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 Video: Prior Auth Reform, GME Take Center Stage At The Capitol

(Budget, Health Insurance, Public Health) Permanent link

Big issues bring out big voices in this week’s Texas Medical Association Legislative News Hotline video. 

TMA’s president, board members, and Council on Legislation members testified in Capitol committees this week, pushing for prior authorization reform and improvements to graduate medical education. 

We also get a glimpse at the House budget passed this week, and we hear briefly from Rep. John Zerwas, MD (R-Richmond), the House chief budget writer. 

Also, the newest lawmaker from the family of medicine, Rep. Julie Johnson (D-Carrollton), tells us what’s driving her to reform health insurance. 

Watch all of that and more in this week’s TMA Legislative News Hotline video.

 

Also, make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests, and TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

Legislative Hotline: House OKs Next State Budget

(Budget, Public Health, Texas Medical Board) Permanent link

Capitol_Dome

THE BUDGET
The state’s 2020-21 budget, filed as House Bill 1 by Rep. John Zerwas, MD (R-Richmond), took center stage on the House floor yesterday as deliberations on more than 300 pre-filed amendments continued into the wee hours of this morning. The bill passed without dissent early today.

One of the strictly enforced budget rules requires any additions to be offset by reductions elsewhere, which led several times to tense discourse on the House floor.

Some notable points from the marathon session:

  • Representatives first passed their version of a supplemental spending bill, Senate Bill 500, to patch holes in the current two-year budget. Under that bill, several state agencies would receive $9.3 billion from all state funds, including $4.3 billion from the Economic Stabilization Fund (ESF), or Rainy Day Fund. Included in this is $6.1 million to the State Board of Pharmacy for integration of and updates to the Prescription Monitoring Program, and $2.1 billion to fill a gap in the state’s Medicaid program, which lawmakers intentionally underfunded in 2017.
  • Rep. Jeff Leach (R-Plano) proposed an amendment to HB 1 that would provide $15 million to extend postpartum Medicaid coverage for women from 60 days to 12 months, contingent on the passage of House Bill 1110 by Rep. Sarah Davis (R-West University Place), or a similar measure. While this amount does not fully fund the expected cost, lawmakers supported finding additional funds elsewhere in the budget.
  • Combined state graduate medical education (GME) support is $269.4 million, an increase of 34 percent from the current budget and the highest level ever.
  • Included in Article XI, which is akin to a parking lot of issues for later discussion, are several items of importance to the house of medicine:
    • The $500 million request for additional Medicaid payments to physicians.
    • An additional $2 million for the Family Medicine Residency Program. This will not completely offset the nearly $7 million cut made in the current budget, but it’s a step in the right direction.
    • An additional $2 million for the Mental Health Professionals Loan Repayment Program. 
     

Article XI amendments will be discussed and deliberated by the House-Senate Conference Committee as the budget continues to take shape. If an item is not included in Article XI at this point, it most likely will not be included in the final negotiated budget.

After allocations from the Rainy Day Fund are taken into account, the fund will have a balance of $8.4 billion, well over the required minimum balance of $7.5 billion.

The Senate adjourned until Monday afternoon.

BILLS THAT ARE MOVING

Senate Bill 559 by Sen. Borris Miles (D-Houston) would establish a 30-day timeline for medical-records custodians to respond to Department of State Health Services records requests for patients who died while pregnant or who had been pregnant. It passed the Senate unanimously and awaits committee referral in the House. 

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,593 bills. TMA is monitoring 1,933 of them, although that will likely grow. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Sixty days remain until sine die. 

BILLS OF NOTE

Here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 870 by Rep. Four Price (R-Amarillo) would ensure that primary care physicians will be paid for telemedicine services provided through Medicaid. Senate Bill 760 by Sen. Dawn Buckingham, MD (R-Lakeway), the companion bill, passed the Senate unanimously yesterday and awaits committee referral in the House. TMA supports these bills. 
  • House Bill 871 by Representative Price would expand the use of telemedicine to rural trauma hospitals. TMA supports this bill.   

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.

TODAY’S GRASSROOTS ADVOCACY TIP

Part of your success as a physician is knowing your patients well so you can provide the care they need. The same is true with legislators: part of their success comes from knowing their constituents and the issues of concern to them. Make contact with your legislators repeatedly, and not just when you need them. Be credible and reasonable, and stay in touch with them during the interim. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is Diana Cook, MD, of Hutto. Dr. Cook graduated from the University of Florida College of Medicine, and is a member of both TMA and the Williamson County Medical Society.

WHAT WE’RE READING

Sexually transmitted diseases are rising in Dallas County, and we aren’t doing all we can to stop them [Opinion – Editorial] – The Dallas Morning News

Stop vaccine exemptions in Texas [Opinion – Editorial] – San Antonio Express-News

Even Doctors Want to Work Remote Now – Bloomberg News

What Happens if Obamacare Is Struck Down? – The New York Times

Audit: Disabled youth program sees scaled-back care, issues – The Associated Press

UT Tyler Launches New Pre-Med Academy – Tyler Morning Telegraph

The Texas budget is up for debate in the House. Here are four things to know. – The Texas Tribune

Legislative Hotline: GME Must Keep Up With Med School Growth

(Budget, Public Health) Permanent link

Curran_March_Hotline

UNDER THE ROTUNDA
Texas physicians are pushing lawmakers on the importance of ensuring enough residency slots exist to train doctors who study in Texas and of preventing gun violence.

Lubbock pulmonologist Cynthia Jumper, MD, today testified in support of Senate Bill 1378 by Sen. Dawn Buckingham, MD (R-Lakeway). SB 1378, heard in the Senate Higher Education Committee, would require graduate medical education (GME) capacity to increase as medical school enrollment grows.

“It simply makes no sense to enroll medical students who will likely have little chance of staying in the state for their residency training when they graduate from medical school due to a shortage of GME,” said Dr. Jumper. “We will simply be setting up medical schools to provide physicians for other states. Medical schools do not produce physicians ready for practice. GME does.”

Yesterday, on the other side of the rotunda, Athens family physician and TMA President Doug Curran, MD, testified in support of House Bill 3054 by Rep. Barbara Gervin-Hawkins (D-San Antonio), which would designate June as Gun Violence Awareness Month.

“Having strong state laws on firearm safety will not adequately ensure protection as long as the public is not aware of these requirements or of other measures to reduce firearm violence,” said Dr. Curran.

These bills were left pending in committee and will be voted on at a later time.

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,526 bills. TMA is monitoring 1,934 of them, although that will likely grow. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Sixty-one days remain in this session; the pace will continue to accelerate and the meetings will lengthen. TMA will be calling on you for grassroots advocacy participation and support. 

BILLS OF NOTE

Here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1, the 2020-21 state budget bill, by Rep. John Zerwas, MD (R-Richmond), is up for consideration on the House floor today. With hundreds of amendments already in the hopper, debate on the massive bill could stretch well into the night. 
  • House Bill 1832 by Rep. Julie Johnson (D-Carrollton) would clarify the prudent layperson standard and prohibit health plans from retroactively denying emergency care based on a utilization review. TMA supports this bill. 
  • House Bill 1960 by Rep. Four Price (R-Amarillo) would create a Governor’s Broadband Council that must include a medical advocacy representative. Developing more broadband infrastructure will expand access to telemedicine and is a priority of TMA’s Committee on Rural Health. TMA supports this bill.   

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

At the top of the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session. 

PHYSICIAN OF THE DAY

Today’s physician of the day is Sister Rosanne Popp, MD, of Houston. Dr. Popp graduated from the UT Health San Antonio Long School of Medicine, and is a member of both TMA and the Harris County Medical Society.

WHAT WE’RE READING

Whooping cough prompts health advisory at Texas Capitol building – KXAN-TV

More medical residency funding needed [Opinion – Editorial] – San Antonio-Express News

Texas House Committee Advances Bill Making 21 Minimum Age to Buy Cigarettes – WOAI Radio

Affordable Care Act Sign-Ups Total 11.4 Million for This Year – The Wall Street Journal

The measles virus was down and out. Now it’s primed for a comeback – STAT News

CDC Study Suggests Some Pregnant Women Use E-Cigarettes Despite Dangers Of Smoking – KERA News

Legislative Hotline: Physicians Urge Lawmakers to Fix Prior Authorization Hassles

(Health Insurance, Liability Reform, Public Health) Permanent link

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UNDER THE ROTUNDA
As physicians, we don’t want our patients to suffer a financial crisis in the wake of a medical crisis. Yet current insurance industry practices – narrow networks, inaccurate directories, unrelenting prior authorization and utilization review hassles – impede our ability to provide timely care to our patients. That’s the message Texas Medical Association physicians delivered today as they testified on several bills addressing health plans’ coverage issues.

