The Senate passed an omnibus Medicaid reform package this week that would use federal waivers to reshape the program. Among its provisions, Senate Bill 10 by Sen. Jane Nelson, R-Flower Mound, would increase the state’s premium assistance program and encourage enrollees to make healthy lifestyle choices through incentive programs.

“Members, these reforms will help stabilize our costs, it will increase access to health care and most importantly I believe, it will encourage patients to live longer healthier lives,” Sen. Nelson said in an address to the Senate on April 17.

Other provisions outlined in the bill include developing tailored benefit packages for Medicaid recipients, creating a method of subsidizing low-income adults’ policies through their employers, investigating wider use of health savings accounts and encouraging more preventive care for all enrollees, especially children.

Managed care bills make their way through the process

The House Committee on Insurance passed House Bill 839 by Rep. Craig Eiland, D-Galveston, that would stop third-party payers known as “silent PPOs” from renting out a physician’s contracted rates to other plans without the physician’s consent. The bill is now in the House Calendars Committee waiting to be set for House floor debate.

TAFP’s fair contracting bill, SB 1170 by Sen. Juan “Chuy” Hinojosa, D-McAllen, was heard by the Senate State Affairs committee this week and left pending. Frances Cason, insurance services manager for the Medical Clinic of North Texas, testified on behalf of TAFP, emphasizing that physician practices have little bargaining power when negotiating contracts with health plans.

“We just want simplified, transparent contracts that are fair and equitable to both sides,” Cason told the committee.

On the House side, the fair contracting bill, HB 2016 by Rep. John Smithee, R-Amarillo, is still pending in the House Committee on Insurance after a couple of committee members raised concerns about the bill.

In an interview with TAFP, Insurance committee member Craig Eiland warned of the consequences of unnecessarily stalling managed care legislation.

“Hopefully we’re going to remind people back when we had the prompt pay bill and a certain House member was slowing things down in the Calendars committee and kept tagging it so it wouldn’t come out to be voted on the House floor,” Eiland said. “That member was defeated by the doctors the next session, so I’m just trying to remind everybody that if they’re going to be monkeying with either one of these important bills, they need to remember that member because they may join his ranks if these bills are killed by time and the fingerprints are traceable.”

Senate passes budget, no increases for GME

The Senate passed the largest budget in state history last week, calling for $152 billion in spending over the next two years and spending about $2 billion more than the House budget. Because the House voted to reject Senate amendments to the budget, a conference committee of appointed senators and representatives will work out differences between the two versions. House Speaker Tom Craddick, R-Midland, appointed the House conferees: Reps. Warren Chisum, R-Pampa; Dan Gattis, R-Georgetown; Ryan Guillen, D-Rio Grande City; Lois Kolkorst, R-Brenham; and Sylvester Turner, D-Houston. Senate conferees will be named next week.

Neither the House nor the Senate chose to boost the state’s investment in graduate medical education, leaving that area of the budget virtually unchanged despite a looming shortage of primary care physicians. There’s a possibility to address that need in the conference committee, where members could raise funding for residency programs back to 2003 levels. The Primary Care Coalition will be submitting testimony to conference committee members urging them to consider boosting funding for graduate medical education. The PCC has also released an issue brief on graduate medical education and the physician workforce, available on the advocacy page of the TAFP Web site.

“We recognize there are intense, competing demands for available state funds and we understand the need to balance those funding priorities,” PCC Chair Eugene Stokes, M.D., wrote in the letter. “However, given Texas’ current and impending shortage of physicians – particularly primary care physicians – this increased funding will ensure Texas families continue to have access to timely, cost-effective primary health care.”

Roland Goertz, M.D., a Waco family physician and president of the McLennan County Medical Education and Research Foundation, told TAFP in an interview that the state needs to put as many dollars as possible toward producing more family doctors and encouraged TAFP members to speak out.

“Family physicians have the best model,” he said. “If you’re away from the urban environment there really isn’t a good model to replace what we can do. In rural Texas, we are health care. I want the legislators to hear that from our members. I want our members to tell them about that. It’s a compelling story.”

House Insurance Committee passes “smart card” bill

The House Insurance Committee passed House Bill 522 by Rep. Beverly Woolley, R-Houston, which would require health plans to issue patient identification cards to enrollees. The committee substitute mandates a pilot program be conducted by the Texas Department of Insurance in a county with at least 3 million residents and it creates a committee to advise TDI on timeframes for adoption by all health plans. The bill is now headed to the House Calendars Committee.

Thanks to this week’s Physicians of the Day

More volunteers needed to finish the session

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 Harold High, M.D., of Cuero; David Schneider, M.D., of San Antonio; and Erica Swegler, M.D., of Keller.

Don’t miss your chance to participate in the Physician of the Day program during the 80 th Legislative Session. Eight spots remain in May and need to be filled as soon as possible to ensure a family physician is on the Capitol grounds each day. Open days include May 1, 3, 8, 11, 16, 22, 23 and 28. Please contact Kate McCann for more information on how to participate in this service or visit the Physician of the Day page of the TAFP Web site for an up-to-date list of open spots.