Complications-Report Requirement Would Invade Patient-Physician Relationship

TMA Testimony on House Bill 2962 by Rep. Giovanni Capriglione

House Committee on State Affairs

March 29, 2017

The Texas Medical Association (TMA), representing more than 50,000 physicians and medical students, appreciates the opportunity to voice our concerns with House Bill 2962 as filed by Rep. Giovanni Capriglione relating to requirements for reporting on complications of abortion. 

As we have explained to you, our members fall on both sides of the abortion issue, so our comments are not on that highly personal and private matter. Our objections relate to the components of this legislation that create further reporting requirements on abortion and the potential for imposing administrative or legal action against a physician. 

HB 2692 requires reporting of abortion complications, and it sets forth a list of what those reportable complications are. The bill also requires that the report of complications “meet the federal reporting requirements that mandate the most specific, accurate, and complete coding and reporting for the highest level of specificity.” A description of the complication is not the same as a specific diagnosis code. Furthermore, the bill does not define what coding it is referring to. Finally, this reporting requirement requires strict compliance; there are no exceptions for inaccurate or incomplete coding. In TMA’s view, these add up to an unworkable standard.

As currently written, this bill would require a physician who diagnoses a complication following an abortion and/or initiates treatment of a woman following an abortion to report that information. This is a particular concern in an emergency department (ED) setting where a physician will have no or limited contact with the patient following her discharge from the ED, but the health care facility nonetheless would be required to submit the complication-reporting form. The failure of the physician or the health care facility to complete the form puts the physician at risk of disciplinary action and even a misdemeanor. Even a simple error in the information would put the physician and the facility at great risk.  

Even if a substitute bill provides that physicians are specifically removed from the reporting requirement, a physician’s office still might be viewed as included in the definition of a reporting “facility” if the physician’s office provided even sporadic emergency care (such as care for a patient’s extreme pain, unrelated to an abortion, that results from, for example, a severe migraine headache). 

Physicians know complications from an abortion are rare — in Texas and in the United States. Such complications occur in 1 to 2 percent of all abortions and often are associated with greater gestational age and the health of the woman. The state already has established reporting requirements for complications from abortions. Yet physicians are unaware of how this information is used and what public health benefit exists as a result of the abortion-complications reporting the state currently requires.   

Removing the reference to physicians does not address our deep concerns with further intrusion into the care and process of providing care to our patients — each of whom presents with unique health needs. There is no clear public health purpose to HB 2962. Instead, measures like this merely build on the existing intrusive foundation for future lawmakers to gather even more details on the sacred relationship between patients and physicians. 

TMA was founded with the mission of supporting the education of the public on medicine and public health. We will continue our work in this area so that public health policy is based on sound scientific evidence that supports the health of the residents of our state. We look forward to working with the committee to address our concerns with HB 2962.

Testimony main page

TMA Legislative main page

Last Updated On

March 30, 2017