Athens family physician and TMA President Doug Curran, MD, testified in strong support of a pair of bills by Rep. Greg Bonnen, MD (R-Friendswood).

House Bill 2327 would exempt physicians with a demonstrated approval record from many prior authorization requirements. It also would make the prior authorization process more transparent by requiring health plans to inform physicians and patients in advance of the preauthorization process and specific requirements.

“Insurance companies need to stop creating hurdles to maintaining the patient-physician relationship,” Dr. Curran said. “This bill will make the prior authorization process easier to navigate and let us focus more on patient care, not paperwork.”

Representative Bonnen’s House Bill 2387 likewise would strengthen the patient-physician relationship by requiring utilization reviews to be done by a Texas-licensed physician who practices in the same or a similar specialty.

“We think this is imperative to avoid improper denials of service and delays in medically necessary care,” Dr. Curran said.

Austin oncologist Debra Patt, MD, testified in support of House Bill 2520 by Rep. Julie Johnson (D-Carrollton), which would require a health plan, when approving a prior authorization request, to inform patients ahead of time about the network status of physicians or providers who may participate in the procedure and the patient’s expected financial responsibility.

“If a plan requires a physician to go through prior authorization review, the information submitted on the standardized form could be put to good use in helping patients in ways beyond merely obtaining authorization for their medical care,” said Dr. Patt. “If health plans are allowed to create these burdens, then the information physicians must provide to health plans should be used more fully to benefit the patient.”

Dr. Patt also testified in support of House Bill 2408, also by Representative Johnson, which would disallow prior authorization requirements for state-mandated health plan benefits, such as mammograms and prostate cancer screening.

“If by law, a health plan must cover these medical services, it makes little sense to permit health plans to subject these services to their prior authorization process,” Dr. Patt said.

Do you have a prior authorization disaster to share? Send the details (no protected health information, please) to Genevieve Davis, TMA’s associate vice president for payment advocacy.

Representative Johnson also introduced House Bill 2630, which would require a health plan’s network directory to clearly identify which radiologists, anesthesiologists, pathologists, emergency physicians, neonatologists, and assistant surgeons are in-network at network facilities.

“I often must refer my patients to a facility for necessary care,” Dallas cardiologist Rick Snyder, MD, testified in support of HB 2630. “When making these referrals, the absolute last thing I want to do is refer them to an out-of-network facility because I recognize that this could create a surprise out-of-network balance bill for my patient. This does not help my long-term relationship with the patient and potentially creates unnecessary financial stress for my patient.”

TMA submitted written testimony in support of 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.

“Insurance companies often use nonmedical switching to force patients to use a less expensive medication,” TMA’s statement said. “This bill does not require a health plan to change its entire formulary but instead requires modification of the formulary on a patient-by-patient basis.”

These bills were left pending in committee and will be voted on at a later time, most likely next week.

BILLS THAT ARE MOVING

House Bill 76, which would require school districts to provide student-athletes with information about cardiac arrest and electrocardiogram testing before participating in sports, received preliminary approval on the House floor. TMA will continue to watch progress on this bill. 

House Bill 749, which would raise the minimum age to purchase tobacco and vape products to 21, passed out of the House Public Health Committee unanimously and awaits scheduling for a hearing on the House floor. TMA strongly supports this bill. 

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,526 bills. TMA is monitoring 1,934 of them, although that will likely grow. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral will be complete next week. Sixty-two days remain in this session; the pace will accelerate and the meetings will lengthen. TMA will be calling on you for grassroots advocacy participation and support. 

BILLS OF NOTE

Here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1754 by Representative Bonnen would entitle schools to use the funds allocated for safety improvements for student mental health prevention and treatment. TMA supports this bill. 
  • Senate Bill 14 by Sen. Robert Nichols (R-Jacksonville) would allow electric cooperatives to construct, maintain, and operate cables for broadband service, potentially expanding access to telemedicine in rural communities. House Bill 1446 by Rep. John Kuempel (R-Seguin) is the companion. TMA supports these bills.  

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.

TODAY’S GRASSROOTS ADVOCACY TIP

Part of your success as a physician is knowing your patients well so you can provide the care they need. The same is true with legislators: part of their success comes from knowing their constituents and the issues of concern to them. Make contact with your legislators repeatedly, and not just when you need them. Be credible and reasonable, and stay in touch with them during the interim. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is Mary Anne Snyder, DO, of San Antonio. Dr. Snyder graduated from the Kansas City University of Medicine and Biosciences, and is a member of both TMA and the Bexar County Medical Society.

WHAT WE’RE READING

Cloud of Cancer-Causing Chemical Hangs Over the Houston Channel – Bloomberg News

Edinburg doctor to speak with lawmakers on reducing opioid prescriptions – The Monitor

Texas cancer researchers vying to renew CPRIT beyond its 2023 sunset date – The Cancer Letter

Grieder: Raising the legal age for tobacco sales in Texas is a popular, sensible idea amid rise of ‘vaping’ – Houston Chronicle

Texas can fight the teen e-cigarette epidemic and raise the legal age for tobacco products to 21The Dallas Morning News

The Flu Season Hasn’t Been This Bad This Late in 20 Years – The Wall Street Journal

Legislative Hotline: It’s Past Time To Hold Insurers Accountable For Inferior Products

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

March_22_Hotline

UNDER THE ROTUNDA
Insurance reform – broadening network access, ensuring accurate directories, preventing the need for balance billing – has long been a Texas Medical Association priority. And yesterday, a bill confronting health plans’ inadequacy head-on took center stage at the Capitol.

Keller pediatrician Jason Terk, MD, who serves at the chair of TMA’s Council on Legislation, testified during the Senate Business and Commerce Committee on two bills.

Dr. Terk testified in opposition to Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills) that would give health plans the unilateral power to determine reasonable payments for out-of-network physician services.

In an often tense and contentious exchange with the bill sponsor, Dr. Terk repeatedly reassured the committee that TMA very much supports the need to protect patients from surprise out-of-network bills, but SB 1264 would not accomplish this.

“Much of the value of any health plan network product lies in how robust the network is,” Dr. Terk told lawmakers. “For this reason, we think it is imperative that the legislature ensure health plans are subject to out-of-network payment obligations and a claim dispute resolution process that are sufficient to encourage plans to develop (rather than dismantle) their networks.”

“To be clear, TMA is not opposed to addressing surprise billing. We are, however, opposed to health plans skirting responsibility for the products they sell to our patients.”

Dr. Terk also testified in support of Senate Bill 747 by Sen. Lois Kolkhorst (R-Brenham), which would require the Texas Department of State Health Services (DSHS) to alert physicians to any increase in cost for the state-mandated newborn screening test, and would require health plans to cover any cost increases associated with it.

“Physicians often purchase these screening tests in bulk to have them immediately on hand for newborn patient visits,” Dr. Terk said. “But when new conditions or diagnoses are added to the protocol, the prepurchased screening kits are no longer valid.

“Pediatricians are dedicated to the health of their infant patients and the convenience of providing this second screening in the clinic, but they need to be paid in whole for their participation in this vital program,” Dr. Terk concluded.

These bills were left pending in committee and will be voted on at a later time, most likely next week.

LEGISLATIVE HOTLINE VIDEO

This week’s Legislative Hotline video follows several physicians who spoke out against some key bills, and defended others.

First, watch Dr. Terk argue why Senate Bill 1264 falls short in attempting to address surprise medical bills.

Then hear John Carlo, MD, explain why Senate Bill 21, which would raise the legal age to sell tobacco from 18 to 21, is crucial in protecting young people.  

Also, Medicaid coverage should extend to 12 months postpartum to save lives, Moss Hampton, MD, said in a public health hearing this week.

