• TMA's 2013 Legislative Report Card

    Texas Legislature Delivers for Patients and Physicians

    Most Wins in a Decade

    Stephen L. Brotherton, MD, TMA President ImageTexas patients and their physicians won big at the state Capitol. We had more wins than in recent sessions across all issues affecting patient care, as outlined in TMA’s Healthy Vision 2020. In fact, nearly every TMA bill made it to the finish line, either intact or as an amendment. And every bill TMA wanted stopped was stopped.

    It was a triumphant legislative session for medicine. As credited to late U.S. House Speaker Tip O’Neill, “all politics is local,” and this year we did local better than ever. The keys to our success are the time and effort TMA members took to educate their legislators about issues affecting patient care. Texas legislators listened and delivered for their constituents. Bills unsuccessful in the past two, three, even five sessions moved this year, like no other.

    Thanks to our many friends at the state Capitol, companies no longer can steal physicians’ discounted fees, vaccines now are tax-deductible, and the physician-led medical team model of care is now law.

    But our work isn’t finished. Left undone was finding a way to broaden coverage for the 6 million Texans without health care coverage. We will continue to look for innovative solutions that leverage federal dollars to help provide access for these working poor Texans.

    We also must ensure legislators friendly to medicine stay in office and all our elected officials clearly understand issues facing patients and their physicians. Together, we can and do make a difference.

    Download our report card to share with your colleagues

    Celebrating TMA's Wins

    • Cut red tape and paper work hassles, including for Medicaid
    • Stopped theft of physician services
    • Reined in overzealous Medicaid fraud- and-abuse investigations
    • Stopped unwarranted scope expansions
    • Protected 2003 liability reforms
    • Protected physician independent medical judgment
    • Strengthened Texas’ physician workforce
    • Increased mental health and substance abuse treatment funding
    • Restored and increased women’s health care funding
    • Firmly established physician-led medical teams, allowing all involved to practice at their level of education and training
    • Protected public health with improved vaccination policies for children, adolescents, and adults
    • Secured tax relief for small businesses


    Stephen L. Brotherton, MD

  • Cut Red Tape and Regulation

    Six hassle-busting bills passed. One lets patients sign in with a swipe of their driver license. The others will bring uniform prior-authorization forms for medications and medical services, a much more streamlined way of renewing physicians’ state Controlled Substances Registration, and significant simplifications complying with the state’s medical privacy law.

    TMA Red Tape Reduction Acts of 2013

    • Victory: One medical prior-authorization form
    • Victory: One prescription prior-authorization form
    • Victory: NEW Controlled Substances Registration process — one-stop online renewal, every two years with medical license renewal
    • Victory: Check in patients with one swipe of their driver license
  • Stopped Theft of Physician Services

    It took more than six years, but TMA and our state legislators never gave up. Now a new law regulating silent PPOs penalizes unethical third parties who steal and resell physicians’ discounted rates, for commercial and Medicaid contracts.

    Lawmakers also passed a prompt-pay law for Medicaid HMOs; no more low-pay, slow-pay, no-pay.

  • Reined in Medicaid Fraud Investigations

    Now in place is a new law to improve due process, transparency, and expediency when the Medicaid Office of Inspector General accuses a physician of fraud and abuse. 
  • Protected Your Medical Judgment

    TMA’s 2011 legislation limiting direct hiring of physicians to rural areas and mandating protections for physicians’ independent medical judgment in all employment scenarios remained intact. Two bills passed adhering to Texas’ 2011 employment law and providing additional protections for physicians.
  • Battled Physician Shortages

    Graduate medical education (GME) funding slashed in 2011 was nearly restored. Lawmakers recognized the dire need to retain Texas’ medical school graduates and for first time created incentive programs to grow GME by providing more money for training costs. Family medicine residency program funding was doubled. Texas’ physician loan repayment programs were enhanced to ensure more physicians can practice in rural and underserved areas. Lawmakers also stopped off-shore medical schools from buying up core clinical clerkship spots in Texas hospitals. A 2011 law that made Texas the only state that forced physicians on visas (international medical graduates) to spend three years working in medically underserved areas was repealed.
  • No Budget Cuts. More Money for Health Care

    Legislators wrote a big increase in funding for mental health and substance abuse services, along with important changes in our mental health screening and education systems. The steep budget cuts to women’s health services in 2011 were reversed. Lawmakers even added more money to these programs to ensure low-income women receive timely care.
  • Enacted Tax Relief for Doctors

    Tax relief for small businesses — like so many Texas physicians’ practices — passed. Primary care physicians finally get a tax break for their vaccine stock. And, the hard-fought-for 2005 tax exemption for physicians who treat patients covered by Medicaid, Medicare, Children’s Health Insurance Program, workers’ compensation, and other government payers are intact.
  • Blocked Scope Expansions

    Our landmark scope bill that sets up a more collaborative, delegated practice among physicians and advanced practice nurses or physician assistants is now law. The law firmly establishes the physician-led medical team, allows all involved to practice at their level of education and training, and places more authority and responsibility on the physician to supervise. TMA never deviated from the core principle that diagnosing and prescribing remain the practice of medicine. Now we have a process and a model for future scope-of-practice discussions. Also, lawmakers added a provision that defines pain management as the practice of medicine. All unwarranted scope expansion bills were stopped.
  • Protected Young Texans

    New laws improve Texas’ immunization policies.  Child care centers now must have a vaccination policy place for their workers, and minor parents now can consent for their own vaccines. The state budget keeps the state Fitnessgram program alive in schools, providing critical data to address the state’s obesity epidemic.