With less than a week remaining in the 80th Legislative Session, the endgame is still unclear for the state budget. The budget conference committee all but finished its work late last week, yet as of Tuesday morning, May 22, the committee has not published its report. Once it does, the full budget – a 1,000-page document – must be printed and distributed to the full House and Senate. That takes some time, and time is running short.

Meanwhile the House appears to be in full-scale rebellion as an insurgent group of representatives has mounted a challenge against Speaker Tom Craddick, R-Midland. If the Legislature doesn’t succeed in passing a budget before the final day of the session, May 28, lawmakers would have to try again in a special session.

As the budget stands, physicians would get a 25-percent increase in reimbursement for pediatric Medicaid services and a 10-percent increase in adult Medicaid services.

UPDATE: Senate passes CHIP bill

Austin pediatrician Ari Brown, M.D., addressed a group at the Capitol on behalf of the Primary Care Coalition and TMA

After languishing for seven weeks in committee, the CHIP restoration bill was passed by the full Senate Tuesday, May 22. House Bill 109 by Rep. Sylvester Turner, D-Houston, had been stuck in the Senate Finance Committee but last week, committee members approved a committee substitute that would remove many of the enrollment barriers erected in 2003 that caused approximately 200,000 children to be dropped from the program.

The version of the bill passed by the Senate maintains the 12-month eligibility period but it mandates a six-month income verification component for families earning more than 150 percent of the federal poverty limit. That restriction has led the Legislative Budget Board and the Health and Human Services Commission to lower the anticipated caseload and cost for the program over the next two years. HHSC estimates that the new version of HB 109 would cover about 33,000 fewer children than the House’s version of the bill.

Now the bill awaits a response by the House. If the House doesn’t accept the Senate changes, a conference committee will be appointed to work out the differences between the two versions. That committee could be announced as early as today. They’ll have to make quick work of it though, as the session ends on Monday, May 28.

Advocates for CHIP held a press conference on the Capitol steps on Friday, May 18 to call on the Legislature to pass HB 109. Ari Brown, M.D., an Austin pediatrician addressed the group on behalf of the Primary Care Coalition and TMA. Holding up a home nebulizer, she told a crowd of children, parents and reporters that managing chronic diseases like asthma with continuous care is much less expensive and much better for patients than waiting for acute attacks and providing care in emergency rooms.

“This is what primary care is all about,” Brown said. “It’s preventing illness and keeping chronic diseases at bay. The emergency room is not meant to be a child’s medical home, but that’s where an uninsured child lands for a simple ear infection or asthma flare-up if there’s a gap in insurance coverage. Twelve months of continuous coverage is fundamental for a child’s medical care.”

Residency program funding study passes committee

The House Public Health Committee passed Senate Bill 1095 by Sen. Carlos Uresti, D-San Antonio, which calls for a study of the feasibility of using a portion of physician licensing fees to fund additional medical residency positions in the state. Rep. Vicki Truitt, R-Keller, presented the bill to the committee.

“Some of us here in the Legislature are under the impression that if we have a medical school in our area, that means the likelihood of retaining physicians trained at that medical school will be good for our area,” Truitt told the committee on May 16. “But in fact it is the medical residency program that is key in influencing whether or not a physician stays within an area. Historically, physicians stay within 100 miles of where they did their residency, not their medical school, so it’s really important to look at the residency programs.”

Vaccine distribution bill heard by Public Health

A bill to give physicians priority in influenza vaccine distribution over some retail establishments was reported favorably by the House Committee on Public Health last week. Senate Bill 164 by Sen. Bob Deuell, R-Greenville, would direct the executive commissioner of the Health and Human Services Commission to study vaccine distribution in the state and determine the feasibility of implementing a health care provider-favored distribution system.

Two managed care reforms await Perry’s signature

One of TAFP’s major goals during this legislative session has been to bring some fairness to the relationships physicians have with health insurance companies. Two bills that would bring some meaningful reforms to the managed care industry await the governor’s signature.

House Bill 522 by Rep. Beverly Woolley, R-Houston, calls on health plans to implement technology that would give physicians real-time information on patient benefits and out-of-pocket costs. The bill sets up a pilot program so the Texas Department of Insurance can examine the use of different technologies such as smart cards, Web portals and biometrics. It also establishes a technical advisory committee to help the department.

The Senate also passed HB 1594 by Rep. John Zerwas, M.D., R-Fulshear, which would expedite the health plan credentialing process for a physician joining a group practice already in the plan’s network. The bill is an important step to make sure patients are not stuck with unexpected and expensive out-of-network charges.

HIT bill headed to Senate floor

A bill that aims to bring health information technology to the state’s health care system has cleared one of its final hurtles. House Bill 1066 by Rep. Dianne Delisi, R-Temple, would create a statewide network of public and private health care stakeholders to encourage the adoption of health information technology. The Senate Health and Human Services Committee passed the bill last week, putting it on the fast track for Senate approval.

Thanks to the Physicians of the Day

Thanks to the physicians who volunteered during the last two weeks of the session to serve at the Texas Capitol as Physician of the Day. Last week’s physicians were Jennefer Sutton, M.D., of San Antonio; Tamara Dominguez, M.D., of San Antonio; John Egerton, M.D., and Judith Egerton, M.D., of Austin; James Martin, M.D., of San Antonio; and Jennifer Cameron, M.D., of Georgetown. The physicians who will finish the session are David McClellan, M.D., and resident James Qui, M.D., of Bryan; Shashi Mittal, M.D., of Garland; Amina Patel, M.D., of Sugar Land; Joane Baumer, M.D., of Fort Worth; and Rick Edwards, M.D., and Barbara Estment, M.D., of Corpus Christi.

Make sure you are on the list for the 81st Legislative Session or any special sessions called between the end of the current session and the beginning of the next by contacting Kate McCann at TAFP to be placed on the Physician of the Day contact list. Visit the Physician of the Day page of the TAFP Web site at any time for more information on the program and upcoming sessions.