And TMA Board Trustee Ray Callas, MD, and Harris County Medical Society Immediate Past-President George Santos, MD, each testified in support of bills that would protect physicians who respond to disasters like Hurricane Harvey. 

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,526 bills. TMA is monitoring 1,932 of them, although that will likely grow. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral will be complete next week. Sixty-six days remain in this session; the pace will accelerate and the meetings will lengthen. TMA will be calling on you for grassroots advocacy participation and support. 

BILLS OF NOTE

Here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • Senate Bill 2252 by Sen. Donna Campbell, MD (R-New Braunfels), would require the Texas Department of Insurance (TDI) to conduct a network adequacy examination for preferred provider benefit plans at least every two years. House Bill 3911 by Rep. Hubert Vo (D-Houston) is the companion. TMA supports these bills. 
  • Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio) would require a health plan’s network directory to clearly identify which radiologists, anesthesiologists, pathologists, emergency physicians, neonatologists, and assistant surgeons are in-network at in-network facilities. Facilities include ambulatory surgery centers, birthing centers, hospitals, and freestanding emergency rooms. House Bill 2630 by Rep. Julie Johnson (D-Carrollton) is the companion. TMA supports these bills. 
  • Senate Bill 1886 by Senator Kolkhorst would require insurers to provide additional proof that a health plan could not (versus would not) contract with physicians of a certain specialty in an area, after making three materially different offers. This gives TDI another tool to ensure health plans are selling the best networks possible to Texas consumers. House Bill 2962 by Rep. Stan Lambert (R-Abilene) is the companion. TMA supports these bills.  

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

At the top of the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for APRNs.
  • Register for First Tuesdays at the Capitol – there are two left: April 2 and May 7;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 p.m. each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

PHYSICIAN OF THE DAY

Today’s physician of the day is Marian Allen, MD, of Spring. Dr. Allen graduated from the Baylor College of Medicine, and is a member of both TMA and the Harris County Medical Society.

WHAT WE’RE READING

Texas Awards $28M Contract for New Medicaid System – Government Technology

Is your child care center safe from measles? Texas won’t say. [Opinion] – Houston Chronicle

Fentanyl-Linked Deaths: The U.S. Opioid Epidemic’s Third Wave – NPR

Expert Opinion: How to Address the Physician Shortage in Booming DFW – D CEO Healthcare

Why the US, And Texas, Need To Catch Up When It Comes To Dementia Care – Texas Standard

The fattest city in America is in Texas, according to this list – WFAA-TV

Legislative Hotline: Bills Would Protect First Responders in Disasters

(Budget, Liability Reform, Medicaid, Public Health) Permanent link

 May_Runoff

UNDER THE ROTUNDA
When physicians and first responders rushed to the coast to help their fellow Texans deluged by Hurricane Harvey in August 2017, their efforts at times were hampered by confusion surrounding their vaccination status.

Two bills working their way through the Texas House of Representatives, House Bill 1256 and House Bill 1418, both by Rep. Dade Phelan (R-Beaumont), seek to clear up that confusion and protect first responders during disasters.

HB 1256 would allow first responders’ employers to access their immunization records in the Texas Immunization Registry, known as ImmTrac2, during a disaster. Currently, access to the registry is limited to the individual, and a busy first responder might not be able to check his or her immunization status in an emergency.

HB 1418 would ensure that first responders receive a push notification of their immunization status when their initial certification or annual recertification is complete.

Testifying before the House Public Health Committee on Wednesday, Beaumont anesthesiologist Ray Callas, MD, spoke in support of both bills. Harvey dumped almost three feet of rain in one day on Beaumont, making it one of the storm’s hardest-hit areas.

“We didn’t have time to plan or evacuate,” Dr. Callas told lawmakers. “We had to get started with what we had. Knowing their vaccination status could not only help first responders be better prepared and protected, but also may prevent potentially costly and unnecessary over-vaccination.”

Both bills passed unanimously out of House Public Health and will be set for debate on the House floor.

A related bill, Senate Bill 752 by Sen. Joan Huffman (R-Houston), passed the Senate yesterday and was received in the House, where it awaits committee referral. SB 752 would provide liability protections for physicians who volunteer in the aftermath of disasters.

Also in yesterday’s House Public Health Committee, TMA submitted written testimony seeking refinements to House Bill 2191 by Rep. Giovanni Capriglione (R-Southlake.)

HB 2191 would tighten access to information that a physician might be compelled to produce under a public information request. In uncommon circumstances, the Texas Public Information Act currently could compel a physician to respond to a public information request by providing anything not protected by the patient-physician communications. That could mean the physician would have to disclose patient information. TMA says patients’ “protected health information” – which is broader and more all-encompassing than patient-physician communications – should be protected.

Also in the Public Health Committee, Belton anesthesiologist Tim Bittenbinder, MD, testified in support of House Bill 1532 by Rep. Morgan Meyer (R-Dallas), which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference.

“Baylor Scott & White has a very good internal system to resolve issues,” Dr. Bittenbinder said, referring to the clinic where he practices. “But this may not necessarily be the case with other organizations. From a standpoint of fairness and transparency, this bill is a modest proposal to resolve those areas of friction that cannot be resolved locally.”

In the House Homeland Security and Public Safety Committee, TMA submitted written testimony in support of House Bill 316 by Rep. Donna Howard (D-Austin). That bill would require the Department of Public Safety to develop and implement a public awareness campaign on firearm safety, prevention of firearm accidents involving children, and suicide prevention.

“The public health data tell us that children who are with an untrained or otherwise careless adult or a friend with access to a firearm are most likely to be injured or killed in an unintentional discharge,” TMA said.

These three bills were left pending in committee and will be voted on at a later time.

GETTING A BILL MOVING

So far this session, lawmakers filed 7,520 bills. TMA is monitoring 1,906 of them, although that will likely grow. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral will be complete this week. We have passed the halfway point; 67 days remain in this session. 

 BILLS OF NOTE

Here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • Senate Bill 364 by Sen. Kirk Watson (D-Austin) would direct the State Board of Education to develop recess policies that encourage outdoor playtime and physical activity. House Bill 455 by Rep. Alma Allen (D-Houston) is the companion. TMA supports these bills. 
  • Senate Bill 1238 by Sen. Nathan Johnson (D-Dallas) would shorten the time-frame for a physician to evaluate a voluntary mental health patient admission from 72 to 24 hours. TMA is closely monitoring this bill. 
  • Senate Bill 982 by Sen. Lois Kolkhorst (R-Brenham) would direct the Texas Division of Emergency Medicine to work with the Department of State Health Services to develop a plan to increase the capabilities of local emergency shelters to care for specialty care populations during a disaster. TMA supports this bill.   

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.

TODAY’S GRASSROOTS ADVOCACY TIP

Motivation for contacting your legislator may stem from frustration about a particular issue, so take care to be diplomatic in communications with your legislators and/or their staff. Don’t begin your conversation by saying, “As a citizen and taxpayer …” Don’t be argumentative or abrasive. And don’t ignore your legislator, then contact a legislator from another district for help with your issue. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is Philip Pippin, MD, of Tyler. Dr. Pippin graduated from The University of Texas Medical Branch School of Medicine at Galveston, and is a member of both TMA and the Smith County Medical Society.

WHAT WE’RE READING

Will Physicians Soon Be Allowed to Dispense Drugs in Texas? – D CEO Healthcare

Dallas struggles with rise in STDs – The Dallas Morning News

Texas lawmakers are prioritizing mental health for school safety. But advocates worry about stigma. – The Texas Tribune

Massive statewide women’s health care coalition working closely with legislators – KSAT-TV

Lack of affordable housing hurting health of Texas children – Houston Chronicle

New Effort Enhances Access to Mental Health Treatment for Veterans – State of Reform

Amid measles outbreak, lawmaker seeks simpler way to opt out of vaccines – Austin American-Statesman

TMA Legislative Hotline: Medicaid Cutoff Puts New Moms At Risk, TMA Tells Lawmakers

(Budget, Health Insurance, Public Health, Scope of Practice, Women’s Health) Permanent link

HHSC_grants

UNDER THE ROTUNDA
Texas physicians on Tuesday urged lawmakers to reduce the state’s unacceptably high maternal mortality and morbidity rates by expanding women’s access to care. A TMA member physician also pushed for more appropriate safeguards for residents of long-term care facilities.

