Legislative Hotline: Working to Keep Balance Billing Reform Moving
By Jennifer Perkins


Most of yesterday’s high profile action took place on the House and Senate floors, but one of the most important bills for the Texas Medical Association is still being negotiated behind the scenes.

Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills), which would require baseball-style arbitration for most surprise medical bills, is currently awaiting a hearing in the House Insurance Committee. SB 1264 seeks to end the problem of surprise or balance billing for patients by removing them from the process altogether. It would implement an arbitration process in which health plans and physicians work out billing differences using market rate benchmarks.

TMA strongly supports the arbitration process because it uses benchmarks based on market rates. However, TMA continues to work with the bill authors – Senators Hancock and John Whitmire (D-Houston); and Reps. Tom Oliverson, MD (R-Cypress), and Trey Martinez Fischer (D-San Antonio) – to get the best arbitration process that is fair to patients and physicians. Recommendations have been submitted to the authors to address medicine's concerns with potential barriers to utilization of the arbitration process, such as a quick time frame to resolve an arbitration, ensuring physicians have the information necessary to collect allowed amounts from the patient, and ensuring enforcement on all parties. TMA has full faith in the authors that once these clarifications are made, a bill everyone supports will pass this session.


Senate Bill 2089 by Sen. Bryan Hughes (R-Mineola) would require hospitals, physicians, nurses, and other health care professionals to provide what physicians believe amounts to medically inappropriate and potentially harmful care for an unlimited period of time. The Senate Health and Human Services Committee approved SB 2089 yesterday.

TMA is vehemently opposed to this bill and issued a legislative alert earlier today to stop the bill from making any further progress. Please contact Lt. Gov. Dan Patrick today and ask him to not bring SB 2089 up for debate on the Senate floor.


TMA is monitoring 1,952 of the 7,771 bills filed this session. 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. House bills must be out of House committee by Monday, May 6 – the day before our last First Tuesdays of this session – to be considered this session.

Bills that haven’t yet moved out of committee may be proposed as amendments to legislation that is moving.

A long debate on property taxes consumed the vast majority of the time on the House floor yesterday, so not many of the bills medicine is tracking made any progress. Below is an update on a few TMA-tracked bills:

  • House Bill 2387 by Rep. Greg Bonnen, MD (R-Friendswood), which would require that utilization reviews be conducted by a Texas-licensed physician and that prior authorization processes be more transparent, passed the House 141-0 yesterday and heads to the Senate for deliberation. TMA testified in support of HB 2387 in late March and continues to strongly support this bill.
  • House Bill 39 by Rep. John Zerwas, MD (R-Richmond), which would allow the Cancer Prevention and Research Institute of Texas (CPRIT) to continue its cancer research beyond 2022, was set for a hearing in the Senate Administration Committee today. As of press time, the bill had not yet come up. TMA strongly supports this bill.
  • House Bill 1065 by Rep. Trent Ashby (R-Lufkin), which would create a grant program to develop residency training tracks to prepare physicians for practice in rural, underserved settings, is set for a hearing today in the Senate Higher Education Committee. TMA testified in support of HB 1065 in early March.

TMA is watching each bill, committee substitute, and amendment for any changes. It is not uncommon for revised legislation to prompt a revised position from TMA, particularly when bad bills become better bills through rewriting or amendments. If you have a question about a specific bill, contact the advocacy team via the TMA Knowledge Center by email or call (800) 880-7955, Monday-Friday, 8:15 am to 5:15 pm CT. 


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.

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. 


Today’s physician of the day is David Palafox, MD, of El Paso. Dr. Palafox graduated from the Texas Tech University Health Sciences Center School of Medicine and is a member of both TMA and the El Paso County Medical Society.


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Last Updated On

May 01, 2019

Originally Published On

May 01, 2019

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