“Gold Card” Bill Heard in Senate Committee
By Joey Berlin

A trio of testifiers for the Texas Medical Association hit Tuesday’s Senate Finance Committee hearing to keep pushing a crucial prior authorization reform measure toward the finish line.

House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood), would allow physicians to earn a “gold card” from insurers to be exempt from prior authorizations for certain services the following year. Specifically, under the bill, an 80% approval rate on a given service in one plan year would earn the physician a gold card the next year. HB 3459 also would require utilization reviews to be conducted by a physician in the same or a similar specialty as the patient’s physician.

Austin oncologist Debra Patt, MD, and San Antonio radiologist Zeke Silva III, MD, testified in support of the bill Tuesday morning. Houston internist Lisa Ehrlich, MD, was scheduled to testify later that day.

Dr. Patt told the committee her oncology practice has tripled its staffing in the past few years to manage prior authorizations.

Preauthorization “in its current state delays, detours, and diminishes care,” she testified. “It causes an increased burden on patients, and the natural consequence is adverse patient outcomes. We know that some patients abandon treatment because of prior auth. Treatment is delayed and frequently detoured.”

Patients and physicians both would like to reduce prior auth’s intrusive impact on their relationship, she added.

Preserving physicians’ conscience rights

What was originally “treat until transfer” legislation for patients on life-sustaining treatment now has a 90-day window for a physician to find a transfer facility to take the patient.

That’s not good enough, say TMA, the Texas Hospital Association, Texas Alliance for Life, and others fighting to see that Senate Bill 917 by Rep. Bryan Hughes (R-Tyler) doesn’t make it into law. The organizations sent a letter to senators Monday urging them not to suspend Senate rules to pass SB 917.

The bill would extend the current 10-day period to find a transfer destination for a patient on life-sustaining treatment following a hospital ethics committee decision that the care is medically inappropriate. As originally filed, SB 917 would have made that 10-day period indefinite. Now, in the version that passed out of committee late last week, physicians would have 90 days to find a transfer destination, after which the physician could withdraw the treatment without facing civil or criminal liability.

The alert from TMA, THA, Texas Alliance for Life, and several other organizations expressed their enduring opposition to SB 917.

“We believe that all patients deserve to die with dignity. SB 917 violates a physician’s foundational oath of ‘do no harm’ by forcing doctors to provide excessive and medically inappropriate interventions, absent of any therapeutic benefit to the patient, that cause more pain and suffering,” the letter said. “Extending the current dispute resolution process in Texas law from 10 days to 90 days prevents physicians from exercising their rights of conscience. Moreover, the bill lacks meaningful improvements for patients’ rights. True reform of the Texas Advance Directives Act safeguards both the rights of patients and the conscience rights of health care providers.”

TMA remains committed to making sure physicians can act on their conscience and medical judgment in end-of-life situations and opposes SB 917 as currently written. The letter lays out a series of reforms the bill needs to include, including several improvements to the state’s confusing and pitfall-laden laws surrounding do-not-resuscitate orders.

Vaping regulation bill advances

A TMA priority bill to establish licensure requirements for e-cigarette retailers passed out of a House committee on Monday, meaning it’s eligible to move on to the House floor – and, if it clears that hurdle, the governor’s desk.

Senate Bill 248 by Sen. Nathan Johnson (D-Dallas) establishes a framework for vaping products to be regulated the same way as other cigarette products. TMA sees the bill as a vital vehicle for curbing e-cigarette use, with medicine’s eye particularly trained on e-cigs’ popularity among youth.

The House Ways & Means Committee voted the bill out Monday.

Last Updated On

May 18, 2021

Originally Published On

May 18, 2021

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