The House Human Services Committee heard testimony on House Bill 744 by Rep. Toni Rose (D-Dallas), which would allow continued Medicaid coverage for eligible women up to 12 months postpartum. Medicaid coverage currently expires 60 days after delivery, but the vast majority of maternal deaths in Texas occur from 61 to 365 days postpartum.

Lubbock obstetrician-gynecologist Moss Hampton, MD, testified about the importance of access to care after and between pregnancies to address chronic disease, behavioral health, and substance-use issues.

“Unmanaged diabetes, for example, increases several fold the risk of birth defects, such as neural tube abnormalities, miscarriage, and preterm birth,” Dr. Hampton said. “Yet if women receive early diagnosis and comprehensive treatment and management of chronic diseases before pregnancy, these poor birth outcomes can be dramatically reduced, thus improving the lives of mothers and babies while also reducing Medicaid costs.”

Austin geriatrician Michael Krol, MD, testified in opposition to House Bill 2050 by Rep. Chris Paddie (R-Marshall), which would add undue burdens on physicians trying to administer antipsychotic medications to patients in long-term care facilities.

Currently, consent is provided when patients are admitted to long-term care facilities, but HB 2050 would require consent each time a medication is administered, which could take away a physician’s ability to treat a patient in a timely fashion.

In his testimony, Dr. Krol cited an example of an incident that might not rise to the level of “imminent harm,” but does require intervention, such as a patient trying to pull out a feeding tube.

“Many times, relatives and contacts for these patients are disengaged and unavailable. Valuable time can be lost attempting to contact an authorized representative, leaving patients, physicians, and the health care providers at risk,” Dr. Krol said. “Failure to act expediently and appropriately from a medical standpoint is far riskier than administering an antipsychotic or neuroleptic medication.”

Both of these bills were left pending in committee and will be voted on at a later time.

THE BUDGET

On Monday, the House Appropriations Committee, chaired by Rep. John Zerwas, MD (R-Richmond), approved both House Bill 1, the House’s budget bill for 2020-2021, and Senate Bill 500 by Sen. Jane Nelson (R-Flower Mound), which is the Senate’s supplemental appropriations bill. Both of those bills are scheduled for debate on the House floor on March 27. 

BILLS THAT ARE MOVING

The House on Wednesday unanimously approved House Bill 111 by Rep. Mary Gonzalez (D-Clint), which would ensure that school employees have the necessary information and training to protect children with cognitive and developmental disabilities from child abuse. The bill, which TMA supported, will now be considered by the Senate. 

On Tuesday, the House Public Health Committee approved House Bill 278 by Rep. Tom Oliverson, MD (R-Cypress), which outlines how physicians supervise prescriptive authority agreements with advanced practice registered nurses. HB 278 was sent to the House Local and Consent Calendars Committee, where it should pass easily. 

GETTING A BILL MOVING

With a flurry of activity, the bill filing deadline finally passed, and lawmakers filed 7,514 bills. TMA is monitoring 1,908 of them, although that will likely change. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral will be complete this week. We have passed the half-way point; sixty-eight days remain in this session. 

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1576 by Rep. Dade Phelan (R-Beaumont) would allow Medicaid to contract with a transportation network company, such as Uber, for nonemergency transportation to or from a medical appointment. Senate Bill 1667 by Sen. Dawn Buckingham, MD (R-Lakeway) is the companion. TMA supports these bills. 
  • House Bill 1518 by Rep. Garnet Coleman (D-Houston) would prohibit the over-the-counter sale of dextromethorphan products, mainly cough syrups, to minors. Senate Bill 349 by Sen. Kel Seliger (R-Amarillo) is the companion. TMA supports these bills.   

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for APRNs.
  • Register for First Tuesdays at the Capitol – there are two left: April 2 and May 7;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

PHYSICIAN OF THE DAY

Today’s physician of the day is John Manning, MD, of Temple. Dr. Manning graduated from The University of Texas Medical Branch School of Medicine at Galveston, and is a member of both TMA and the Bell County Medical Society.

WHAT WE’RE READING

Should Texas raise the smoking age from 18 to 21? Nation’s largest tobacco company agrees – The Dallas Morning News

Working full time for health coverage? Many who want part-time jobs are stymied by costs – USA TODAY

40% of people with HIV transmit most new infections in the US, a new analysis says. Here’s the plan to stop the spread – CNN

Cardenas: A Red Letter Day for the Rio Grande Valley – Rio Grande Guardian

Rates of colon cancer rising in young adults – KVUE-TV

2nd Case of Measles Confirmed in Collin County – KXAS-TV

TMA Legislative Hotline: Physicians Issue Call to Raise Tobacco Sale Age

(Public Health) Permanent link

Capitol_Dome

UNDER THE ROTUNDA
In a busy start to the week, Texas physicians on Monday urged lawmakers to raise the age to purchase tobacco and vape products to 21, to provide liability coverage for physicians who volunteer during a disaster, and to protect all children from sexual abuse.

Dallas public health and preventive medicine physician John Carlo, MD, spoke to the Senate State Affairs Committee in favor of Senate Bill 21 by Sen. Joan Huffman (R-Houston), which seeks to increase the minimum age for purchasing tobacco and vape products to 21.

The data Dr. Carlo presented told a shocking story, including the fact that two-thirds of Texas 10th-graders and nearly half of eighth-grade students say it’s easy to get cigarettes from older friends and peers. SB 21 seeks to prevent youth access to tobacco and vape products by lowering the likelihood of them being in the same social networks as those who can purchase tobacco and vape products legally.

“We’ve known for almost four decades how the tobacco industry considers ‘today’s teenagers’ to be ‘tomorrow’s potential regular customer,’” Dr. Carlo told lawmakers. “We as physicians urge this committee to keep our kids today from being tomorrow’s tobacco death statistic.”

Meanwhile, in the House Judiciary and Civil Jurisprudence Committee, Houston psychiatrist George Santos, MD, testified in support of House Bill 1353 by Rep. Tom Oliverson, MD (R-Cypress), which would provide liability protections for physicians who volunteer in the aftermath of disasters.

Dr. Santos told lawmakers that during Hurricane Harvey, the emergency shelter at Houston’s NRG Stadium required the assistance of 450 physicians to treat approximately 7,000 patients.

“One of the biggest challenges in operating a mass shelter clinic for four weeks was the ability to keep our shifts staffed with medical professionals of all sorts,” Dr. Santos said. “One of the ongoing concerns was exposure to liability risks.”

Earlier this month, TMA testified in committee in support of Senate Bill 752 by Senator Huffman, the companion bill to HB 1353. SB 752 could possibly be debated by the full Senate today.

And the House Criminal Jurisprudence Committee took testimony on House Bill 85 by Rep. Mary Gonzales (D-Clint), would eliminate a discriminatory and burdensome mandate that jeopardizes the patient-physician relationship with adolescents. Currently, physicians are not required to report sexual activity between minors of the opposite sex as long as the age range doesn’t exceed three years, however that does not apply to sexual activity of same-sex minors. HB 85 would extend the existing affirmative defense of indecency with a child to same-sex relationships.

Austin pediatrician Celia Neavel, MD, described the quandary she now faces when treating LGBTQ-plus patients, saying, “Do I provide the same compassionate, understanding care to my LGBTQ+ patients as I do to my heterosexual patients, but then have to report the youth to Child Protective Services? The former is my ethical responsibility as a physician; the latter is my obligation under state law.”

All three of these bills were left pending in committee and will be voted on at a later time.

GETTING A BILL MOVING

With a flurry of activity, the bill filing deadline finally passed, and lawmakers filed 7,499 bills. TMA is monitoring 1,908 of them, although that will likely change. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral should be complete this week. Seventy-four days remain in this session.

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1585 by Representative Gonzalez (D-Clint) would require the Health and Human Services Commission to prepare a report on wait lists for people with intellectual and developmental disabilities, and strategies to eliminate the wait lists. TMA supports this bill. 
  • House Bill 937 by Rep. Sarah Davis (R-West University Place) would require Medicaid to cover a full 12 months’ supply of contraception. TMA supports this bill.  

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.

