As the 80th Legislative Session winds down toward its final day on May 28, certain looming deadlines could spell disaster for many bills unless legislators act in time. Rep. Richard Peña Raymond, D-Laredo, says these rules are set in place to ensure bills are given proper consideration by legislators.

“Before I came to the Legislature, bills would be passed at the last minute on sine die, which is the last day of session, at midnight,” Rep. Raymond says. “The problem with that is that often times people didn’t know what got passed in those bills, so we established these deadlines so that members can look at bills with at least some time left and something can’t be snuck in at the last minute.”

Bills have a chance to fail at each stage of the process. The way it works, bills are referred to House or Senate committees for consideration through public testimony and committee discussion. House committees must report a bill favorably by Tuesday, May 7, for it to be placed on a House calendar.

One bill TAFP opposes, HB 1096 by Rep. Rob Orr, R-Burleson, passed the House Committee on Public Health. The bill would greatly relax physician supervision of nurse practitioners and physician assistants. It is not likely to survive the next test to make it to the House floor for debate; after passing a committee, a bill must be scheduled by the House Calendars Committee and make it to the floor for readings. The last day a bill can be heard in the House on second reading is Thursday, May 10.

Senate bills referred to House committees must be reported favorably by Saturday, May 19, or they won’t be eligible for House deliberation. Tuesday, May 22 is the last day for the House to consider the second reading of SBs on the Daily calendar. The next day, Wednesday, May 23, is the last day for the Senate to consider bills.

After these deadlines pass, the House and Senate can only make corrections to bills and hear reports from conference committees.

Senate passes transparency bill

A bill that would bring principles of transparency to health care transactions was passed by the Senate this week. Senate Bill 1731 by Sen. Robert Duncan, R-Lubbock, would establish a consumer health guide from which patients could access information on general pricing information for services at different facilities through the Department of State Health Services Web site.

“This is a bill that has a lot of balance in it and I am very confident that this will be a first major step toward improving our constituents’ ability to deal with the issues like balance billing, choosing health plans and choosing health care facilities that will best suit their needs,” Sen. Duncan said during the Senate floor debate on April 30.

The bill would also require physicians to develop a set of billing policies and it would require health plans to file periodic reports with the Texas Department of Insurance. Among other things, those reports would include a listing of premium costs, details on reimbursement rates and on the accuracy and promptness of claims payment.

While supporting the bill, Sen. Eliot Shapleigh, D-El Paso, voiced a concern that the bill doesn’t require plans to disclose how much of the premiums they collect are spent on marketing, underwriting and denial management.

“The chief difference in health policy in this country versus other countries is the amount of health care dollars tied up in those three expense items and I think the closer we can get to determining why it is that we are embedding so much of our cost not into direct care but into denial, we’re not going to move closer to getting the policies that we need,” he said.

SB 1731 now heads to the House Committee on Public Health.

House passes tax clean-up bill

The House approved a bill to clean up the business tax legislators passed last session. House Bill 3298 by Rep. Jim Keffer, R-Eastland, would raise the floor at which businesses would be subject to the tax. Currently a business would pay no tax if its gross receipts total less than $300,000 for the year. The House voted to raise that amount to $600,000, which would exclude many more family physicians from the tax. The bill now moves to the Senate.

Senate committee hears bill on physician ranking systems

Many health plans have begun rating physicians on their quality of care and how expensive they are, but Senate Bill 1143 by family physician Sen. Robert Deuell, R-Greenville, would require fairness in ranking systems by providing physicians with access to the standards and measurements the plans are using before being evaluated. The bill was heard in the Senate Committee on State Affairs hearing on April 30. It would prohibit the plans from publishing the rankings until physicians have had a chance to question their scores.

“I strongly oppose the use of physician rankings and will continue to work against it, but if these rankings have to occur, physicians should at least have a chance to answer negative rankings and know the rules upon which they will be judged,” Deuell told the committee.

The plans base their physician rankings on claims data alone, a method of measurement that Sen. Deuell told the committee is fraught with flaws.

“There’s just no viable way to rank physicians based upon their economic use and then the implication with some of these companies is that the quality of care might be better and again, there’s just no way,” he said. “I think the decision to use a physician should be up to the patient and not based upon some sort of ranking that really is not possible to do anyway.”

Other bills under consideration by the committee are HB 1594 by Rep. John Zerwas, R-Richmond, and HB 522 by Rep. Beverly Woolley, R-Houston. HB 1594 would expedite the physician credentialing process and HB 522 would require health plans to issue “smart cards” to enrollees containing certain health information.

Thanks to this week’s Physicians of the Day

Three 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 Jason Stokes, M.D., of Austin; Luis Benavides, M.D., of Laredo; Daniel Voss, M.D., of Georgetown; Stephen Benold, M.D., of Georgetown; and Leonides Cigarroa, M.D., of Laredo.

Don’t miss your chance to participate in the Physician of the Day program during the 80th Legislative Session. Three 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 are May 8, 16 and 23. 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.