As with any session, there are wins and losses. Wins this year included GME funding, Medicaid fraud reform, e-cigarette regulations, tax cuts and red tape elimination. In addition, inappropriate and dangerous expansions of non-physician practitioners' scope of practice were kept at bay. Failing to win were Medicaid payment increases, some public health improvements and insurance reforms.
Breakdown of Wins
• Graduate Medical Education: Lawmakers appropriated enough money for the next two-year budget to keep residency slots added in 2013 and to create up to 200 new slots. Senate Bill 18 created a permanent endowment of approximately $300 million to be used solely to help expand GME starting in 2018.
• Medicaid Fraud Investigation Reforms: Senate Bill 207 calls for due process improvements in overzealous Medicaid fraud investigations by the Office of the Inspector General (OIG).The reforms included clarification that "fraud" does not include unintentional technical, clerical or administrative errors, and the OIG is required to give physicians a detailed summary of its evidence relating to the allegation.
• E-Cigarette Regulations: Senate Bill 97 applies many existing state rules on tobacco cigarettes to vapor products, namely barring sales of e-cigs to minors and prohibiting use on public school campuses and at school functions.
• Tax Relief: House Bill 7 eliminates the $200 occupation tax physicians and other professionals pay each year.
• Red Tape Cut: Senate Bill 195 moves the Prescription Drug Monitoring Program from the Texas Department of Public Safety to the Texas State Board of Pharmacy and allows physicians to delegate access to the database to any HIPAA-trained staff member.
• Scope of Practice: No bills passed that would expand the scope of practice of mid-level providers beyond what is safely within their education, skills or training. Almost all of the scope bills were left bottled up in committee. Supported was a bill that will allow emergency medicine technicians to practice in hospitals under the direct supervision of an emergency department physician.
• $50 million increase for women's health
• $20 million investment for infectious disease prevention and response
• $11 million for tobacco cessation programs
Other wins included vaccination bills that allow the storage of childhood vaccination records until the age of 26 and provide liability protections to schools, pharmacists and physicians who encourage the unassigned epinephrine autoinjectors on school campuses for use in emergency anaphylactic reactions; a bill that will help practices identify and educate patients who may fall under the 90-day grace period for subsidized plans purchased through the ACA marketplace exchange - ID cards must now include "QHP" (qualified health plans) and a Medicaid bill that allows payment for some home telemonitoring services. A $1,000 minimum balance for mediation of any out-of-network services from facility-based physicians for any balance due was negotiated down to $500.
Bills Not Passed
• Medicare-parity payment for primary care services in the 2016-2017 state budget
• Parents' right-to-know bill on vaccine exemptions on school campuses
• Ban on health plans' use of virtual credit cards to pay physicians
• Statewide ban on texting while driving
• A bill that would allow physicians to prescribe over the phone without establishing a patient physician relationship
• Removal of the statutory requirement that the Texas Medical Liability Trust insurance is for TMA members only
• Senate Bill 359 that would have allowed a four-hour emergency department hold for mentally ill
patients who the physician believe would be of danger to their self or others
• House Bill 225 that would have protected people who seek emergency care for someone suffering from drug overdose from prosecution and would have allowed first responders to administer an opioid antagonist to save someone from fatal overdose.
For information on these and other legislative issues, contact Senior Director of Physician Services and Community Relations Stephanie Triggs at firstname.lastname@example.org or 512-206-1124.
Source: Texas Medical Association