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Monday, June 1, 2009

STRANGE DAYS: TEXAS LEGISLATURE ADJOURNS

We warned you that partisan politics would play a major role in the 2009 session of the Texas Legislature. The five-day House battle between Democrats and Republicans over a bill requiring voters to show a picture ID brought chaos to the legislature’s closing weeks. The 140-day session ends today with the fate of many bills still uncertain. The capitol is filled with rumors that Gov. Rick Perry will call a special session. Here’s a rundown on bills important to medicine that passed:
  • The $182.3 billion state budget increases funds for graduate medical education and mental health services. It will not increase Medicaid payments to physicians. We stopped a plan to expand HMO-like Medicaid programs and cut physicians’ out-of-network Medicaid payments.
  • House Bill 1888 by Rep. John Davis (R-Houston) and Sen. Robert Duncan (R-Lubbock) requires health plans to use accurate physician data in any physician ranking system, allows due process for physicians prior to the publication of their ranking, and specifies that the measurements used be reliable, evidence-based, and consistent across all health plans in the market.
  • HB 2256 would provide important patient protections as well as a mediation venue to resolve disputes for out-of-network, facility-based physician claims. Senator Duncan and Rep. Kelly Hancock (R-North Richland Hills) carried the bill.
  • Small physician practices could get a double benefit from HB 2154 by Rep. Al Edwards (D-Houston) and Sen. Juan Hinojosa (D-McAllen). It enhances the state’s loan repayment program to provide up to $160,000 over four years for physicians who work in a medically underserved area. The bill raises money through a new way to tax smokeless tobacco and also helps cover the cost of increasing to $1 million the exemption for businesses subject to the margins tax.
  • A session-long battle over allowing hospitals to employ physicians directly ended with two bills passing: SB 1705 by Sen. Royce West (D-Dallas) for the Dallas County Hospital District and a Senator Duncan amendment to HB 3485 by Rep. Garnet Coleman bill (D-Houston) that applies to government-owned hospitals in counties of 50,000 or less. TMA won very strong protections for physicians' clinical autonomy including a Texas Medical Board-supervised certification program. The bill potentially expands liability exposure to government hospitals that use this option to employ physicians. That has drawn the governor’s attention for a possible veto.
  • SB 532 by Sen. Robert Deuell, MD (R-Greenville), and Representative Coleman ensures proper oversight of physicians' delegation of prescriptive authority and other responsibilities to allied health practitioners at retail health clinics.
  • No bills passed that would dilute our 2003 health care liability reforms.
  • Two immunization bills by Sen. Jane Nelson (R-Lewisville) passed: SB 1328 gives state and local experts an opportunity to assess the vaccine needs of first responders before they respond to emergencies and disasters. SB 346 creates a lifelong adult immunization registry in Texas.

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