In the Interim... 
So that’s what they do when they’re not in session

by Tom Banning 

Understanding the sheer number of issues likely to generate debate next legislative session, the lieutenant governor and speaker of the House assign standing or select committees various issues to study. These interim studies are designed to provide more in-depth discussions of emerging issues and to help make recommendations prior to the beginning of the regular legislative session.

It appears health-care-related issues will again dominate the legislative agenda next session, which means TAFP will have to closely scrutinize and monitor these interim studies and give testimony when needed to ensure the concerns of family physicians and their patients are addressed. The Legislature will study a broad array of issues including a thorough review of the state’s Workers’ Comp program, financing and delivery system issues for state-sponsored graduate medical education, and a host of public health concerns.

Separate and apart from the Legislative studies, Gov. Perry has created a select workgroup on Medicaid reform that has been charged to review the program’s design, utilization and reimbursement methodologies and outline possible cost containment and reform recommendations.

The Sunset Advisory Committee will be examining the operations of the Texas State Board of Medical Examiners, as well as almost every other allied health group. In addition to these studies, TAFP along with TMA has created several internal workgroups to study and make recommendations on budding issues.

Here is an overview of issues TAFP will be following over the interim:

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Contact your State Representative and Senator

Senate Select Committee on Workers’ Compensation

  • Examine the status of the Health Care Network Advisory Committee’s implementation of the regional workers’ compensation health care delivery networks.

  • Study the potential impact of networks on the workers’ compensation health care delivery system. Include in the study:

  1. Quality of care;

  2. Network adequacy and access to care;

  3. Disclosure of information to patients, complaint procedures, appeal rights and overall patient satisfaction;

  4. Costs of care;

  5. Provider credentialing, selection and dispute resolution;

  6. Financial risks to providers, employers and carriers;

  7. Effects of networks on the Texas Workers’ Compensation Commission;

  8. Quality monitoring systems such as independent report cards.

  • Study the impact of the Texas Workers’ Compensation Commission’s 2002 Medical Fee Guideline on access to quality medical care for injured workers and medical costs, including recommendations on whether the legislature should statutorily prescribe a methodology for calculating the workers’ compensation conversion factor.

  • Survey the costs and benefits of other health system cost-containment strategies as they relate to medical, therapeutic, and pharmaceutical care, including but not limited to, doctor selection, deductibles, co-payments, preauthorization of services and return-to-work programs.

  • Conduct a cost-benefit analysis, to the extent possible, comparing the Texas workers’ compensation system to systems operating in other states. Make recommendations to improve the quality of care for injured workers, reduce fraud and inefficiencies, reduce overall claim costs, and streamline the administration of the system. Recommendations should address data exchange, advisory groups and review panels, dispute resolution, enforcement issues, paperwork reduction, and billing and administrative efficiencies.

  • Study the efficiency and effectiveness of the state’s workers’ compensation system including a comparison of the medical and indemnity costs associated with the Texas A&M University system, the University of Texas system, the Texas Department of Transportation and the State Office of Risk Management. Evaluate the potential costs and benefits associated with state agency participation in workers’ compensation networks.

 

Contact the TAFP Legislative Department:

 

 Tom Banning, Director of Legislative Affairs

 

House Committee on Appropriations

  • Evaluate all current funding streams for graduate medical education for financial viability and educational effectiveness in light of changes in Medicaid, managed care and other cost factors, including the impact of uncompensated care. This shall include a role of the state’s teaching hospitals in the provision of indigent health care and the role of graduate medical education in addressing health care needs of under-served regions of the state.

House Committee on Border and International Affairs

  • Identify areas of health care need that specifically affect the border region or that disproportionately affect the border region, and develop strategies to improve conditions and reduce demand on the health care system.

House Committee on Business and Industry

  • Study ways to reduce specific cost drivers under the workers’ compensation systems related to provider, surgical and physical therapy services or care and the reduction of return-to work time periods.

  • Study the cost effectiveness of the state workers’ compensation system.

  • Study the potential impact on the cost and quality of medical care through employer and/or insurance carrier selection of initial treating doctor and change of doctor in the workers’ compensation system.

House Committee on Civil Practices

  • Monitor the legislation passed by the 78th Legislature, with particular emphasis on the implementation of and rulemaking for HB 4, the tort reform bill.

Select Committee on Health Care Expenditures

  • Monitor the implementation of the Driver Responsibility Act in response to the collection of associated surcharges for trauma care.

  • Study the effects of “crowd out” in the Children’s Health Insurance Program and Medicaid to determine accurate data and to ascertain if additional policy changes are needed to prevent “crowd out” of private insurance and escalating public insurance costs.

  • Study current consumer-directed care models that are in use by the state and look at other states’ consumer-directed care models that may benefit Texas in areas such as long-term health care and chronic health care.

  • Continue to identify and seek new models for the provision of health care benefits within the Employee Retirement System and the Teachers Retirement System.

House Committee on Insurance

  • Monitor the implementation and effect of SB 418, the prompt pay bill.

  • Monitor the implementation and effect of SB 10 and SB 541, in relationship to the cost and availability of health insurance coverage.

House Committee on Public Health

  • Study the need to regulate products containing dietary supplement ephedra. Include a review of other state actions.

  • Examine the demographics and costs of diabetes in Texas. Assess the impact diabetes will have on Texas’ population, budget and health care system in the future and recommend appropriate policy changes.

  • Collect, review and report on the statistics and statewide impact of drug and alcohol abuse by pregnant women on the unborn.

  
 

New face in TAFP’s legislative affairs division

TAFP is excited to announce the addition of Raif Massey Calvert to TAFP’s division of Legislative Affairs. He will help coordinate political grassroots and legislative/regulatory advocacy.

Raif grew up in Austin, attended Texas Tech University in Lubbock, and went on to attend law school at Pepperdine University in Los Angeles, Calif. After earning a J.D., he returned to Austin, and joined the staff of then Speaker of the Texas House of Representatives Pete Laney, as a legislative aide. After leaving the speaker’s office he was hired as legislative liaison for the Office of the Attorney General under now U.S. Senator John Cornyn. Raif remained in this position under current Attorney General Greg Abbott. We are excited and honored to have such an experienced individual representing our interests in Austin.