pay off student loans in return for a four-year practice commitment. Governor Abbott signed this bill.  


House Bill 3345 by Rep. Four Price (R-Amarillo) allows physicians to choose the best platform for providing services rather than having health plans dictate the platform. HB 3345 complements Senate Bill 1107 from the last legislative session, which stipulated that services provided via telemedicine are to be covered the same as any other service provided by a physician. Governor Abbott signed this bill.

Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway) requires Medicaid to cover telemedicine services. Governor Abbott signed this bill.

House Bill 1063 by Representative Price will require Medicaid to cover home telemonitoring for specific pediatric patients. HB 1063 will prevent families from having to take very ill children to their physician’s office when the necessary care and monitoring can happen from home. Governor Abbott signed this bill.

Long-Term Care

House Bill 2050 by Representative Paddie requires written consent for the administration of psychoactive drugs to patients in long-term care facilities. Frequently, residents in long-term care facilities have limited contact with family members, so allowing one-time written consent will save precious time when medications may need to be provided. Governor Abbott signed this bill. 


House Bill 3703 by Rep. Stephanie Klick (R-Fort Worth) updates the Compassionate Use Act adopted by the legislature in 2015, broadening the list of symptoms and illnesses for which patients can use low-THC cannabis. Governor Abbott signed this bill. 

If you have a question about a specific bill from this legislative session, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 a.m. to 5:15 p.m. Central Standard Time. 


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

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

Beware the Bait-and-Switch of Short-Term Insurance Plans

(Health Insurance) Permanent link


Short-term insurance plans were originally intended to be a stopgap solution for people between jobs or who needed temporary coverage for other reasons. But that is changing, and that could be a problem for you or your patients. 

Initially, short-term plans were just that: short-term, or limited to 90 days of coverage. Short-term plans have evolved to provide 364 days of coverage. And short-term plans cost much less than Affordable Care Act (ACA) plans. 

If that all seems too good to be true, that’s because it is. 

Short-term plans essentially provide only catastrophic coverage. They do not cover pre-existing conditions, and they do not cover preventive care. ACA premium subsidies are not available for short-term plans. Yet people still buy the plans. 

For Texas at least, a new state law seeks to prevent the shock and awe that happens when patients attempt to access care covered by short-term plans. 

Senate Bill 1852 by Sen. Angela Paxton (R-McKinney) mandates that short-term plans inform enrollees about the limitations and possible exclusions of short-term coverage, including:No prescription drug coverage;

  • No mental health services;
  • No substance abuse treatment;
  • No maternity care;
  • No hospitalization;
  • No surgery;
  • No emergency health care; and
  • No preventive health care. 

Gov. Greg Abbott signed the bill into law last week. It will take effect Sept. 1. 

SB 1852 requires patients to sign a disclosure form acknowledging what short-term plans do and don’t cover. Expiration of the short-term plan may occur outside of the ACA open-enrollment period, meaning that if patients want to switch to an ACA plan for its more comprehensive coverage, they may not be able to immediately enroll in that plan. 

This can be a sticky wicket for physicians when they must be the bearer of bad news: the short-term plan doesn’t cover the patient’s visit. And since more and more patients are selecting short-term plans instead of full coverage, the Texas Medical Association encourages physicians to verify eligibility before providing services.

Legislative Top 10: What It Took To Renew the TMB for 12 Years

(Texas Medical Board) Permanent link

“Seems like the last two sessions it’s been sort of ‘Groundhog Day.’” 

The movie reference is how Texas Medical Association Vice President of Advocacy Darren Whitehurst summed up lawmakers’ quest to pass legislation to renew the Texas Medical Board for another 12 years. 

The Texas Legislature passed the sunset bill this session, House Bill 1504, after the 2017 legislature couldn’t get it done. It awaits Gov. Greg Abbott’s signature. 

In today’s TMA’s Legislative News Hotline video, Mr. Whitehurst credits bill sponsors Rep. Chris Paddie (R-Marshall) and Sen. Robert Nichols (R-Jacksonville) for successfully shepherding the bill “unscathed.” Mr. Whitehurst explains how such a broad bill to renew the board was ripe for myriad amendments that could negatively affect physicians, but the authors kept the bill clean. 

Mr. Whitehurst also credits physicians and TMA Alliance members for much of TMA’s success this session. He says the record showing for TMA’s First Tuesdays at the Capitol helped cement TMA’s position on bills important to medicine and patient care. 

