The House Appropriations Committee finalized its budget proposal this week. The plan, contained in House Bill 1, calls for $150.1 billion in state spending over the coming biennium, which includes a $2.5-billion increase for health and human services. The House is expected to begin debate on the budget late next week.

House Bill 15 – the emergency supplemental budget bill – also passed out of committee this week. The supplemental appropriations bill pays for budget items through the rest of fiscal year 2007 that have run out of allotted funds. H.B. 15 includes $108.9 million for Medicaid provider reimbursement, an amount that restores the 2.5-percent cut enacted in 2003. H.B. 1 contains a 7.5 percent increase in Medicaid payment rates, bringing the total increase to 10 percent.

While any increase in Medicaid reimbursement is a welcome development, will a 10-percent increase be enough to entice a significant number of physicians to participate in the program? According to a recent TMA survey, only 38 percent of Texas physicians accept all new Medicaid patients. The top reason cited for limiting access or refusing to see new Medicaid patients is the program’s dismal reimbursement rates. TAFP, TMA and the Primary Care Coalition have all called for a 22-percent increase in Medicaid payment rates over the biennium.

Download the Primary Care Coalition Issue Brief on Medicaid and CHIP.

CHIP reform stalls in House

The CHIP reform bill made its first appearance on the House floor Monday, March 19, but it was a short one. An omitted word in the bill analysis shut down debate before it even started. House Bill 109 by Rep. Sylvester Turner, D-Houston, would make it easier for patients to enroll in the program by eliminating the 90-day waiting period for newly enrolled uninsured children and implementing a more realistic asset test. It would also reinstate the program’s original 12-month eligibility period, meaning families would no longer have to re-enroll every six months.

Immediately after Rep. Turner introduced the bill, Rep. Robert Talton, R-Pasadena, raised a point of order that closed debate and sent the bill back to committee. The word “family” had been left out of the phrase “net family income” in one line of the bill analysis.

The House Committee on Human Services convened late that night to correct the mistake and the bill should get another hearing by the full House early next week.

Fair contracting bill gets first hearing

Monday, March 19, the House Committee on Insurance heard House Bill 2016 by Rep. John Smithee, R-Amarillo. The bill would bring fairness and transparency to contracts between physicians and entities that provide health insurance coverage. TAFP Treasurer Robert Youens, M.D., of Weimar testified in front of the committee about some of the difficulties physicians have when dealing with health plans.

“Imagine trying to run a small business when you don’t know how much you’re going to get paid for your service,” Youens said. “In my small practice, I have 60 unique contracts. Many of these contracts are with the same health plans for different products.”

Rep. Smithee left the bill pending for further debate. Fair contracting is one of TAFP’s legislative priorities this session. Read TAFP’s Issue Brief: Fair Contracting, for more information on this issue.

Committee approves “smart card” bill

A bill that would require health plans to issue smart cards to patients was voted out of a House committee this week. House Bill 522 by Rep. Beverly Wooley, R-Houston, would force plans to use technology similar to that of ATM cards. Physicians’ staff could swipe the cards as patients checked in and receive up-to-date information on benefit coverage, their deductibles and their financial responsibility. The bill would initiate a pilot project in the Harris County area, allowing officials an opportunity to test different technologies and systems.

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 David Knuth, M.D., of Huntsville; Ron McMurry, M.D., of Jasper; resident Ruchi Wanchoo, M.D., of Houston; Katie Youngblood, M.D., of Conroe; and Stephen Spann, M.D., of Houston.

Spots are still available in April and May and need to be filled as soon as possible to ensure that a family physician staffs the Capitol Health Clinic each day of the Legislative session. Please contact Kate McCann for more information on how to participate in this service.