Outcome of other 2019 bills important to medicine
BUDGET
House Bill 1, by Representative John Zerwas, MD (R-Richmond), is the $250 billion 2020-21 biennial budget. Governor Abbott signed HB 1 with no line-item vetoes.
The budget does not include any physician rate increases for Medicaid, and it requires the state to find $350 million in Medicaid savings.
However, the budget does increase funding for programs and initiatives that will help improve maternal health, behavioral health, and graduate medical education.
PROFESSIONAL LIABILITY
Senate Bill 752 by Senator Joan Huffman (R-Houston) provides liability immunity for volunteer health care providers and health care institutions that render care, assistance, or advice during a natural or man-made disaster. This was a top priority for HCMS.
PHYSICIAN WORKPLACE PROTECTION
House Bill 1532 by Representative Morgan Meyer (R-Dallas) provides a TMB complaint process for 501a employed physicians and requires Non-Profit Health Corporations to develop and implement a no retaliation policy. This was another top priority for HCMS this session.
INSURANCE
Senate Bill 1264 by Senator Kelly Hancock (R-North Richland Hills) requires winner-take-all arbitration for most surprise medical bills, effectively removing patients from the billing dispute resolution process. Patients who elect to go out-of-network for health care are not covered by this arbitration process.
House Bill 1941 by Representative Dade Phelan (R-Beaumont) prohibits free-standing emergency facilities from charging “unconscionable” rates, defined as 200% or more of the average charge for the same or substantially similar treatment at a hospital emergency room. HB 1941 financially protects patients seeking care in an emergency.
House Bill 3911 by Representative Hubert Vo (D-Houston) requires the Texas Department of Insurance to examine the network adequacy of preferred provider organizations (PPOs) and exclusive provider organizations (EPOs) at least once every three years. Inadequate or narrow networks contribute to higher costs for patients and frustration for physicians.
House Bill 1584 by Representative Senfronia Thompson (D-Houston) prohibits step therapy protocols for stage-4 metastatic breast cancer. HB 1584 was filed without signature by the governor.
House Bill 1576 by Representative Phelan allows Medicaid to contract with a transportation network company, such as Uber or Lyft, for non-emergency transportation to or from a medical appointment. Making it easier to get to the doctor improves patient compliance with prescriptions and other remedies prescribed by the physician.
House Bill 2536 by Representative Tom Oliverson, MD (R-Cypress) requires vastly improved transparency regarding prescription drug costs, including posting drug price information on the Health and Human Services Commission’s website and explaining cost increases of greater than 40 percent.
House Bill 2041 by Representative Oliverson, MD requires freestanding emergency room facilities to post conspicuous notices that the facility or the physician might be out of network, along with written disclosure of possible observation and facility fees. Pricing transparency helps patients make more prudent choices for emergency health care.
OPIOIDS
House Bill 2174 by Representative Zerwas, MD limits the duration of opioid prescriptions, requires electronic prescribing beginning on Jan. 1, 2021, requires opioid-related CME, and prohibits prior authorization for medication-assisted treatment for opioid-use disorder. HB 2174 helps prevent “doctor shopping” by patients seeking opioids for non-therapeutic uses.
House Bill 3285 by Representative Sheffield, DO permits telehealth treatment for substance-use disorder, develops and implements an opioid misuse public awareness campaign, and collects and analyzes data regarding opioid overdose deaths.
GRADUATE MEDICAL EDUCATION/WORKFORCE
House Bill 2261 by Representative Armando Walle (D-Houston) increases the Physician Education Loan Repayment Program’s allowable repayment assistance amounts by $5,000 each year, bringing the total amount of repayment assistance available to $180,000. The repayment program is designed to encourage new physicians to start their careers in under-served communities by helping them pay off student loans in return for a four-year practice commitment.
MOTHERS AND CHILDREN
House Bill 170 by Representative Diego Bernal (D-San Antonio) requires health plans to cover diagnostic mammograms at 100%, the same as screening mammograms.
Senate Bill 355 by Senator Royce West (D-Dallas) directs the Department of Family and Protective Services to create a strategic plan so Texas can access new federal matching funds for services to help children at risk of entering foster care.
Senate Bill 952 by Senator Kirk Watson (D-Austin) requires that child care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards.
TELEMEDICINE
House Bill 3345 by Representative Four Price (R-Amarillo) allows physicians to choose the best platform for providing services rather than having health plans dictate the platform. HB 3345 complements Senate Bill 1107 from the last legislative session, which stipulated that services provided via telemedicine are to be covered the same as any other service provided by a physician.
Senate Bill 670 by Senator Dawn Buckingham, MD (R-Lakeway) requires Medicaid to cover telemedicine services.
House Bill 1063 by Representative Price requires Medicaid to cover home telemonitoring for specific pediatric patients. HB 1063 prevents families from having to take very ill children to their physician’s office when the necessary care and monitoring can happen from home.
LONG-TERM CARE
House Bill 2050 by Representative Paddie requires written consent for the administration of psychoactive drugs to patients in long-term care facilities. Frequently, residents in long-term care facilities have limited contact with family members, so allowing one-time written consent saves precious time when medications may need to be provided.
CANNABIS
House Bill 3703 by Representative Stephanie Klick (R-Fort Worth) updates the Compassionate Use Act adopted by the legislature in 2015, broadening the list of symptoms and illnesses for which patients can use low-THC cannabis.
VETOES
Governor Abbott vetoed two bills TMA supported:
House Bill 448 by Representative Chris Turner (D-Grand Prairie) would have required transporting a child younger than 2 in a rear-facing car seat unless the child meets certain height and weight thresholds. Governor Abbott vetoed this bill, saying it is overly prescriptive and micromanages parents.
House Bill 455 by Representative Alma Allen (D-Houston) would have directed the State Board of Education to develop recess policies that encourage outdoor play time and physical activity. While acknowledging the educational and health benefits of recess, Governor Abbott vetoed the bill, saying it’s another mandate and is bureaucracy for bureaucracy’s sake.