See this and more in today’s final installment of TMA’s Legislative News Hotline “Top 10” legislative issue videos. The two-week series also covered the budget, surprise billing, prior authorization, opioids and prescribing, scope of practice, mental/behavioral health, maternal health, tobacco-21, and volunteer liability protection.

Legislative Top 10: Law Gives Liability Protections to Physicians Who Respond to Disasters

(Liability Reform, Public Health) Permanent link

The Texas Legislature passed a bill this session to allow physicians and health care providers to voluntarily respond to disasters without fear of medical liability. 

Today’s Texas Medical Association Legislative Hotline video examines that bill, Senate Bill 752, which aims to clear the minds of physician volunteers like those who rushed to provide care after Hurricane Harvey in 2017. SB 752 was sponsored by Sen. Joan Huffman (R-Houston). Gov. Greg Abbott signed the bill in May, and it takes effect Sept. 1. 

“If you’re volunteering your services … you shouldn’t be subject to liability as long as you’re doing your best in providing those services,” TMA Vice President of Advocacy Darren Whitehurst said. 

See this and more in today’s TMA Legislative News Hotline video, the ninth in our “Top 10” legislative summary series.

Legislative Hotline: Governor Signs Corporate Practice, Maternal Health, and Insurance Bills

(End-of-Life Care, Health Insurance, Medicaid, Public Health) Permanent link



Five days remain for Gov. Greg Abbott to sign or veto bills. Below is a list of several pieces of legislation important to medicine that have been signed into law this week.

Corporate Practice of Medicine

House Bill 1532 by Rep. Morgan Meyer (R-Dallas) creates a process at the Texas Medical Board that employed physicians can use to file complaints against a hospital or other health organization – protecting employed physicians’ clinical autonomy and independent medical judgment from administrator interference. Under the law, which Governor Abbott signed Monday, a health organization may not retaliate against a physician who in good faith files a complaint against the organization, including termination, demotion, discipline, or discrimination. Health organizations must develop an anti-retaliation policy by Dec. 31, 2019. HB 1532 takes effect Sept. 1. 

Expanding Health Care Access for Pregnant and Postpartum Women

Senate Bill 749 by Sen. Lois Kolkhorst (R-Brenham) addresses physician and hospital concerns about how to implement hospital neonatal and maternal level of care designations, which state law previously directed the Department of State Health Services (DSHS) to establish. Chief among the changes, SB 749 clarifies that family physicians, and not only OB-gyns, can provide on-call obstetrical and gynecological services at Level I or II maternal care facilities.

SB 749 directs DSHS to allow on-call physicians to use telemedicine in accordance with current law and pending DSHS rules. 

SB 749 was signed by the governor and took effect Monday.

Senate Bill 750 by Senator Kolkhorst will improve maternal access to prenatal and postpartum care by:

  • Requiring the Health and Human Services Commission (HHSC) to seek federal dollars to implement models of care to improve availability and quality of care for women with an opioid-use disorder;
  • Providing Healthy Texas Women (HTW) enrollees with information on the Primary Care Program, which provides a limited array of prevention and primary care services via contracted clinics across Texas;
  • Directing HHSC to develop and implement enhanced prenatal services for certain high-risk pregnant women covered by Medicaid;
  • Directing HHSC to evaluate postpartum benefits available via HTW and, based on that evaluation, develop a limited, enhanced postpartum care package that will last no longer than 12 months from a postpartum woman’s enrollment into HTW; and
  • Requiring HHSC to develop and implement a postpartum depression treatment network for women covered by Medicaid or enrolled in HTW. 

SB 750 was signed by the governor and took effect Monday.

House Bill 25 by Rep. Mary Gonzalez (D-Clint) will create a pilot program to streamline nonemergent medical transportation services in Medicaid. Currently, prenatal and postpartum women are not allowed to take their children to medical appointments. Additionally, prenatal and postpartum women are often shuttled to appointments in shared vans, resulting in long waits in physician offices. 

This transportation barrier also leads to missed appointments, which are associated with increased medical costs for patients, disruption of patient care and patient-physician relationships, delayed care, and increased emergency room visits. 

The pilot program created by HB 25 will enable more mothers to more easily access much-needed prenatal and postpartum care. 

HB 25 was signed by the governor Monday and takes effect Sept. 1. 


Senate Bill 1207 by Sen. Charles Perry (R-Lubbock) will require more explicit prior authorization procedures and denial notices for both patients and physicians. SB 1207 also will establish an explicit goal to reduce the overall number of prior authorizations in Medicaid.

