TMA to Fight for Health Coverage Expansion, Scope of Practice During 2021 Legislature
By Jennifer Perkins


Although the details about how the 2021 Texas Legislature will operate beginning in January are still unclear, the topics lawmakers will vigorously debate will have a familiar refrain.

At the 2020 Texas Medical Association Advocacy Retreat on Saturday, Debra Patt, MD, chair of TMA’s Council on Legislation, laid out a preview of medicine’s top legislative priorities for the upcoming session.

Among the highlights discussed:

Meaningful health care coverage expansion: Texas already had the highest uninsured rate in the nation before the COVID-19 pandemic, and millions more are now unemployed and uninsured. The state budget also has been negatively affected by the pandemic, meaning creative approaches to expanding coverage must be explored. One such option is drawing down a 9-to-1 match – up from a 6-to-1 match – in federal funds to expand coverage to the working poor. TMA will continue to work with legislative leaders on a solution to ensuring all Texans can access the health care they need when they need it.

Scope of practice encroachment: Both California and Florida recently expanded scope of practice permissions for advanced practice registered nurses (APRNs), allowing independent diagnosing and prescribing. APRNs and other groups like chiropractors are expected to push for such expansion in Texas. As in past sessions, TMA will vigorously defend the physician-led team model of care.

Telemedicine: The use of telemedicine has increased exponentially throughout the COVID-19 pandemic, aided in large part by state and federal protections and flexibilities that allow for payment parity and the use of audio-only telemedicine services. But those flexibilities are contingent upon declaration of a national emergency, which remains in effect until Jan. 20. TMA has called on federal and state leaders to make those flexibilities permanent and will continue to do so throughout the 2021 session.

Taxes on medical billing services: TMA and a coalition of more than 40 organizations and companies are working on an amendment to the Texas Tax Code that would ensure third-party medical billing services are not subject to sales and use tax – an interpretation announced by the State Comptroller’s Office last year. Thanks to TMA advocacy, Comptroller Glen Hegar delayed the start date to Oct. 1, 2021, giving TMA time to work with lawmakers on the issue this session.

In addition to the state’s pandemic response, other important topics TMA will monitor include onerous, care-impeding prior authorization requirements; public health infrastructure; graduate medical education funding; medical liability; and balance billing arbitration.

Last Updated On

July 17, 2023

Originally Published On

December 08, 2020

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