TODAY’S GRASSROOTS ADVOCACY TIP

Motivation for contacting your legislator may stem from frustration about a particular issue, so take care to remember to be diplomatic in communications with your legislators and/or their staff. Don’t begin your conversation by saying, “As a citizen and taxpayer…” Don’t be argumentative or abrasive. And don’t ignore your legislator, then contact a legislator from another district for help with your issue. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

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

WHAT WE’RE READING

Bill to raise smoking age to 21 in Texas gets first hearing today – Houston Chronicle

There are more Texas medical schools than ever, but are there enough residencies to train them? – San Antonio Express-News

Death By A Thousand Clicks – Kaiser Health News, Fortune

Our view: Texas must do better for children with disabilities – Lubbock Avalanche-Journal

Texas Is One Of Only 14 States That Haven’t Expanded Medicaid – Despite Strong Public Support – KUT

Our view: Vaccination rate transparency good idea for public schools – Amarillo Globe-News

Walk with a Doc program to begin Thursday; walks to cover topics including mental health, how to live to 100 – Tyler Morning Telegraph

Legislative Hotline Video: Physicians Push For Stronger Medical Board, Liability Protections

(Health Insurance, Liability Reform, Medicaid, Public Health, Texas Medical Board) Permanent link

In this week’s Texas Medical Association Legislative News Hotline video, five TMA physicians argue why they support various bills that would extend children’s Medicaid, preserve liability protections for physicians who respond to disasters, and strengthen the Texas Medical Board (TMB).

First, TMA Board Secretary/Treasurer Michelle Berger, MD, lobbies for TMB improvements during a sunset review bill hearing.

Pediatrician Ben Raimer, MD, explains why Medicaid should cover eligible children continuously for 12 months instead of the current patchwork schedule, and he describes the current system’s challenges to patients, parents, and doctors. Thousands of kids are bumped off of Medicaid each month though nearly all are eligible to stay covered.

Also, see Beau Briese, MD, a Houston emergency physician, tell lawmakers why new liability protection for doctors during disasters is necessary. He should know: He ran an emergency clinic during Hurricane Harvey.

Other physicians tell us why they support bills to protect and improve the lives of our most vulnerable people: our children and long-term care facility residents.

Watch all of this and more in this week’s TMA Legislative News Hotline video.     

Also, make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests, and TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

March 14 Hotline: Physicians Call For Stronger Texas Medical Board

(Budget, Public Health, Texas Medical Board) Permanent link

vote story

UNDER THE ROTUNDA

Texas physicians on Wednesday urged lawmakers to support bills that would strengthen the Texas Medical Board (TMB), would help fetuses who were exposed to drugs and alcohol, and would protect certain children at day cares.

Austin ophthalmologist Michelle Berger, MD, spoke to the House Public Health Committee in favor of House Bill 1504 by Rep. Chris Paddie (R-Marshall), which is a replay of the TMB sunset bill that was held hostage late last session.

The recommendations outlined by Dr. Berger would strengthen the practice of medicine in Texas by expediting licensing, establishing guidelines on vacating orders, and maintaining accurate physician profiles by quickly removing outdated remedial plan actions.

“If you meet these criteria, please consider practicing in Texas,” Dr. Berger told lawmakers. “It’s a great place, and we need more physicians.”

San Antonio neonatologist John Isaac, MD, testified in support of House Bill 405 by Rep. Ina Minjarez (D-San Antonio), which would designate June as Neonatal Abstinence Syndrome (NAS) Awareness Month.

Dr. Isaac told lawmakers that NAS is a serious condition caused by the sudden discontinuation of fetal exposure to substances, including alcohol or illicit drugs that were used or abused by the mother during pregnancy. Between 2010 and 2014, NAS rates in Texas increased by 51.3 percent, Dr. Isaac said, illustrating the urgent need for increased recognition of the condition.

House Bill 1849 by Rep. Stephanie Klick (R-Fort Worth) would permit day-care centers to possess and administer epinephrine auto-injectors that are prescribed to the centers by a physician. The bill would also require day-care centers that keep epinephrine injections on hand to train personnel who will administer them to children. TMA submitted written testimony in support of HB 1849.

These bills are pending in committee and will be voted on at a later time.

In the other chamber, the Senate unanimously passed Senate Bill 500 by Sen. Jane Nelson (R-Flower Mound), which, for the biennium ending Aug. 31, appropriates: $2.1 billion in general funds to cover the Medicaid shortfall due to caseload growth that couldn’t be anticipated; $300 million from the Rainy Day Fund for improvements to state hospital facilities; and $110 million from the Rainy Day Fund to repay Medicaid money that had been transferred to Hurricane Harvey disaster assistance programs.

Earlier this week, Austin pediatrician Kimberly Avila Edwards, MD, testified in support of Senate Bill 952 by Sen. Kirk Watson (D-Austin), which would require that child-care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards.

BILLS THAT ARE MOVING

Last week, TMA testified in support of House Bill 1065 by Rep. Trent Ashby (R-Lufkin), which would create a grant program for the development of rural training tracks to prepare physicians for practice in rural, underserved settings. HB 1065 passed out of the House Higher Education Committee and awaits an assigned date to be heard on the House floor.

GETTING A BILL MOVING

With a flurry of activity, the bill filing deadline finally passed, and lawmakers filed 7,480 bills. TMA is monitoring 1,658 of them, although that will likely change. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral should be complete this week. Seventy-four days remain in this session.

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • Senate Bill 1591 by Sen. John Whitmire (D-Houston) would require health plans to pay out-of-network physicians a fair amount, based on objective standards, while a bill is in dispute. The measure also requires the physician and insurer to come to an agreement with an arbitrator using fair market values as a benchmark. House Bill 2967 by Rep. Tom Oliverson, MD (R-Cypress) is the companion. TMA supports these bills. 
  • House Bill 1418 by Rep. Dade Phelan (R-Beaumont) would establish a system to periodically inform first responders of their vaccination status so there’s no question or confusion when they respond to a disaster. TMA supports this bill. 
  • House Bill 1292 by Rep. Four Price (R-Amarillo) would direct the Department of State Health Services and the Maternal Mortality and Morbidity Task Force to develop and implement initiatives to improve the health of women with opioid-use disorder and newborns with Neonatal Abstinence Syndrome. Senate Bill 436 by Senator Nelson is the companion. TMA supports these bills.   

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for APRNs.
  • Register for First Tuesdays at the Capitol – there are two left;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

PHYSICIAN OF THE DAY

Today’s physician of the day is Sherri Onyiego, MD, of Houston. Dr. Onyiego graduated from the Ross University School of Medicine in Barbados, and is a member of the Harris County Medical Society.

WHAT WE’RE READING

Property tax proposal piles one more worry on Texas’ rural hospital districts – The Texas Tribune

Texas lawmakers look to Uber, Lyft to transport Medicaid patients – San Antonio Express-News, Houston Chronicle

Dallas doctors are right to turn away unvaccinated kids, for the health of every kid [Opinion – Editorial] – The Dallas Morning News

Why the Canceled Baylor-Memorial Merger Might Be Good For Hospital Quality and Cost – D CEO Healthcare

McAllen pledges $1 million to UTRGV medical school – The Monitor

UnitedHealthcare Will Expand a Drug Discount Aimed at Lowering Consumer Costs – The New York Times

Trump Medicaid budget plan could leave states and enrollees hanging – Modern Healthcare

March 13 Hotline: Physicians Push For Better Care For Seniors, Children

(Health Insurance, Public Health, Women’s Health) Permanent link

Capitol_Dome

UNDER THE ROTUNDA
In poignant testimony delivered yesterday at the Capitol, Texas Medical Association members demonstrated that physicians are dedicated to improving the health of Texans of all ages.

In the House Human Services Committee, Austin geriatrician Michael Krol, MD, spoke in favor of House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which would establish infection control programs in long-term care facilities.

“Long-term care facilities are home to some of the state’s most vulnerable residents, including the elderly and those with chronic illnesses,” Dr. Krol told lawmakers. “Residents in nursing homes and long-term care facilities are our parents, grandparents, family members, and friends.”

Establishing infection-control programs, including rapid flu testing when outbreaks are suspected, would reduce the spread and severity of infectious diseases in these facilities, he said.

