Legislative Hotline: TMA Pushes Lawmakers To Streamline Prior Auth Requirements
By Jennifer Perkins

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UNDER THE ROTUNDA
With fewer than six weeks remaining in the legislative session, this week is a crucible of sorts: If a bill doesn’t get an initial committee hearing this week, it likely is dead for the session. The Texas Medical Association is pushing today to win committee approval for several bills as well as a successful House floor debate on a critical piece of legislation.

Today in the House Insurance Committee, Little Elm internist John Flores, MD, testified for TMA on a pair of bills that would streamline prior authorization requirements.

House Bill 3232 by Rep. Julie Johnson (D-Carrollton) would prohibit requiring prior authorization if a patient seeks care from an in-network physician.

House Bill 3828 by Rep. Carl Sherman (D-DeSoto) would require health plans to use physician-supplied prior authorization information to inform a patient of the network status of any physician or health care professional who may be involved in the preauthorized care. HB 3828 also would require that, for elective health care services, the referring physician inform the patient that the physician or health care professional to whom the patient is being referred may be out of network.

In testifying about prior authorization, Dr. Flores said the hassles extend well beyond administrative burdens for physicians.

“Prior authorization can cause delays in medically necessary care, which may detrimentally affect a patient’s health and finances,” Dr. Flores said. “Excessive prior authorization requirements also consume time that physicians could otherwise dedicate to patient care.”

In the House Licensing and Administrative Procedures Committee, Austin adolescent medicine physician Maria Monge, MD, testified in support of House Bill 1610 by Rep. Trent Ashby (R-Lufkin.) HB 1610 would ban the manufacture and sale of powdered alcohol.

“The average age of first alcoholic drink is 13 years of age,” Dr. Monge testified. “The consequences of adolescent alcohol consumption are well documented, and powdered alcohol presents a frightening opportunity for adolescents to access, consume, conceal, and overconsume alcohol in potentially new and deadly ways.”

Speaking more of children, in the House Human Services Committee, Austin pediatrician Ryan Lowery, MD, testified in support of House Bill 3541 by Rep. Toni Rose (D-Dallas.) HB 3541 would incentivize the purchase of fruits and vegetables with Supplemental Nutrition Assistance Program (SNAP) benefits.

“In Texas, more than half of SNAP beneficiaries are children,” Dr. Lowery told lawmakers. “Unfortunately, low-income children disproportionately experience obesity.” Texas has the seventh-highest rate of obesity for youth aged 10-17.

On the House floor today, the Texas Medical Board Sunset Bill – House Bill 1504 by Rep. Chris Paddie (R-Marshall) – was scheduled for debate and vote on preliminary approval. Representative Paddie’s office requested that no floor amendments be added – that the bill hew closely to only the sunset issues – to improve the bill’s odds of passing. TMA will work with Sen. Robert Nichols (R-Jacksonville) to refine Senate Bill 610, the Senate companion.

THE BUDGET

Speaker Dennis Bonnen (R-Angleton) has named the House members of the budget’s conference committee. These representatives will negotiate with soon-to-be-named senators on the two chambers’ differences in the proposed 2020-21 state budget:

  • Rep. John Zerwas, MD (R-Richmond), chair; Representative Zerwas chairs the House Appropriations Committee;
  • Rep. Greg Bonnen, MD (R-Friendswood), who chairs the House Appropriations Subcommittee on Article III, which addresses higher education;
  • Rep. Sarah Davis (R-West University Place), who chairs the Subcommittee on Article II, which addresses health and human services;
  • Rep. Armando Walle (D-Houston), who is vice chair for the Subcommittee on Article III; and
  • Rep. Oscar Longoria (D-Mission), who is vice chair of the House Appropriations Committee. 

TMA is cautiously optimistic that the house of medicine’s budget concerns will be taken to heart during negotiations. A top priority remains our request for a $500 million infusion of new state dollars to increase physicians’ Medicaid payment rates. 

BILLS THAT ARE MOVING  

The House passed House Bill 10 by Rep. Senfronia Thompson (D-Houston), on third reading today with a vote of 114-32. HB 10 would create the Texas Behavioral Health Research Institute (TBHRI), award grants to increase the number of psychiatric residency positions, and create a child and adolescent psychiatric nursing grant program. The bill now goes to the Senate for committee referral. TMA testified in support of HB 10 in late February. 

Yesterday, Senate Bill 21 by Sen. Joan Huffman (R-Houston) – which would raise the minimum age to purchase tobacco or vape products to 21 years – passed out of the House Public Health Committee on an 8-0 vote. The bill now awaits debate on the House floor. TMA strongly supports this bill and testified in favor of it last month. The companion bill (House Bill 749 by Representative Zerwas) is awaiting a hearing on the House floor. 

Yesterday, Senate Bill 952 by Sen. Kirk Watson (D-Austin) – which would require that child care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards – was referred to the House Human Services Committee after receiving Senate approval last week. TMA testified in support of this bill in March. 

GETTING A BILL MOVING

So far this session, lawmakers have filed 7,731 bills . TMA is monitoring 1,943 of them. Bills must be voted out of 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. 

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 800 by Rep. Donna Howard (D-Austin) would direct the Children’s Health Insurance Program to make contraception available to young women in the enrolled program. HB 800 received preliminary approval on the House floor yesterday and awaits third reading. TMA supports this bill. 
  • House Bill 1110 by Representative Davis would require 12 months continuous Medicaid coverage for eligible postpartum and women who have had a miscarriage. This bill is still pending in the House Human Services Committee. 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 Thomas Shima, DO, of Mansfield. Dr. Shima graduated from the Kansas City University of Medicine and Biosciences and is a member of the Tarrant County Medical Society.

WHAT WE’RE READING

CDC reports surge in confirmed cases of measles – Reuters

Rise in suicide attempts in Texas prisons alarms advocates – The Associated Press

The HPV vaccine is important for preteens and teenagers. What about older women? – The Washington Post

Here’s why doctors should worry about the feds’ novel approach to prosecuting health care kickback casesThe Dallas Morning News

Powdered alcohol? Why some want Texas to ban it before it hits store shelves – Fort Worth Star-Telegram

A run to a freestanding emergency room shouldn’t involve a game of billing roulette [Editorial]The Dallas Morning News

Moving to increase legal age for tobacco use wise [Editorial] – Amarillo Globe-News, Lubbock Avalanche-Journal

Last Updated On

April 16, 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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