The House Committee on Appropriations and the Senate Finance Committee are trying to wrap up deliberations on Article II of the state budget, which sets funding levels for state health care programs. The current proposal includes a 10-percent increase in Medicaid provider reimbursement. That would add about $4.70 to the average new patient office visit.

The House version of Article II contains a contingency rider that would fund the CHIP reforms in House Bill 109 by Rep. Sylvester Turner, D-Houston, which was passed out of committee last Friday. That bill will be heard on the House floor on Monday, March 19.

Political insiders worry that the CHIP reform bill may fall victim to fears that the state might have a huge debt to pay once U.S. District Judge William Wayne Justice rules in Frew v. Hawkins, the federal lawsuit alleging that Texas has not met its obligations to children in the Medicaid program. As we reported last week, Judge Justice will hear the case on April 9 and is expected to rule in the plaintiffs’ favor.

Estimates on what the reforms might cost range from $1 billion to $5 billion, an amount that has led lawmakers to question the prudence of current proposals to strengthen CHIP and other health care programs.

An analysis released this week by the Center for Public Policy Priorities claims those worries are unfounded. According to CPPP, the expected ruling will cause the state to spend $2 billion more at most on children’s Medicaid – a significant amount but not so much that it would force the state to short other programs.

The chair of the House Appropriations Committee, Rep. Warren Chisum, R-Pampa, told the Rio Grande Guardian this week that he believes the state can comply with the expected ruling “without breaking the budget.” He told the paper that he is confident the ruling will cost the state $1 billion in new Medicaid spending over the biennium.

Next up for the Appropriations Committee is debate on Article III, which contains state funding for graduate medical education.

Sen. Nelson tackles Medicaid reform

Sen. Jane Nelson, R-Flower Mound, is tackling one of the biggest health care issues of the session, Medicaid reform. She’s filed Senate Bill 10, an ambitious set of measures that aim to change how the state finances the program.

“We’re creating options rather than mandates,” Nelson said in early March. “We are investing in prevention and over the long term, I truly believe this bill will stabilize costs, it will increase access to health care and most importantly it will help Texans live longer and healthier lives.”

Under this legislation, Medicaid recipients would receive incentives to stop smoking, control their weight and implement other preventive health measures. The bill would increase premium assistance programs to help Medicaid-eligible workers participate in employer-sponsored plans and it would set up a pilot project for health savings accounts under Medicaid. Other reforms include a state evaluation of the merits of expanding the integrated care model to manage the care of Medicaid recipients, an effort to pool state Medicaid dollars with employer and beneficiary contributions to pay for private insurance premiums in a “three-share” or “multi-share” program, and the creation of customized Medicaid benefit packages.

For more information on Sen. Nelson’s hopes for the bill, read her press release on SB 10.

Pathology bill heard in House committee

On Monday, the House State Affairs Committee took up a bill by Rep. Dan Gattis, R-Georgetown, that would prohibit billing or being reimbursed for anatomic pathology services unless the physician actually performed the test.

Albert Gros, M.D., an obstetrician-gynecologist from Austin, testified against the bill on behalf of TMA. You can read his testimony on TMA’s Web site.

TAFP has published a one-page policy brief on this issue on the Policy Initiatives page of the Academy’s Web site. For all talking points, policy briefs and other advocacy resources, go to the Advocacy page of TAFP’s
Web site.

Download TAFP Issue Brief: Oppose Anatomical Pathology Legislation, HB 1557.

Update: Provider flu vaccine bill voted out of the Senate

Should it be proven feasible, physicians would receive shipments of the influenza vaccine before retail establishments, Texas senators decided this week. Senate Bill 164 by Sen. Bob Deuell. M.D., R-Greenville, was voted out of the Senate Wednesday, March 14 and has now been sent to the House for consideration.

After making its way through committee hearings, the bill was modified from its original language—to give priority to physicians requesting the influenza vaccine starting later this year—to new language that directs the Health and Human Services Commission to conduct a study on the feasibility of implementing a physician priority system. If HHSC determines such a system to be reasonable for influenza vaccine distribution, the executive commissioner could employ the system.

Read the updated version of SB 164.

Managed care reform on House committee docket for Monday

The House Committee on Insurance will hear TAFP’s fair contracting bill on Monday, March 19, along with a host of bills on balance billing. TAFP Treasurer Bobby Youens, M.D., of Weimar, will testify before the committee. To read about House Bill 2016 by Rep. John Smithee, R-Amarillo, and its companion in the Senate, SB 1170 by Sen. Juan “Chuy” Hinojosa, D-McAllen, download TAFP’s Issue Brief on the need for fair and transparent health care contracts.

Thanks to these Physicians of the Day

Thanks to the physicians who volunteered their time this week to serve at the Texas Capitol as Physician of the Day. This week’s physicians were Rosanne Popp, M.D., of Houston; Shelton Jackson, M.D., of San Angelo; David Watson, M.D., of Yoakum; and Samuel Adkins, M.D., of Austin.

Spots are still available in April and May. Please contact Kate McCann for more information on how to participate in this service.