Galveston pediatrician Ben Raimer, MD, testified in strong support of House Bill 342 by Rep. Phillip Cortez (D-San Antonio), urging lawmakers to provide 12 months of continuous coverage for children on Medicaid, something already in place for the Children’s Health Insurance Program (CHIP).

“Lost coverage means children often have gaps in care – gaps that harm their health and contribute to an inefficient Medicaid program for everyone: families, physicians, providers, and the state,” Dr. Raimer told the committee. “As a family’s trusted pediatrician, I do everything I can to ensure children receive medically appropriate preventive, primary, and specialty care at the right time. But all that is for naught if arbitrary red tape and government inefficiency cause a child to lose coverage.”

Both bills were left pending in committee and will be voted on at a later time.

IN OTHER NEWS

Sen. Charles Perry (R-Lubbock) and Rep. John Frullo (R-Lubbock) presented Senate and House proclamations Tuesday, recognizing the Lubbock and South Plains Colon Cancer Prevention Task Force for its continued efforts in colon cancer prevention and control. Lubbock oncologist Davor Vugrin, MD, who serves both as chairman of the Task Force and as a member of TMA’s Committee on Cancer, was joined at the Capitol by Austin obstetrician-gynecologist Marian Yvette Williams-Brown, MD, chair of TMA’s Committee on Cancer.

GETTING A BILL PASSED

With a flurry of activity, the bill filing deadline finally passed, and 7,452 bills have now been filed. TMA is monitoring 1,622 of them, although that likely will change. Bills must next be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. At this point, almost two-thirds of House and Senate bills have been referred to committee for consideration. Seventy-five days remain in this session. 

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1532 by Rep. Morgan Meyer (R-Dallas) would establish a process for physicians employed by a health care facility to file a complaint with the Texas Medical Board against their employer without being subject to retaliation. TMA supports this bill. 
  • House Bill 3332, Rep. James Frank (R-Wichita Falls), would ensure that a patient’s guardian cannot override a do-not-resuscitate order that was requested by the patient. TMA supports this bill. 
  • House Bill 2086 by Rep. Jay Dean (R-Longview) would require pharmacies and health care facilities to establish a controlled-substance disposal program. TMA supports this bill. 

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.

TODAY’S GRASSROOTS ADVOCACY TIP

When contacting your legislator, remember to be specific about the action you need, e.g., vote yes on HB10. Remember that every constituent contacting a legislator thinks his or her issue is the most important, so sharing facts or a memorable story as part of your communication will have more staying power than a simple action request. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is Mark Eidson, MD, of Weatherford. Dr. Eidson graduated from the UT Health San Antonio Long School of Medicine, and is a member of both TMA and the Parker County Medical Society.

WHAT WE’RE READING

This HIV pill saves lives. So why is it so hard to get in the Deep South? – The Washington Post

At least 228 measles cases have been reported in the US this year, CDC says – CNN

Hospitals, Insurers Set to Resist Price Transparency Proposal – The Wall Street Journal

Texas Floats Plans to Boost Medicaid Funding Through SNF Quality Program – Skilled Nursing News

Poll: 78 percent of Texans support required vaccinations for kids – KXAN-TV

Anti-vaxxers make intrusive public health methods more likely [Opinion – Editorial] – San Antonio Express-News

Surge in measles, flu shows need for vaccines [Opinion – Editorial]Beaumont Enterprise

Trump proposes big cuts to health programs for poor, elderly and disabled – The Washington Post

March 12 Hotline: Bill Provides Liability Protections For Physicians During Disasters

(Budget, Public Health) Permanent link

Harvey_Houston

 UNDER THE ROTUNDA

The Senate State Affairs Committee unanimously approved a bill Monday that would provide limited liability protections to volunteer physicians and other health care professionals who provide care during disasters in Texas.

Senate Bill 752 by Sen. Joan Huffman (R-Houston) also would extend protections to the facilities that sponsor those health care professionals, except for cases of reckless criminal conduct or intentional, willful, or wanton misconduct.

A thorough situational evaluation taken in the wake of Hurricane Harvey revealed many opportunities for improvement, including how best to utilize the volunteer services of physicians and other health care professionals who rush into action to care for fellow Texans.

Houston emergency medicine physician Beau Briese, MD, on Monday shared a detailed account of the heroic efforts of volunteers in the initial hours after the hurricane made landfall in 2017, telling legislators that the emergency shelter at Houston’s NRG Stadium treated as many patients in three hours as the 444-bed Ben Taub Hospital treats in a day.

“With more hands at the ready, we can do even better when the next natural disaster strikes,” Dr. Briese told the committee.

The Texas Medical Association worked during the interim to educate and inform legislators of the liability restrictions placed on volunteer physicians.

The bill is now headed to the Senate Local Calendar, where it likely will be passed on consent.

BUDGET UPDATE

The House Appropriations Committee, chaired by Rep. John Zerwas, MD (R-Richmond), heard testimony yesterday on riders, or amendments, to the 2020-21 budget. Health and human services riders adopted Monday include:

  • Two riders on expanding access to and utilization of Long Acting Reversible Contraceptives (LARCs) in an effort to remove the red tape that deters physicians and clinics from providing them. One approved rider would end the prohibition against transferring an unused LARC to another patient.
  • Tracking the percent of indigent patients receiving medication assisted treatment as part of their opioid-use treatment.
  • Requiring the Department of State Health Services to conduct a study on the costs to local and state health institutions for investigating and responding to vaccine-preventable disease outbreaks.

The budget still has many steps to go through, but getting riders added now greatly increases the odds they will be in the budget at the end of negotiations.

GETTING A BILL PASSED

With a flurry of activity, the bill filing deadline has finally passed, and 7,434 bills were filed. TMA is monitoring 1,524 of them, although that will likely change. Bills must next be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. At this point, about one-third of House bills and two-thirds of Senate bills have been referred to committee for debate. Seventy-six days remain in this session, and they are guaranteed to be busy. 

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 2028 by Rep. Julie Johnson (D-Carrollton) would automatically enroll eligible mothers covered by CHIP Perinatal into the Healthy Texas Women (HTW) program. TMA supports this bill. 
  • House Bill 2029, also by Representative Johnson, would provide a list of area physicians, plus program benefits information, to mothers enrolled in HTW. TMA supports this bill. 
  • House Bill 1092 by Rep. Bill Zedler (R-Arlington) would give prescribing authority to psychologists. Senate Bill 268 by Sen. Jose Rodriguez (D-El Paso) is the companion bill. TMA opposes these bills.  

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for APRNs.
  • Register for First Tuesdays at the Capitol – there are two left;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

PHYSICIAN OF THE DAY

Today’s physician of the day is Michael McLeod, MD, of Victoria. Dr. McLeod graduated from UT Southwestern Medical School, and is a member of both TMA and the Dewitt-Lavaca County Medical Society.

WHAT WE’RE READING

Anti-vaxxer parents are unwelcome at more Dallas clinics amid latest measles scare – The Dallas Morning News

Measles case confirmed in Collin County is second for Dallas-Fort Worth, 11th statewide – The Dallas Morning News

2019 is shaping up to be the worst year for measles since ‘90s, CDC data show – The Washington Post

Suicide second leading cause of death for Texas youth – Houston Chronicle

‘It’s Kind of Crazy in a Developed Country’: Inside the Amputation Crisis in the Rio Grande Valley – Texas Observer

ROBERTS: Continue CPRIT cancer research funding [Opinion – Op Ed] – The Lufkin Daily News

Will Texas Legislators Finally Do Something About Surprise Medical Billing? [Opinion – Commentary] – Houston Press

Report: Texas foster kids left in state psychiatric hospitals for weeks or months – Austin American-Statesman

UT Health Center to triple residency program with hopes of adding more doctors in region – Tyler Morning Telegraph

Hotline Video: Medicine Calls For Tobacco Reforms

(Budget, Health Insurance, Medicaid, Public Health) Permanent link

In this week’s TMA Legislative Hotline Video, watch physicians and lawmakers argue why a bill making its way through the Capitol could save the lives of thousands of young Texans.

