Legislative Hotline: Medicaid Managed Care Needs “Major Tune-up,” TMA Tells Lawmakers
By Jennifer Perkins

Capitol_Dome

UNDER THE ROTUNDA
Less than seven weeks remain in the 2019 legislative session, and lawmakers are now deep into the meaty issues.

In the House Human Services Committee today, TMA President Doug Curran, MD, testified in support of House Bill 4178 by Rep. James Frank (R-Wichita Falls), which would significantly overhaul the Medicaid managed care program.

HB 4178, also referred to as the Medicaid Efficiency Act, would update the fair hearings process, streamline enrollment and coordination of benefits, and simplify the prior authorization process. The bill was left pending in committee.

Dr. Curran testified that in his practice, he sees patients in every Medicaid managed care program and is thus in a position to know what works and what doesn’t in each.

“After a quarter-century of Medicaid managed care, it is time for a major tune-up to ensure the program works for everyone – patients, physicians, health plans, and taxpayers.”

In the House Insurance Committee today, Dallas public health physician and TMA Council on Legislation member John Carlo, MD, testified in support of a pair of bills that TMA supports.

House Bill 2582 by Rep. Eddie Lucio III (D-Brownsville) would require health plans to advise physicians of price changes for the Department of State Health Services-mandated newborn screening tests, and to reimburse physicians for purchasing the tests.

“Texas has one of the most successful and robust newborn screening programs in the entire world,” Dr. Carlo said. “Texas Medicaid pays the state lab directly for babies covered under the program, but screening babies covered under a commercial plan requires the physician to purchase the tests and hope for reimbursement.”

House Bill 3058 by Rep. Julie Johnson (D-Carrollton) would prohibit prior authorization for HIV and AIDS prescription drugs. Dr. Carlo testified about the need for urgency in beginning treatment, noting that today, with timely treatment, surviving HIV/AIDS is likely, not a dream as it was in the past.

On the other side of the rotunda, Dallas cardiologist and TMA Board of Trustees member Rick Snyder, MD, reprised recent testimony in support of more accurate network directories.

Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio) would require health plan directories to clearly identify which physician specialties are in-network at network facilities.

“Requiring insurance companies to report online their physician directories at each facility, grouped by specialty, empowers both patients and physicians in the struggle against balance billing events,” Dr. Snyder said.

Bishops Support Advance Directives

TMA works regularly with the Texas Catholic Conference of Bishops, and many other groups, in our efforts to defend the Texas Advance Directives Act (TADA). Every legislative session, this loose coalition works hard to protect patients’ autonomy and dignity at the end of their lives and to ensure physicians and other health care professionals aren’t forced to provide medical care they believe to be inappropriate or that violates their ethical principles. 

Two anti-TADA bills – Senate Bill 2089 by Sen. Bryan Hughes (R-Mineola) and Senate Bill 2129 by Sen. Brandon Creighton (R-Conroe) – are scheduled for a hearing tomorrow in the Senate Health and Human Services Committee. TMA joins the Conference of Bishops and others in opposing both of these bills. We were impressed with the message the bishops are asking Texas Catholics to send to their state senators on that committee, and wanted to share it with you. 

“I oppose these bills because they allow an assault on the dignity of the human person by requiring unnecessary pain and suffering for an incompetent patient at the end of his/her life, when the patient's family is demanding inappropriate medical interventions against the conscience and medical judgment of the physician.”

 BILLS THAT ARE MOVING

Today, House Bill 2261 by Rep. Armando Walle (D-Houston) – which would increase the physician education loan repayment program’s allowable repayment amounts by $5,000 each year, bringing the total amount to $180,000 – passed on third reading 130-17. The bill will now move on to the Senate. TMA strongly supports this bill.

Yesterday, House Bill 1532 by Rep. Morgan Meyer (R-Dallas) – which would protect employed physicians’ clinical autonomy and independent medical judgment from hospital administrators’ interference – won unanimous approval from the House Public Health Committee and now awaits debate on the House floor. TMA strongly supports this bill.

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,693 bills. TMA is monitoring 1,940 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. Bills in the House must be out of committee by May 6 to be considered by the Senate this session. Forty-eight 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 3345 by Rep. Four Price (R-Amarillo) would allow physicians to choose the best platform to use for providing telemedicine services to their patients, rather than having health plans dictate the platform. TMA supports this bill. 
  • Senate Bill 2316 by Sen. Juan “Chuy” Hinojosa (D-McAllen) would delay the mandate to check the Prescription Drug Monitoring Program until March 1, 2020, to allow time for electronic integration. The bill also would create an advisory committee to the Board of Pharmacy. TMA supports this bill.   

HEALTHY VISION 2025

Healthy Vision 2025 – released in late January – 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.

TODAY’S GRASSROOTS ADVOCACY TIP

Just as you do with your patients, make sure you follow up with your legislator after you’ve had a meeting or phone call. Be persistent but polite, and remind your legislator how important the issue is to you. Ask for an update on where the issue stands, and don’t get dejected if it takes more than one session to address your issue. That is quite common. Get more tips in our Grassroots Advocacy Guide.

PHYSICIAN OF THE DAY

Today’s physician of the day is My-Huyen Mary Tran, MD, of Tyler. Dr. Tran graduated from Louisiana State University Health Sciences Center Shreveport and is a member of both TMA and the Smith County Medical Society.

WHAT WE’RE READING

Blue Cross Blue Shield of Texas tries new way to trim health costs: Opening its own medical centers  35 – The Dallas Morning News

CDC finds 78 new measles cases as outbreak sprints toward record and experts blame anti-vaxxers  16 – The Washington Post

Facing Escalating Workplace Violence, Hospital Employees Have Had Enough  49 – NPR

Dogs sniff out lung cancer with 97% accuracy, study finds  60 – KVUE

Last Updated On

April 09, 2019

Related Content

Texas legislation

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..

More stories by Jennifer Perkins