Legislative Hotline: Insurance Bill Improves Dramatically; White Coat Invasion Returns
By Jennifer Perkins

April_2_hotline

UNDER THE ROTUNDA
The Capitol’s hallways were filled with hundreds of physicians, medical students, and Alliance members today during the third First Tuesdays at the Capitol advocacy event.

Meanwhile, in the House Insurance Committee, Beaumont anesthesiologist Ray Callas, MD, testified in support of brand new versions of House Bill 2967 by Rep. Tom Oliverson, MD (R-Cypress) and House Bill 3933 by Rep. Trey Martinez Fischer (D-San Antonio), identical bills that would require baseball-style arbitration for most surprise medical bills. It also would remove the patient completely from the balance bill dispute resolution process.

The new versions were introduced yesterday afternoon at a Capitol news conference involving four key legislators. Last month in a Senate committee, TMA testified strongly against the original version of one of the bills.

“We would like to thank Representatives Tom Oliverson and Trey Martinez Fischer for working with Senators John Whitmire and Kelly Hancock for finding a solution to out-of-network surprise bills,” Dr. Callas said Tuesday. “The bill prevents a physician or provider from sending a bill to the patient  for any remaining cost for services rendered out-of-network, but it provides a quick and simple appeals process for either the carrier or the provider for a dispute over these costs. It completely removes the patient from the middle.”

Dr. Callas also testified in support of House Bill 3911 by Rep. Hubert Vo (D-Houston), which would require the Texas Department of Insurance to examine the network adequacy of preferred provider organizations (PPOs) and exclusive provider organizations (EPOs) at least once every two years.

“Last year the Texas Society of Anesthesiologists discovered that Humana unilaterally terminated  all private anesthesia group contracts mid-contract,” Dr. Callas said. “This left over 200 facilities in Texas with no anesthesia coverage with Humana, including the children’s hospitals in Austin and San Antonio. It also meant that the only coverage for anesthesia was at academic hospitals in Houston, San Antonio, and the DFW Metroplex. Humana did not notify the Texas Department of Insurance, nor did they update their directories of this huge drop in coverage.”

Austin oncologist Debra Patt, MD, testified in support of House Bill 2231, by Representative Oliverson, which would rein in the pharmacy benefit manager (PBM) program and keep PBMs from interfering with physicians who provide care through pharmaceuticals. Not only would this improve care coordination, but it would save patients money on prescriptions because they wouldn’t be faced with price markups imposed by PBMs.

“To improve patient access and adherence , many community-based cancer clinics, like Texas Oncology, have established medically integrated platforms or practice-based pharmacies,” Dr. Patt said. “The current lack of transparency and accountability in the pharmacy benefit manager system is contributing to the rising cost of treatment in community oncology, specifically, PBMs’ use of retroactive pharmacy price concessions, and PBMs’ practice of steering patients to PBM-owned mail order or specialty pharmacies.”

In the House Human Services Committee, Austin pediatrician Kimberly Avila Edwards, MD, testified in support of House Bill 1808 by Rep. Eddie Lucio, III (D-Brownsville), which would require that child-care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards.

“My role as a pediatrician is extremely rewarding because preventive interventions in the early years have a lasting impact on a child’s life,” Dr. Edwards said. “Being physically active and having a healthy diet before the age of 5 is associated with improved child development and cognitive outcomes.”

TMA President and Athens family physician Doug Curran, MD, testified in strong support of House Bill 2453 by Rep. Sarah Davis (R-West University Place). The extensive Medicaid managed care organization (MCO) oversight proposed by HB 2453 was inspired by last year’s Dallas Morning News series, “Pain & Profit,” which detailed missteps in the program.

“We must not focus exclusively on removing or punishing bad MCOs, but also recognizing and rewarding plans that perform well,” Dr. Curran said. “Strengthening oversight and accountability will also strengthen care coordination, establishing a fairer appeals process, and streamlining redundant administrative procedures.”

HOUSE DEMONSTRATES VACCINES ARE STILL IMPORTANT

House Bill 1418 by Rep. Dade Phelan (R-Beaumont) seeks to ensure emergency services personnel receive up-to-date information about their immunization status when they seek certification or recertification. The House of Representatives gave the bill preliminary approval without dissent. A final House vote is scheduled for today. TMA testified in favor of this bill last month. 

BILLS THAT ARE MOVING

Senate Bill 21 by Sen. Joan Huffman (R-Houston), which would raise the minimum age for purchasing tobacco and vape products to 21, passed out of the Senate State Affairs Committee yesterday on a 5-4 vote and now awaits debate on the Senate floor. TMA strongly supports this bill and testified in favor of it last month. 

House Bill 1849 by Rep. Stephanie Klick (R-Fort Worth) would permit day-care centers to possess and administer epinephrine auto-injectors prescribed by a physician. The bill also would require day-care centers that keep epinephrine auto-injectors on hand to train personnel who will administer them to children. TMA testified in support of this bill last month. The House gave preliminary approval yesterday without dissent. 

House Bill 405 by Rep. Ina Minjarez (D-San Antonio) would designate June as Neonatal Abstinence Syndrome Awareness month. TMA testified in support of this bill last month. It also received preliminary approval with no dissent. 

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,636 bills. TMA is monitoring 1,936 of them. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Fifty-five days remain until sine die. 

BILLS OF NOTE

Here are some bills TMA is watching. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 2306 by Rep. Jon Rosenthal (D-Houston) would call for an interim committee to review the methods the Texas Department of Transportation uses to integrate public health considerations in major highway project planning. TMA and the Texas Public Health Coalition support this bill. 
  • House Bill 1320 by Rep. Joe Moody (D-El Paso) would create mental health courts as an alternative to incarceration for people with nonviolent behavior. TMA supports this bill.  

ARE YOU A LEGISLATIVE JUNKIE?

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.

TAKE ACTION

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

At the top of 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:

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

Today’s physician of the day is John Gibson, MD, of Fort Worth. Dr. Gibson graduated from the UT Southwestern Medical School, and is a member of the Tarrant County Medical Society.

WHAT WE’RE READING

Texas kicks thousands of low-income children off Medicaid over missing paperwork – San Antonio Express-News, Houston Chronicle

Fact-check: About 1 in 4 women of reproductive age in Texas are uninsured – Austin American-Statesman

Legislation seeks remedy for sticker shock at freestanding emergency rooms – Austin American-Statesman

Fixing health care is hard, but ending ‘surprise billing’ should be easy for Texas lawmakers [Opinion – Commentary] – The Dallas Morning News

Commentary: Student mental health bills address many classroom challenges – Austin American-Statesman

University Health System to invest $170 million in new medical record technology – San Antonio Express-News

Tradition-bound healthcare is learning a few things in Austin’s innovation-focused atmosphere – Modern Healthcare

One foot in front of another: East Texas doc is getting her community moving – Thrive Global

Life was sacred to Abilene’s first female physician Virginia Connally, 106 – Abilene Reporter News

 

 

Last Updated On

April 02, 2019

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Jennifer Perkins

Advocacy Communication Manager

(512) 370-1469
Jennifer Perkins

Jennifer Perkins, a native Texan and University of Texas Longhorn, has worked in politics, public affairs, and advocacy for more than two decades, covering a litany of subject areas and a number of states, using a marketing-oriented communications style as informed by her MBA. Jennifer has two dogs, is a college football fanatic, loves to entertain, and prefers to be outdoors..

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