SB 1207 requires an external reviewer for denials, and an annual review of prior authorization requirements.

HHSC must publish data from external medical reviews, including the rate of prior authorization denials overturned by the external medical reviewer.

HHSC must also improve assessment tools used for children in the Medically Dependent Children’s Program (MDCP), in part by reducing the amount of time needed to complete the assessment.

Responding to physician and patient complaints about Medicaid managed care, more than 50 bills to reform the system were filed this session. SB 1207 is one of the few that survived.

SB 1207 was signed by the governor Monday and takes effect Sept. 1. 


House Bill 2088 by Rep. Jay Dean (R-Longview) will require health care professionals who dispense controlled substance prescriptions to provide written notice of the closest safe disposal location and other safe disposal methods available. 

Studies indicate that nearly 70 percent of opioids prescribed post-surgery are not used, and as many as two-thirds of people who use opioids non-medically obtain them from a friend or relative. Informing patients of safe disposal options will prevent diversion and misuse of potent medications. 

HB 2088 was signed by the governor Monday and takes effect Sept. 1.

Senate Bill 1564 by Sen. Royce West (D-Dallas) will require Medicaid to cover medication-assisted treatment (MAT) for opioid- or substance-use disorder without requiring prior authorization or precertification. 

SB 1564 will ensure that patients needing treatment aren’t left waiting due to administrative burdens. The bill was signed by the governor and took effect Monday. 

Graduate Medical Education/Workforce

House Bill 1065 by Rep. Trent Ashby (R-Lufkin) will create a grant program to develop residency training tracks to prepare physicians for practice in rural, typically underserved settings. 

Rural medical practice is different than urban or even suburban practice. Often there is only one physician, and he or she is not able to refer a patient with complex health issues to a specialist across town because the nearest specialist may be 150 miles away. 

To be prepared for that type of practice, a physician needs to receive the right kind of training. HB 1065 will provide the necessary training.  

HB 1065 was signed by the governor and took effect Monday. 

Mental Health

House Bill 2813 by Rep. Four Price (R-Amarillo) codifies in statute the statewide behavioral health coordinating council that lawmakers established in 2015. The council’s function is to ensure a strategic statewide approach to behavioral health services. The council is tasked with developing and monitoring the implementation of a five-year statewide behavioral health strategic plan.

HB 2813 was signed by the governor and took effect Monday.

Public Health/Long-Term Care

House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth) will establish infection control programs in long-term care facilities. 

Aging Texans are among the most vulnerable to influenza outbreaks, particularly Texans who live in long-term care facilities. Seventy-six percent of Texans who died from the flu in 2017-28 were older than 65 years, and 200 of the 268 reported flu outbreaks happened in long-term care facilities, according to DSHS. 

Additionally, state inspections of nursing home in 2015-16 found the No. 1 deficiency was infection and lack of disease control. 

HB 1848 will require monitoring of key infectious diseases and establish procedures for making rapid flu diagnostic tests available to facility residents. 

HB 1848 was signed by the governor Monday and takes effect Sept. 1.

Senate Bill 1519 by Senator Kolkhorst will establish a statewide council on long-term care facilities as a permanent advisory committee to HHSC. The council must have at least one member who is a practicing medical director of a long-term care facility and one member who is a physician with expertise in infectious diseases or public health. 

The council will study and make recommendations regarding best practices to make inspection and informal dispute resolution processes more efficient and less burdensome on long-term care facilities. 

SB 1519 was signed by the governor and took effect Monday.

If you have a question about a specific bill from this legislative session, 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 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the interim session.

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

Legislative Top 10: A Closer Look at Texas’ New “Tobacco 21” Law

(Public Health) Permanent link

One of the major public health achievements the Texas Medical Association pushed for this past legislative session was Senate Bill 21, which raises the minimum age to buy tobacco and vape-product in Texas from 18 to 21 years. 

This was the second consecutive session in which Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Richmond), sponsored the bill, which died in the Senate in 2017. 

The lifesaving measure is featured in today’s TMA’s Legislative News Hotline video report. TMA Vice President of Advocacy Darren Whitehurst credits the support of Lt. Gov. Dan Patrick and House Speaker Dennis Bonnen for the bill’s passage. Gov. Greg Abbott late last week signed the bill, which will take effect Sept. 1. 

See this and more in today’s Hotline video report, the eighth in TMA’s legislative summary series on the top 10 issues lawmakers addressed this year.