Progress Made So Far

Thanks to the collective efforts of Texas’ state and federal legislators, state agency leaders, organized medicine, and public health advocates, we accomplished many of the recommendations in the first edition of TMA’s Healthy Vision 2020. Most of the results stem from actions of the Texas 2013 Legislature, while others are from federal laws and regulations.

Ensure an Adequate Health Care Workforce  

  • Restored much of the graduate medical education (GME) funding cuts from 2011.  

  • Created new incentive programs to grow GME, providing more money to train young physicians — family medicine residency program funding was doubled. 

  • Reinstated funding for Texas’ physician loan repayment programs to ensure more physicians can practice in rural and underserved areas. 

  • Prohibited off-shore medical schools from buying up core clinical clerkship spots in Texas hospitals and displacing Texas medical students. 

  • Enacted a new law that 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. 

  • Stopped scope of practice expansions beyond that safely permitted by nonphysician practitioners’ education, training, and skills.  

Protect Physicians’ Independent Medical Judgment   

  • Preserved the primacy of the patient-physician relationship in the face of health system reform. 

  • No laws passed harming Texas’ landmark legislation mandating protections for physicians’ independent medical judgment in all employment scenarios. 

  • No laws passed requiring physicians to provide care that they believe is medically inappropriate or that violates their personal conscience and moral beliefs.   

Promote Efficient and Effective New Models of Care   

  • Increased funding for mental health and substance abuse services to reduce waiting times for treatment, provide training for teachers and others, improve jail diversion, and to provide residential services for chronically homeless persons with behavioral illnesses. 

  • Restored funding that was cut in 2011 to women’s health services and added more money to these programs to ensure low-income women receive timely care. 

  • Enacted several physician-driven, patient-centered medical home (PCMH) pilot projects, which provide financial incentives from both state and private payers, such as the pregnancy PCMH in Houston for Medicaid enrollees. 

  • Established a Maternal Mortality and Morbidity Review Task Force to identify causes of and remedies for pregnancy-related deaths and severe morbidity.   

Repeal Harmful and Onerous State and Federal Regulations   

  • Delayed ICD-10 implementation until October 2015 to ensure systems are reliable and tested appropriately. 

  • Passed new laws that will create standardized prior authorization forms for prescription drugs and health care services for public and private payers. 

  • Streamlined the standards practices must follow in training staff on privacy laws and for notifying patients in the case of a breach of private information. 

  • Enacted a new law allowing patients to check in using the electronic strip on the back of their Texas driver licenses. 

  • Created a much more streamlined way of renewing physicians’ state Controlled Substances Registration permit. 

  • Excluded the cost of vaccines from the state business tax for primary care physicians.   

Invest in Prevention   

  • Passed new state laws to improve Texas’ immunization policies. Childcare centers now must have a vaccination policy in place for their workers, and minor parents now can give consent for their own vaccines. 

  • Allocated more funding for the state’s adult vaccination safety net. 

  • Aligned college meningitis immunization requirements with the recommendations of Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices while maintaining the current public health exemption process. 

  • Provided funding for proven interventions to reduce tobacco use, such as Texas’ Quitline and education in schools. 

  • Retained the Fitnessgram program in Texas’ public schools, which provides critical data to address the state’s obesity epidemic.   

Protect and Promote a Fair Civil Justice System   

  • Protected Texas’ strong medical liability reform laws, including caps on noneconomic damages and protections for emergency services. 

  • Required the Texas Medical Board to focus efforts on quality-of-care issues. 

  • Stopped efforts to create new causes of actions against physicians and other health care providers who are delivering evidence-based and clinically appropriate care. 

  • Prevented federal preemption of state civil justice reforms. 

  • Maintained the integrity of the Texas Advance Directives Act, protecting physicians’ freedom from exposure to medical liability suits.   

Provide Appropriate State and Federal Funding for Physician Services   

  • Reversed cut that eliminated state coverage of Medicare deductible for patients dually eligible for Medicaid and Medicare. 

  • Required the Texas Health and Human Services Commission to reduce administrative hassles, ensure prompt payment of claims, streamline paperwork and credentialing requirements, and strengthen how Medicaid measures network adequacy. 

  • Improved due process and transparency, and expedited review for physicians accused of fraud and abuse in Medicaid by the Office of Inspector General.   

Establish Fair and Transparent Markets for Patients, Employers, Taxpayers, and Physicians  

  • Passed new law that subjects companies and networks that sell, lease, or share physicians’ privately contracted discounts, known as “silent PPOs,” to Texas Department of Insurance (TDI) oversight and other regulations. 

  • Enacted a new law that ensures physicians will know if a health plan is applying their discounted contract rates under Medicaid managed care or the Children’s Health Insurance Program to commercial products.

  • Required health insurers to regularly report their medical loss ratios in a standardized format to TDI as well as to purchasers and enrollees upon request. 

  • Required insurers to notify patients that rescission of their policy is under consideration, and for what reason, before the actual cancellation occurs. 

  • Established tax incentives for businesses to provide health insurance for their employees. 

  • Allowed Texas’ small businesses to challenge health insurance premium quotes, and required insurers to provide information to justify a premium increase. 

  • Protected TDI-Division of Workers’ Compensation due process procedures and made certain physicians subjected to peer review are reviewed by professionals with the same training, education, and licensure. 

 

Healthy Vision 2020

Last Updated On

April 25, 2018

Originally Published On

September 26, 2014