Dallas public health physician John Carlo, MD, who chairs the Texas Public Health Coalition; Rep. John Zerwas, MD (R-Richmond); and TMA President Doug Curran, MD, were front and center speaking in support of Senate Bill 21, which would raise the tobacco sale age from 18 to 21.

We also hear Dr. Curran describe to lawmakers why he backs a bill that would expand Medicaid coverage for Texas’ working poor and would ensure coverage for pre-existing conditions.

Odessa family physician Timothy Benton, MD, explains what thousands of Texans could lose if lawmakers don’t pass a rural residency grant program bill.

And watch as the who’s who of TMA and government at a special ceremony honoring Louis J. Goodman, PhD, CAE, TMA’s executive vice president and CEO.

All of that and more are featured in this week’s TMA Legislative Hotline video.     

Also, make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests, and TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

Legislative Hotline: Senate All Ayes on Children’s Mental Health Bill

(Public Health, Scope of Practice) Permanent link

 Nelson_March_7_Hotline

 UNDER THE ROTUNDA
With a unified voice and a unanimous vote, the Senate passed a bill this week designed to identify children with mental-health needs and direct them to appropriate, timely treatment.

Senate Bill 10, by Sen. Jane Nelson (R-Flower Mound), 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 effectiveness of and access to behavioral health care.

Senator Nelson (pictured) has been frank about the need for SB10, filing it as part of a comprehensive response to last year’s school shooting in Santa Fe. The bill, a priority item for Gov. Greg Abbott, now awaits committee referral in the House.

Meanwhile, the House Appropriations Committee, chaired by Rep. John Zerwas, MD (R-Richmond), heard testimony today on draft spending recommendations for health and human services programs. Chief among the recommendations for the 2020-21 state budget are an additional $72.6 million for Early Childhood Intervention programs and an additional $88.1 million for women’s health. We will share a deeper analysis soon.

The House and Senate both are out until Monday afternoon, but many lawmakers are still in town as tomorrow is the bill filing deadline for the 2019 session. So far, more than 5,400 bills have been filed. TMA is monitoring more than 1,100 of them.

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 602 by Rep. Bill Zedler (R-Arlington) would require the Texas Medical Board (TMB) to inform the National Practitioner Data Bank when an administrative law judge decides an alleged violation by a physician did not occur. TMB also would be required to remove any description or order regarding the alleged violation from its website. TMA supports this bill. 
  • House Bill 603, also by Representative Zedler, would require TMB to submit a copy of any complaint regarding the board or its employees to the House Committee on Public Health within 30 days of receiving the complaint. TMA supports this bill. 
  • House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth) would require long-term care facilities to establish an infection prevention and control program. The idea for this bill originated in TMA’s Committee on Infectious Diseases. House Bill 1360 by Rep. Gene Wu (D-Houston) is identical. TMA supports these bills.  

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.

TODAY’S GRASSROOTS ADVOCACY TIP

When contacting your legislator, remember to be specific about the action you need, e.g., vote yes on HB10. Remember that every constituent contacting a legislator thinks his or her issue is the most important, so sharing facts or a memorable story as part of your communication will have more staying power than a simple action request. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is Paula Denson, MD, of Woodville. Dr. Denson graduated from The University of Texas Medical Branch at Galveston, and is a member of both TMA and the Hardin-Tyler County Medical Society.

WHAT WE’RE READING

Bill Filed to Raise Texas Smoking Age to 21 – KLBJ News Radio

First measles case confirmed in San Antonio – KSAT-TV

Texas Senate approves priority mental health bill – Austin American-Statesman

F.D.A. Commissioner Scott Gottlieb, Who Fought Teenage Vaping, Resigns – The New York Times

How influencers are helping Baylor Scott & White save lives – Becker’s Hospital Review

The Stress of a Natural Disaster Can Take a Toll on Babies in Utero – The Atlantic

March 6 Hotline: TMA Calls On Lawmakers To Back Rural Track GME Expansion

(Medicaid, Public Health) Permanent link

abortion_blog

UNDER THE ROTUNDA
The Texas Medical Association on Tuesday delivered testimony in support of graduate medical education (GME), maternal health, and preventing teenage nicotine addiction.

In the House Higher Education Committee, chaired by Rep. Chris Turner (D-Grand Prairie), Midland family physician Tim Benton, MD, delivered testimony representing TMA in support of House Bill 1065 by Rep. Trent Ashby (R-Lufkin).

HB 1065 would expand rural Texans’ access to care by creating a grant program for the development of rural training tracks to prepare physicians for practice in rural, underserved settings. It is of particular importance to Texas and TMA because the Medicare GME caps established in 1997 can be lifted for teaching hospitals that partner with medical schools to sponsor a rural training track.

Texas’ physician shortage is particularly acute in the state’s vast rural areas. Of Texas’ 177 rural counties, 101 are designated as “Primary Care Health Professional Shortage Areas.” Eighty-four rural Texas counties have five or fewer physicians; 24 counties have none, TMA reported in its Healthy Vision 2025 advocacy priorities. Ten rural Texas hospitals have closed permanently since the beginning of 2013.

“Research has shown that three out of four physicians who train in a rural track go on to practice in rural areas,” Dr. Benton said.

In the House Public Health Committee, TMA members testified in strong support of two bills, including House Bill 800 by Rep. Donna Howard (D-Austin), which would allow coverage under the Children’s Health Insurance Program for contraception if the enrolled child’s parent or guardian consents.

Austin family physician Celia Neavel, MD, noted that 20 percent of the 27,000 Texas teens who gave birth in 2017 already had a child.

“With parental consent, reducing barriers to contraception — including long-acting reversible contraceptives — helps guarantee fewer unplanned pregnancies and associated health risks, [and] abortions, and more education and greater economic opportunities for our patients,” Dr. Neavel told lawmakers.

The House and Senate both adjourned until Monday afternoon, but committee hearings continue through Thursday.

Eight full weeks into session — and just two days before the bill filing deadline — more than 5,000 bills have been filed. TMA is monitoring nearly 1,100 of them — in keeping with previous sessions’ rates of more than 20 percent of all bills filed.

IN OTHER NEWS

Yesterday was TMA’s second First Tuesdays at the Capitol for the 2019 session. Hundreds of physicians, medical students, and TMA Alliance members swarmed the Capitol to speak with lawmakers and their staff about medicine’s priorities. Hot topics of conversation included scope of practice, health insurance reform, Medicaid payments to physicians, mental health, and public health. The next First Tuesdays is April 2. Register today

One important issue for TMA is raising the age to purchase tobacco and vaping products to 21 years. Yesterday, Dallas public health leader John Carlo, MD, led a press conference alongside Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Richmond), the authors of Senate Bill 21 and House Bill 749, respectively, which seek to raise the legal age to purchase tobacco products. Earlier today, the House Public Health Committee heard testimony from Athens family physician and TMA President Doug Curran, MD, in strong support of HB 749

Yesterday, TMA co-authored an article in the Houston Chronicle with an urgent plea to Texas’ legislative leadership to renew the soon-to-expire 1115 Healthcare Transformation Waiver. If it expires, millions more Texas could be left without access to timely, quality, affordable health care, and Texas could lose $6 billion in annual federal funds. The plea came in conjunction with House Insurance Committee testimony from Dr. Curran in support of House Bill 565 by Rep. Garnet Coleman (D-Houston), which seeks to expand Medicaid coverage and protect patients with pre-existing conditions. 

Yesterday, Rep. Joe Deshotel (D-Beaumont) recognized TMA Board of Trustees member and Beaumont anesthesiologist Ray Callas, MD, with House Resolution 630. Dr. Callas was awarded the American Medical Association’s Medal of Valor for his efforts in the aftermath of Hurricane Harvey. Representative Zerwas co-authored HR 630, and all members of the House added their names in support. 

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills.  

  • House Bill 29 by Rep. Ina Minjarez (D-San Antonio) would allow patients to have direct access to physical therapists without a referral by a physician. The bill also would allow physical therapists to treat for up to 30 days a patient who doesn’t have a medical diagnosis or physician authorization for physical therapy. Senate Bill 732 by Sen. Bryan Hughes (R-Mineola) is the companion. TMA strongly opposes these bills. 
  • House Bill 1622, by Rep. Tom Oliverson, MD (R-Cypress) would permit physician dispensing of medications – but not controlled substances – provided at cost to the patient. These medications would largely be prepackaged, low-cost generics. TMA supports this bill. 
  • Senate Bill 305 by Sen. Kirk Watson (D-Austin) would protect from criminal charges the first person to request emergency assistance for someone overdosing when that person remains on scene and cooperates with medical and law enforcement personnel. TMA supports this bill. 
  • Senate Bill 340 by Senator Huffman would establish a grant program to fund access to opioid antagonists for law enforcement personnel. House Bill 1449 by Rep. Phil King (R-Weatherford) is the companion bill. TMA supports these bills. 

