UNDER THE ROTUNDA
With the House and Senate adjourned until tomorrow and just five weeks remaining in this session, below is a recap of the status of numerous bills the house of medicine is tracking.
House Bill 1110 by Rep. Sarah Davis (R-West University Place), which would require 12 months’ continuous Medicaid coverage for eligible postpartum women and those who have had a miscarriage, was approved by the House Human Services Committee and awaits debate on the House floor. The Texas Medical Association strongly supports this bill.
House Bill 1589 by Rep. Lina Ortega (D-El Paso), which would require notifying women whose postpartum Medicaid coverage has lapsed that they are eligible for the Healthy Texas Women program, passed the House 144-1 and awaits committee referral in the Senate. TMA supports this bill.
House Bill 1278 by Rep. James White (R-Hillister), which would allow free-standing emergency room facilities to treat outpatient and acute care needs, has been voted out of the House Public Health Committee and awaits debate on the House floor. TMA opposes this bill because it crosses a line from solely emergency care into a miniature hospital setup.
House Bill 2041 by Rep. Tom Oliverson, MD (R-Cypress), which would require free-standing emergency room facilities to post conspicuous notices that they might be out of network, along with written disclosure of possible observation and facility fees, was voted out of the House Public Health Committee and awaits scheduling for a House floor debate. TMA supports this bill.
House Bill 2630 by Rep. Julie Johnson (D-Carrollton), 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, is set on the House Calendar for Wednesday. TMA strongly supports this bill and testified in support last month.
House Bill 2732 by Rep. Dustin Burrows (R-Lubbock) would require physicians to receive from patients a signed disclosure form with an itemized statement of the amounts to be billed for nonemergency medical services before those services are provided. Otherwise, the physician would be prohibited from sending an unpaid bill to a credit reporting agency. While not identical to Representative Burrows’ bill from last session, it is remarkably similar. TMA killed last session’s bill on the floor and strongly opposes this bill. HB 2732 was left pending in the House Business and Industry Committee last week.
House Bill 765 by Rep. Gene Wu (D-Houston), which would index to inflation the liability caps established by the landmark 2003 tort reform bill, was left pending in the House Judiciary and Civil Jurisprudence Committee last week. TMA strongly opposes this bill.
Scope of Practice
House Bill 912 by Rep. Donna Howard (D-Austin), which would expedite in-state licensing for Advanced Practice Registered Nurses (APRNs), was voted out of the House Public Health Subcommittee on Health Professions and awaits consideration on the House floor. HB 912 is one of few bills passed out of the scope of practice hearing from earlier this month. TMA is closely monitoring this bill.
House Bill 1622 by Representative Oliverson, which would permit in-office dispensing of non-controlled substance medications, was finally heard in the House Public Health Committee last week and is still pending. TMA supports this bill.
House Bill 1792 by Rep. Stephanie Klick (R-Fort Worth), which would grant APRNs “full practice authority” – their term for independent prescribing without delegation, supervision, or limitation – remains pending in the House Public Health Subcommittee on Health Professions. TMA opposes this bill, but does support team-based collaborative care capitalizing on having the right professional provide the right service to the right patient at the right time, with overall direction and coordination by physicians.
House Bill 871 by Rep. Four Price (R-Amarillo), which would expand the use of telemedicine to rural trauma hospitals, passed the House 136-0 and awaits committee referral in the Senate. TMA supports this bill.
House Bill 3345, also by Representative Price, would allow physicians to choose the best platform for providing telemedicine services to their patients, rather than having health plans dictate the platform. TMA supports this bill, which is set on the House Calendar for Wednesday.
Senate Bill 752 by Sen. Joan Huffman (R-Houston), which would provide liability protections for physicians who volunteer in the aftermath of disasters, will be heard in the House Judiciary and Civil Jurisprudence Committee tomorrow. TMA supports this bill.
House Bill 1256 by Rep. Dade Phelan (R-Beaumont) 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 first responder might not be able to check his or her immunization status in an emergency. HB 1256 is pending in the Senate Health and Human Services Committee. TMA testified in support of this bill last month.
Senate Bill 329 by Sen. Kel Seliger (R-Amarillo), known as the Parents’ Right to Know Act, would require school districts to provide student vaccination rates at the school campus level. It has been set for a hearing tomorrow in the Senate Health and Human Services Committee. TMA strongly supports this bill.
