House Passes PBM “Clawback” Ban; Physician to Lead House Budget Conferees
By Joey Berlin



Even in a relatively quiet week for medicine at the Capitol, the Texas Medical Association earned an important incremental win to combat exorbitant fees from pharmacy benefit managers (PBMs).

House Bill 1763 by Rep. Tom Oliverson, MD (R-Cypress) passed the House of Representatives on Tuesday by a 147-0 vote, sending it to the Senate for consideration. HB 1763 would prohibit PBMs from using direct and indirect remuneration (DIR) fees to “claw back” money from pharmacies after an insurance claim is finished.

Earlier this month, Austin oncologist Debra Patt, MD, chair of TMA’s Council on Legislation, told the House Insurance Committee that her clinic, Austin Oncology, had paid more than $16 million in DIR fees during 2020. Her practice has an onsite pharmacy and she called DIR fees “a substantial burden that is growing exponentially.”

HB 1763 is the latest in a growing list of TMA-priority bills that have passed one chamber, including key measures on telemedicine expansion; coverage in Medicaid for pregnant women and their children; and regulation of electronic cigarette products.

Bonnen Leads House Budget Hagglers 

Rep. Greg Bonnen, MD (R-Friendswood), chair of the House Appropriations Committee, will lead the House’s five members on the conference committee that will reconcile the differences between the House and Senate versions of the state's proposed budget.

According to the Quorum Report, Representative Bonnen was named a House conferee along with Reps. Giovanni Capriglione (R-Southlake); Mary Gonzalez (D-Clint); Armando Walle (D-Houston); and Terry Wilson (R-Marble Falls).

On Monday, Lt. Gov. Dan Patrick announced the five Senate conferees: Sens. Jane Nelson (R-Flower Mound), chair of the Senate Finance Committee; Joan Huffman (R-Houston); Lois Kolkhorst (R-Brenham); Robert Nichols (R-Jacksonville); and Larry Taylor (R-Friendswood).

Keeping SHACs Volunteer-Friendly 

Dr. Patt will share comments on Wednesday to air TMA’s concerns about a bill that medicine believes might discourage participation in school health advisory councils (SHACs).

House Bill 3872 by Rep. Stephanie Klick (R-Fort Worth) would define SHACs – which are made up of volunteers, including physicians – as a “governmental body.” As Dr. Patt explains in written comments to Representative Klick and her fellow members of the House Public Health Committee, that designation would make the volunteer members subject to open records laws and the heightened transparency those laws require.

“For the current and future SHAC members suggested in statute (e.g., physicians and health care professionals, members of the clergy, and law enforcement professionals), participation on the SHACs could open their personal communication devices, email, messages, and correspondence to public view,” Dr. Patt wrote. “We are concerned this might become a barrier to recruiting knowledgeable volunteers to ensure the full community participation needed to complete the work of the SHAC.”

If this sounds familiar, it’s because TMA was already successful a month ago in raising this concern on HB 3872’s companion bill, Senate Bill 442 by Sen. Bryan Hughes (R-Mineola). After TMA did so, Senator Hughes introduced new language that ensured SHACs would have transparency requirements without being subject to open meetings or public information laws. Dr. Patt’s letter on HB 3872 asks the committee to consider adopting SB 442’s current language.

SB 442 passed its parent chamber last week and has been referred to House Public Health.

Just one First Tuesdays left  

Next week is your last chance to be a part of First Tuesdays at the Capitol, which will be held virtually May 4. By then, only 27 days will remain in this session. Register for free today to get an update from TMA’s lobby team on what issues and bills are still in play, and what you can do to help in the final stretch before the legislature adjourns.

Easy ways to get involved in TMA advocacy 

Your participation is a vital component of our legislative success. Join our advocacy efforts today. Besides taking part in First Tuesdays, here are some other ways you can help.

Stay up to date on bills TMA is following closely. And take advantage of other opportunities to get involved with our advocacy efforts.


Last Updated On

April 27, 2021

Originally Published On

April 27, 2021

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