Feb. 27 Hotline: Physicians Urge State to Put $500 Million More Into Medicaid
By Jennifer Perkins


Yesterday, the Texas Medical Association urged state budget writers to invest $500 million of general revenue in Medicaid to improve access to care in Texas. 

In a fact sheet sent to the House subcommittee considering health and human services in the state’s 2020-21 budget, TMA reminded legislators that fee-for-service rates have not received a sustained, meaningful increase in decades, contributing to higher health care costs for all Texans and a shortage of physicians who will accept Medicaid patients. 

“Medicaid is the lowest payer in Texas, paying 40 percent to 70 percent of the Medicare physician fee schedule for office-based services,” the fact sheet said. “Physician payments also are not indexed to inflation, meaning that each year Texas fails to increase payments, the farther Medicaid payments fall behind commercial payers and Medicare.” 

One of TMA’s primary requests is 12 months’ coverage for postpartum women, providing more consistent and continuous coverage that will help improve the maternal mortality and morbidity rate in Texas. Medicaid coverage currently ends 60 days postpartum. 

TMA also called on lawmakers to: 

  • Devote higher Medicaid payments for cost-saving collaborations between physicians and Medicaid managed care organizations; and
  • Direct the Texas Health and Human Services Commission to convene a Physician-Payment Advisory Committee to advise the agency on how best to distribute funds to physicians in other high-need places, including rural areas and the border. 

The subcommittee, which is chaired by Rep. Sarah Davis (R-West University Place), will continue deliberations this week.

Yesterday, the House Public Education Committee, chaired by Rep. Dan Huberty (R-Houston), heard deeply personal and heartfelt testimony regarding a committee substitute to House Bill 76, which would require schools to provide information on electrocardiogram (EKG) testing for student athletes. Unsuccessful proposals in years past would have made preparticipation EKGs mandatory.

HB 76 also would require any EKGs that are done to be administered and evaluated by an individual whose scope of practice legally allows him or her to do the testing. TMA thanks Representative Huberty for his collaboration on this bill.

Today, the House Higher Education Committee heard testimony on House Bill 80 by Rep. Lina Ortega (D-El Paso), calling on the Texas Higher Education Coordinating Board (THECB) to conduct a study and develop an inventory of existing doctoral-level health science education programs. Under the bill, the THECB would then issue a report to the legislature with recommendations for establishing new and for expanding existing programs.

And the House Public Health Committee heard House Bill 278 by Rep. Tom Oliverson, MD (R-Cypress) regarding how physicians supervise prescriptive authority agreements with advanced practice registered nurses (APRNs). TMA supports this bill. HB 278 is the first of more than 36 scope-of-practice bills to be heard this session. In yesterday’s Hotline, we incorrectly reported that the bill applies to physician assistants (PAs). The changes that HB 278 makes for supervising APRNs were made for PAs in a law that passed in 2017. The committee was still meeting at press time, so look for an update in tomorrow’s Legislative Hotline.

The House and Senate adjourned until Monday.

More than seven weeks into session — and nine short days before the filing deadline — more than 3,830 bills have been filed. TMA is monitoring more than 800 of them — in keeping with previous sessions’ rates of more than 20 percent of all bills filed. Fewer than 90 days remain in this legislative session.


This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 448 by Rep. Chris Turner (D-Grand Prairie) would require transporting a child younger than 2 years of age in a rear-facing car seat unless the child meets certain height and weight thresholds. TMA supports this bill. 
  • House Bill 2327 by Rep. Greg Bonnen, MD (R-Friendswood) would require health plans to inform physicians ahead of time what procedures require prior authorization and what that process is. Importantly, the bill also requires coverage without prior authorization of procedures that are identified as routine. TMA strongly supports this bill. 
  • House Bill 2408 by Rep. Julie Johnson (D-Carrollton) would require health plans to cover without prior authorization procedures that have state mandated coverage, such as mammograms, prostate exams, and diabetes equipment and supplies. TMA supports this bill. 
  • Senate Bill 340 by Sen. Joan Huffman (R-Houston) would create a grant program to fund law enforcement’s access to opioid antagonists. TMA supports this bill.  


Healthy Vision 2025 — released late last month — 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.


When you secure a meeting with a legislator, it may seem tempting to make the most of your limited time with him or her and pack as many topics as possible into the conversation. The best practice is to stick to one issue and explore it in depth, whether you connect by telephone, letter, or email. Address additional issues in subsequent communications. Get more tips in our Grassroots Advocacy Guide.


If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.


TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Tell your senator and representative why you oppose independent practice for advanced practice registered nurses (APRNs).
  • Register for First Tuesdays at the Capitol – the next one is next week;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.


Physician of the Day is a service the Texas Academy of Family Physicians (TAFP) provides the Texas Legislature. Each day the legislators are in session, the group names a physician to serve in the Capitol. This tradition started in 1971 and has continued every legislative session since, including special sessions.

Today’s physician of the day is Paul Berg, MD, of Georgetown. Dr. Berg graduated from the UTHealth San Antonio Long School of Medicine and is a member of both the Texas Medical Association and the Williamson County Medical Society.

Congress Squares Off With Pharma CEOs In Showdown Over High Drug Prices – Kaiser Health News

Texas hospital owner convicted in $20M healthcare fraud scheme – Becker’s Hospital Review

Dell Medical School, Dell Seton care team forges innovative path toward opioid recovery – Austin American-Statesman

Paramedic House Calls Help Chronically Ill Patients – The Dallas Morning News

Five Possible Reasons the Baylor Scott and White Merger Didn’t Happen – D CEO Healthcare

Amid Measles Outbreak, Texas Lawmakers Want to Make it Even Easier to Opt Out of Vaccines – Texas Observer

Last Updated On

February 27, 2019

Originally Published On

February 27, 2019