Opioids/Prescription Drug Monitoring
Senate Bill 2316 by Sen. Juan “Chuy” Hinojosa (D-McAllen) would delay the mandate to check the Prescription Drug Monitoring Program (PMP) until March 1, 2020, to allow time for electronic integration of the PMP into physicians’ electronic health records. The bill also would create an advisory committee to the Board of Pharmacy. TMA supports this bill, which was approved by the Senate Health and Human Committee and awaits debate on the Senate floor.
House Bill 2174 by Rep. John Zerwas, MD (R-Richmond), which would mandate electronic prescribing of opioids, set a maximum prescription duration, and require continuing medical education for prescribers – is set on the House floor calendar for Wednesday.
Graduate Medical Education/Physician Workforce
House Bill 2261 by Rep. Armando Walle (D-Houston) – which would increase the physician education loan repayment program’s allowable repayment assistance amounts by $5,000 each year, bringing the total amount of repayment assistance available to $180,000 – awaits a hearing in the Senate Higher Education Committee.
House Bill 4039 by Rep. Chris Turner (D-Grand Prairie) would require new medical schools to account for peak class sizes – and not merely inaugural class sizes – when planning residency slots. Texas must have enough residency slots for physicians who study here. TMA strongly supports this bill, which was voted unanimously from the House Higher Education Committee and recommended for the Local and Consent Calendar.
The House and Senate return to work tomorrow.
All 10 of the budget’s conference committee members have now been named. These representatives will negotiate the differences in the two chambers’ proposed 2020-21 state budgets:
- Sen. Jane Nelson (R-Flower Mound), chair of the Senate Conference Committee. Senator Nelson chairs the Senate Finance Committee;
- Senator Huffman, who chairs the Senate State Affairs Committee;
- Sen. Lois Kolkhorst (R-Brenham), who chairs the Senate Health and Human Services Committee;
- Sen. Robert Nichols (R-Jacksonville), who chairs the Senate Committee on Transportation;
- Sen. Larry Taylor (R-Friendswood), who chairs the Senate Education Committee;
- Representative Zerwas, chair of the House Conference Committee. Representative Zerwas chairs the House Appropriations Committee;
- Rep. Greg Bonnen, MD (R-Friendswood), who chairs the House Appropriations Subcommittee on Article III, which addresses higher education;
- Representative Davis, who chairs the Subcommittee on Article II, which addresses health and human services;
- Representative Walle, who is vice chair for the Subcommittee on Article III; and
- Rep. Oscar Longoria (D-Mission), who is vice chair of the House Appropriations Committee.
The conference committee has until late May to distribute a draft of the biennial budget. A top priority remains TMA’s request for a $500 million infusion of new state dollars to increase physicians’ Medicaid payment rates; TMA will submit written comments and recommendations on priority items for medicine early next week.
Additionally, Speaker Dennis Bonnen (R-Angleton) has named the House members to the conference committee for Senate Bill 500 by Senator Nelson, the supplemental spending bill to backfill deficits in the 2018-19 biennial budget.
GETTING A BILL MOVING
TMA is monitoring 1,943 of the 7,731 bills filed this session. Bills must be voted out of committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bills in the House must be out of committee by May 6 – two weeks from today – to be considered by the Senate this session.
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
All politics are local. Know your local legislators. Know if they’re Republican or Democrat, conservative or liberal. Know the committees on which they sit. Those few pieces of information will help you craft a message that will resonate more strongly with your legislator. Get more tips in our Grassroots Advocacy Guide.
PHYSICIAN OF THE DAY
Today’s physician of the day is Martha Cano, MD, of Weslaco. Dr. Cano graduated from The University of Texas Medical Branch School of Medicine in Galveston and is a member of both TMA and the Hidalgo-Starr County Medical Society.
WHAT WE’RE READING
Medicaid’s missing children [Opinion] – San Antonio Express-News
It cost what? Medical pricing shrouded in secrecy, leaving patients in the dark – Houston Chronicle
Congress to Consider Raising Tobacco-Buying Age to 21 – The Wall Street Journal
FDA Oks 1st Generic Nasal Spray of Overdose Reversal Drug – The Associated Press
Two-Wave US Flu Season Is Now the Longest in a Decade – The Associated Press
Despite Controversy, Mental Health Bills Move Forward At Texas Legislature – Texas Public Radio
It’s Dallas County vs. the West Nile Virus in another round of mosquito ‘Battleship’ – The Dallas Morning News
MD Anderson ousts 3 scientists over concerns about Chinese conflicts of interest – Houston Chronicle