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.

TODAY’S GRASSROOTS ADVOCACY TIP

When contacting your legislator, remember to be specific about the action you need, e.g., vote yes on HB10. Remember that every constituent contacting a legislator thinks his or her issue is the most important, so sharing facts or a memorable story as part of your communication will have more staying power than a simple action request. Get more tips in our Grassroots Advocacy Guide.

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 in Washington, DC, and is a member of both TMA and the Travis County Medical Society.

 WHAT WE’RE READING

Should Texans be allowed to vote on Medicaid expansion? – Austin American-Statesman

Protections For Pre-Existing Conditions Joins Medicaid Expansion on Texans’ Healthcare Wishlist – Houston Public Media

Two dozen groups call for Medicaid expansion in Texas, which leads nation in uninsured – Houston Chronicle

Open Wounds, Head Injuries, Fever: Ailing Migrants Suffer at the Border – The New York Times

New bill would crack down on e-cigarette sales to Texas minors – KXAN-TV

Race and the Medical Profession: How Increased Diversity Could Influence the Way White Americans View Black Doctors – D CEO Healthcare

Instead of a surprise in the mail, costly ER bills could be sent straight to mediation in Texas – Austin Business Journal

March 5 Hotline: Physicians Push Lawmakers For Insurance Expansion

(Health Insurance, Medicaid, Public Health) Permanent link

state-capitol

 UNDER THE ROTUNDA
Today was the second of four First Tuesdays at the Capitol, and hundreds of Texas Medical Association and TMA Alliance members donned their white coats and visited with their legislators about issues important to the house of medicine.

In the House Insurance Committee, chaired by Rep. Eddie Lucio III (D-Brownsville), TMA president Doug Curran, MD, delivered testimony supporting House Bill 565 by Rep. Garnet Coleman (D-Houston). HB 565 would expand Medicaid coverage for Texas’ working poor and ensure coverage for pre-existing conditions. TMA supports this bill.

“One in five uninsured children in the United States reside in Texas,” Dr. Curran said. “Children are less likely to have coverage when their parents are uninsured, so Texas’ rising rate of uninsured bodes ill for the health of the youngest Texans, who will grow up to be the state’s future workforce.”

On the other side of the rotunda, several TMA members were busy testifying before the Senate Health and Human Services Committee.

Austin pediatrician Louis Appel, MD, testified in support of Senate Bill 355 by Sen. Royce West (D-Dallas), which 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. TMA supports this bill.

Dr. Appel shared a story about two young siblings whom he treats, whose mother was quite young herself when they were born. The family continues to struggle, inspiring Dr. Appel to share some wisdom: “Prevention services provide cost savings to the state, give parents the support they need to care for children, and most importantly, give children a fair chance at a bright future.”

Noting the data reporting challenges that prompted the alarm about Texas’ maternal mortality and morbidity rates, TMA submitted written testimony in support of Senate Bill 559 by Sen. Borris Miles (D-Houston). SB 559 would establish a 30-day timeline for medical records custodians to respond to Department of State Health Services (DSHS) records requests for patients who died while pregnant or who had been pregnant within the preceding year.

Committee chair Sen. Lois Kolkhorst (R-Brenham) authored Senate Bill 748, which would establish a dedicated general revenue account for newborn screening fees. DSHS cannot add conditions from the national Recommended Uniform Screening Panel without sufficient startup and maintenance funding. Houston neonatologist Charleta Guillory, MD, spoke in favor of the bill.

“We screen every newborn Texan baby twice for 53 separate disorders or conditions, any one of which could potentially lead to an early death or lifelong disability,” Dr. Guillory said. “However, by screening children at birth we have the ability through the miracle of modern medicine to change the developmental outcomes of these children and give many of them the opportunity to live productive, healthy lives.”

Eight full weeks into session — and just three days before the bill filing deadline – more than 4,700 bills have been filed. TMA is monitoring nearly 1,100 of them – in keeping with previous sessions’ rates of more than 20 percent of all bills filed.

BILLS OF NOTE

This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 2327 by Rep. Greg Bonnen, MD (R-Friendswood), would require health maintenance organizations to notify physicians and plan enrollees which procedures require prior authorization and what the process entails. Additionally, physicians whose prior authorization requests are routinely approved by health plans would be exempt from further prior authorization requirements if deemed appropriate by Texas Department of Insurance rules. Senate Bill 1186 by Sen. Dawn Buckingham, MD (R-Lakeway), is the companion. TMA supports these bills. 
  • House Bill 2387, also by Representative Bonnen, would require a utilization review program to be directed by a physician licensed in Texas. Senate Bill 1187, by Senator Buckingham, is the companion. TMA supports these bills. 
  • House Bill 2733 by Rep. Phil Stephenson (R-Wharton) would expand chiropractors’ current statutory scope of “musculoskeletal” to “neuromusculoskeletal,” an unnecessary and unwise expansion. TMA strongly opposes this bill. 
  • House Bill 2408 by Rep. Julie Johnson (D-Carrollton) disallows prior authorization requirements for state-mandated health plan benefits, such as mammograms and prostate cancer screening. TMA supports this bill. 

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.

TODAY’S GRASSROOTS ADVOCACY TIP

When contacting your legislator, remember to be specific about the action you need, such as, “vote yes on HB10.” Remember that every constituent contacting a legislator thinks his or her issue is the most important, so sharing facts or a memorable story as part of your communication will have more staying power than a simple action request. Get more tips in our Grassroots Advocacy Guide.

ARE YOU A LEGISLATIVE JUNKIE?

If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.

TAKE ACTION

TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for APRNs.
  • Register for First Tuesdays at the Capitol – there are two left;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.

PHYSICIAN OF THE DAY

Today’s physician of the day is James King, MD, of Galveston. Dr. King graduated from the University of Oklahoma College of Medicine and is a member of the Brazoria County Medical Society.

WHAT WE’RE READING

The health care crisis Texas isn’t talking about [Opinion] – Houston Chronicle

‘Gotcha!’ Surprise medical bills game the system [Opinion – Op Ed] – San Antonio Express-News

Texas Lawmakers Take Aim At Surprise Medical Bills – KUT, NPR, Kaiser Health News

Silver health plans set stiffer cost-sharing on drugs than employer plans – Modern Healthcare

How Texas and Longhorns Are Tackling Maternal Mortality in Texas – The Alcalde

The Opioid Dilemma: Saving Lives in the Long Run Can Take Lives in the Short Run – The New York Times

Physician Burnout: A Shrinking Problem? – MedPage Today

Look abroad to solve Texas’ primary-care doctor shortage [Opinion – Op Ed] – Waco Tribune-Herald

Why does it take so long to get a doctor’s appointment? – Fort Worth Star-Telegram

New Texas bill would create easier path for vaccine exemptions in public schools – FOX News

State lawmakers pushing for laxer vaccine rules despite measles outbreaks –  Politico

Hotline Video: Should Health Plans Have Sole Power to Set Out-Of-Network Rates?

(Budget, Medicaid, Public Health, Scope of Practice, Women’s Health) Permanent link

This week’s Texas Medical Association Legislative Hotline video takes a first look at a new bill that could give health plans exclusive power to set rates they pay physicians – for out-of-network care.

Also, TMA President Doug Curran, MD, weighs in on a new study that puts a price tag on Texas’ high uninsured population (it’s a very big number).

This week, San Antonio pediatrician Uchenna Umeh, MD, told lawmakers why a new bill is needed to address children’s behavioral health. Dr. Umeh describes the tragic outcomes that happen without such preventive measures.

And see what you’ll be missing if you don’t attend TMA’s First Tuesdays at the Capitol next week.

Click below to see this week’s video. 

Also, make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests, and TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.