UNDER THE ROTUNDA
Five days remain for Gov. Greg Abbott to sign or veto bills. Below is a list of several pieces of legislation important to medicine that have been signed into law this week.
Corporate Practice of Medicine
House Bill 1532 by Rep. Morgan Meyer (R-Dallas) creates a process at the Texas Medical Board that employed physicians can use to file complaints against a hospital or other health organization – protecting employed physicians’ clinical autonomy and independent medical judgment from administrator interference. Under the law, which Governor Abbott signed Monday, a health organization may not retaliate against a physician who in good faith files a complaint against the organization, including termination, demotion, discipline, or discrimination. Health organizations must develop an anti-retaliation policy by Dec. 31, 2019. HB 1532 takes effect Sept. 1.
Expanding Health Care Access for Pregnant and Postpartum Women
Senate Bill 749 by Sen. Lois Kolkhorst (R-Brenham) addresses physician and hospital concerns about how to implement hospital neonatal and maternal level of care designations, which state law previously directed the Department of State Health Services (DSHS) to establish. Chief among the changes, SB 749 clarifies that family physicians, and not only OB-gyns, can provide on-call obstetrical and gynecological services at Level I or II maternal care facilities.
SB 749 directs DSHS to allow on-call physicians to use telemedicine in accordance with current law and pending DSHS rules.
SB 749 was signed by the governor and took effect Monday.
Senate Bill 750 by Senator Kolkhorst will improve maternal access to prenatal and postpartum care by:
- Requiring the Health and Human Services Commission (HHSC) to seek federal dollars to implement models of care to improve availability and quality of care for women with an opioid-use disorder;
- Providing Healthy Texas Women (HTW) enrollees with information on the Primary Care Program, which provides a limited array of prevention and primary care services via contracted clinics across Texas;
- Directing HHSC to develop and implement enhanced prenatal services for certain high-risk pregnant women covered by Medicaid;
- Directing HHSC to evaluate postpartum benefits available via HTW and, based on that evaluation, develop a limited, enhanced postpartum care package that will last no longer than 12 months from a postpartum woman’s enrollment into HTW; and
- Requiring HHSC to develop and implement a postpartum depression treatment network for women covered by Medicaid or enrolled in HTW.
SB 750 was signed by the governor and took effect Monday.
House Bill 25 by Rep. Mary Gonzalez (D-Clint) will create a pilot program to streamline nonemergent medical transportation services in Medicaid. Currently, prenatal and postpartum women are not allowed to take their children to medical appointments. Additionally, prenatal and postpartum women are often shuttled to appointments in shared vans, resulting in long waits in physician offices.
This transportation barrier also leads to missed appointments, which are associated with increased medical costs for patients, disruption of patient care and patient-physician relationships, delayed care, and increased emergency room visits.
The pilot program created by HB 25 will enable more mothers to more easily access much-needed prenatal and postpartum care.
HB 25 was signed by the governor Monday and takes effect Sept. 1.
Senate Bill 1207 by Sen. Charles Perry (R-Lubbock) will require more explicit prior authorization procedures and denial notices for both patients and physicians. SB 1207 also will establish an explicit goal to reduce the overall number of prior authorizations in Medicaid.
SB 1207 requires an external reviewer for denials, and an annual review of prior authorization requirements.
HHSC must publish data from external medical reviews, including the rate of prior authorization denials overturned by the external medical reviewer.
HHSC must also improve assessment tools used for children in the Medically Dependent Children’s Program (MDCP), in part by reducing the amount of time needed to complete the assessment.
Responding to physician and patient complaints about Medicaid managed care, more than 50 bills to reform the system were filed this session. SB 1207 is one of the few that survived.
SB 1207 was signed by the governor Monday and takes effect Sept. 1.
House Bill 2088 by Rep. Jay Dean (R-Longview) will require health care professionals who dispense controlled substance prescriptions to provide written notice of the closest safe disposal location and other safe disposal methods available.
Studies indicate that nearly 70 percent of opioids prescribed post-surgery are not used, and as many as two-thirds of people who use opioids non-medically obtain them from a friend or relative. Informing patients of safe disposal options will prevent diversion and misuse of potent medications.
HB 2088 was signed by the governor Monday and takes effect Sept. 1.
Senate Bill 1564 by Sen. Royce West (D-Dallas) will require Medicaid to cover medication-assisted treatment (MAT) for opioid- or substance-use disorder without requiring prior authorization or precertification.
SB 1564 will ensure that patients needing treatment aren’t left waiting due to administrative burdens. The bill was signed by the governor and took effect Monday.
Graduate Medical Education/Workforce
House Bill 1065 by Rep. Trent Ashby (R-Lufkin) will create a grant program to develop residency training tracks to prepare physicians for practice in rural, typically underserved settings.
Rural medical practice is different than urban or even suburban practice. Often there is only one physician, and he or she is not able to refer a patient with complex health issues to a specialist across town because the nearest specialist may be 150 miles away.
To be prepared for that type of practice, a physician needs to receive the right kind of training. HB 1065 will provide the necessary training.
HB 1065 was signed by the governor and took effect Monday.
House Bill 2813 by Rep. Four Price (R-Amarillo) codifies in statute the statewide behavioral health coordinating council that lawmakers established in 2015. The council’s function is to ensure a strategic statewide approach to behavioral health services. The council is tasked with developing and monitoring the implementation of a five-year statewide behavioral health strategic plan.
HB 2813 was signed by the governor and took effect Monday.
Public Health/Long-Term Care
House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth) will establish infection control programs in long-term care facilities.
Aging Texans are among the most vulnerable to influenza outbreaks, particularly Texans who live in long-term care facilities. Seventy-six percent of Texans who died from the flu in 2017-28 were older than 65 years, and 200 of the 268 reported flu outbreaks happened in long-term care facilities, according to DSHS.
Additionally, state inspections of nursing home in 2015-16 found the No. 1 deficiency was infection and lack of disease control.
HB 1848 will require monitoring of key infectious diseases and establish procedures for making rapid flu diagnostic tests available to facility residents.
HB 1848 was signed by the governor Monday and takes effect Sept. 1.
Senate Bill 1519 by Senator Kolkhorst will establish a statewide council on long-term care facilities as a permanent advisory committee to HHSC. The council must have at least one member who is a practicing medical director of a long-term care facility and one member who is a physician with expertise in infectious diseases or public health.
The council will study and make recommendations regarding best practices to make inspection and informal dispute resolution processes more efficient and less burdensome on long-term care facilities.
SB 1519 was signed by the governor and took effect Monday.
If you have a question about a specific bill from this legislative session, 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.
HEALTHY VISION 2025
Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators during the interim session.
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