Chief Houston Doctor: TMA Working for Real TMB Reform

TMA battles to improve the “Texas Medical Board” process for doctors

Reprinted from Harris County Physician Newsletter, May 15, 2011, President’s Page by Guru N. Reddy, MD, President of Harris County Medical Society

Many physicians in Harris County and across the state of Texas have been unhappy with the Texas Medical Board (TMB) processes. We have felt the actions of the TMB at times overarching and draconian.

In the April 15th newsletter, we reported that several bills had been filed to address physicians’ issues with the Texas Medical Board, some of which we’ve been struggling with for years. Over that time, we have conducted three member surveys to identify your primary concerns. We were able to address several of the issues through rule making at the TMB, but many of the issues require legislative actions.

Over the past several sessions, the Texas Medical Association (TMA) has drafted legislation to address many of your complaints against the TMB. We have been educating our elected officials and making some progress, but past efforts at passing a bill were unsuccessful.

This year, TMA enlisted the help of Sen. Jane Nelson (R-Flower Mound), the chair of the Senate Health and Human Services Committee. Sen. Nelson has filed three bills, SB 190, 191 and 227. The principal components of each bill are:

  • • SB 190
    • eliminates anonymous complaints;
    • extends the physician response period from 30 to 45 days;
    • establishes notification if the complaint is filed by an insurance agent, insurer or third-party administrator;
    • establishes a statute of limitations of seven years for adult patients where none currently exists; and
    • allows the recording of Informal Settlement Conference at the physician’s request.
  • SB 191: Provides that findings of fact and conclusions of law by an Administrative Law Judge (ALJ) are binding onqqq the TMB, except that the TMB can seek judicial review of an ALJ’s decision.
  • SB 227: Establishes the authority of the TMB to issue a remedial plan, which could not be used against a physician in court, for the resolution of relatively minor complaints.

These bills all successfully passed the Senate with a vote of 31-0, have been voted out of their House Committee, and now as of this writing are awaiting a vote by the full House. TMA worked diligently with Senator Nelson to develop these bills (SB 190, 191 and 227) and has testified and lobbied strongly for their passage. By dividing the issues into three bills, there is a greater likelihood of passing one or two of them, even if the Legislature gets bogged down at the end of the session on other issues.

Another bill, HB 1013, by Rep. Fred Brown (R-College Station), addressed some of these issues but not all of them. This bill has been supported by the Association of American Physicians and Surgeons (AAPS). Recently, the AAPS sent out various communiqués to physicians across Texas that claim that the TMA opposes reform because it does not support HB 1013. That statement is completely false. TMA strongly advocates for reform of TMB and is in favor of Sen. Jane Nelson’s bills, which have already passed Senate and have a good chance of passing the House.

TMA does not support HB 1013 because Senator Nelson’s bills are better bills and have the best chance of passage. The TMA bills do for the profession all that HB 1013 would do, and more. The TMA determined early on that the best strategy to pass a bill was to work with the chair of a powerful Senate committee and get it through that body quickly, so that it would have plenty of time to get through the House as the end of the session drew near. If the House passes the three Senate bills, they will to the governor for signature. However, if HB 1013 passes the House, it must go through the Senate Committee process and pass the full Senate. If it gets amended, then it must go back to the House, and possibly a conference committee. At this stage of the session, the more steps a bill must go through, the slimmer the chance of it passing. TMA did not wish to go through another session and see its hard work at reform of the TMB just perish in the closing days.

I, along with many physicians from Harris County and other counties across Texas, was in Austin on May 3 for the “First Tuesdays at the Capitol” event. We visited with legislators and their staff and emphasized the importance of Texas Medical Board process reforms.

TMA has heard our concerns and is working diligently through SB 190, 191 and 227 to advocate for reform. If you would like to help TMA, go to the HCMS Web site, www.hcms.org, and click on News/Choose Your News-HCMS Direct to sign up for irect emails on legislative updates. Then you can access the status of these bills, so that you can contact your representatives and urge them to cast votes that support Texas patients and physicians.