With less than two months remaining in the 81st Texas Legislative Session, there are several fast-approaching deadlines that will spell doom for many of the more than 7,000 bills filed. Some say that if a bill hasn’t been heard in committee before Easter, it has little chance to make it to the House or Senate floor. That means that the first large hurdle in the legislative process is simply getting a bill heard before a committee.

Two of TAFP’s most important initiatives cleared not only that hurdle on March 31, but have also been voted out of committee and are on their way to the House Calendars Committee to be scheduled for a hearing on the House floor. The first is House Bill 1342 by Rep. Jose Menendez, D-San Antonio, which would require health plans to provide instant verification of health coverage to physicians at the point of care, including what services are covered, the amount of the patient’s co-pay and deductible, and what the patient’s out-of-pocket costs will be for services provided.

Bradley Reiner, who serves as a practice management consultant for TAFP, testified to the House Committee on Insurance that the absence of this information causes trouble for patients and physicians alike. “Speaking on a personal note, I actually have a large-deductible plan and it would really be nice when you go into a doctor’s office to be able to know specifically what those out-of-pocket expenses are,” Reiner said. “It really allows the patient to make some informed decisions.”

With the increasing popularity of low-cost, high-deductible health plans in which the patient pays much more of the cost for services, physicians need to know what to collect from the patient before that patient leaves the office. But with many plans, doctors have to wait until they’ve filed a claim and received a response to know what the patient owes. TAFP member Justin Bartos, M.D., of North Richland Hills, says that trying to collect payment weeks after the services were performed is difficult.

Bartos’ six-physician practice spends around $100,000 a year on salaries and benefits for employees who are solely dedicated to finding out what they should collect from patients. “I think anybody can see in what priority things get paid around the household and I don’t think the doctor’s bill is on the top. Consequently, when we’re relying on so much of the revenue billed directly from the patient and we don’t collect it up front, it is a very difficult process to get it later.”

TAFP member Jake Margo, M.D., tells members of the House Committee on Public Health about the difficulties of recruiting physicians to the Rio Grande Valley and keeping them there.

The second important initiative is the bill that would establish a substantial new loan repayment program, H.B. 1876 by Rep. Warren Chisum, R-Pampa. During the March 31 hearing of the House Committee on Public Health, TAFP member Jake Margo, M.D., of Rio Grande City, told the committee about the difficulties of trying to recruit young physicians to practice in poor, underserved areas. He is one of a handful of physicians willing to practice primary care in his area of the Rio Grande Valley of Texas.

“I know I always wanted to go back home [to practice], and once I was accepted to medical school, I found out how much it would cost. It was going to be pretty difficult to go back home and be able to pay knowing what I grew up seeing. I worked in the summers sometimes when I was in college at the clinics and get to see what kinds of patients we see in our clinics now.”

H.B. 1876 would restructure and consolidate the state’s disparate health-related loan repayment programs and provide a new, substantial investment in debt relief for primary care physicians, dentists and other health care providers who agree to serve in communities of need. Modeled after the National Health Service Corps program, the new fund would offer up to $160,000 for four years of service.

TAFP member Adrian Billings, M.D., is currently completing a term of service with the program in Alpine. “I took a federal scholarship from the National Health Service Corps to go to medical school, and that allowed me to graduate debt-free, and it’s also what allowed me to go back to my home area of Alpine, Texas, around the Mexican border, to practice without having to worry about repaying loans for medical school,” Billings says. “Also, it has allowed me to serve the medically underserved, Medicaid, Medicare and the indigent population without having to worry about repaying large scholarship loans.”

Rep. Richard Peña Raymond of Laredo, the bill’s co-sponsor, recognizes the importance of the legislation and encouraged supporters to act during his video interview for TAFP’s Capitol Report.

“We need more physicians, more dentists, we do need more medical help in the underserved areas in the state of Texas,” Raymond said. “I think that most who are watching [Capitol Report] also know that if we don’t do more to get more medical personnel into the underserved areas, I think we will fall further behind in providing quality health care in the state of Texas. This is a good step in the right direction. I hope it’s something that those who are watching can support, and if they can, let your legislators know that House Bill 1876 is something that will be good for Texas.”

Now that both bills are on track to go to the full House, TAFP will need you to contact your representative and ask for their support on these initiatives. We will put out a call for action when needed. To find your representative, his or her phone number and send an e-mail, use the Speak Out tool on AAFP’s Web site, http://capitol.aafp.org/aafp/home.

Senate passes budget, the ball now in House’s court

The Senate passed Senate Bill 1—its version of the budget—last week by a 26-to-5 margin. The $182 billion plan uses $11 billion in federal stimulus funds and includes a small increase in Medicaid provider fees. S.B. 1 doesn’t include money to cover more families through the Children’s Health Insurance Program and it doesn’t fund an extension to 12-month continuous coverage for children in the Medicaid program. The Senate passed S.B. 1 to the House Appropriations Committee, which is still working on its version of the budget.

Other bills of interest: TDI sunset and managed care

The Senate Government Organization Committee passed the sunset bill for the Texas Department of Insurance. Expect more action on issues important to physicians when the bill makes it to the House.

On the managed care front, the House Committee on Insurance took up House Bill 1932 by Rep. Senfronia Thompson, D-Houston, which would require health plans to develop a standardized label containing details of the plan so patients can easily compare one plan to another. TAFP supports this bill and we’ll keep you up to date on its progress.

Thanks to the Physicians of the Day

Six physicians still needed during the 81st session

Thank you to the physicians who volunteered as Physicians of the Day last week and this week: Steven Rossi, M.D., of Tulia; Thomas Smith, M.D., of Amarillo; Rita Schindeler-Trachta, D.O., of Austin; Jennifer Raley, M.D., of Pearland; David Palafox, M.D., of El Paso; Erica Swegler, M.D., of Keller; Dana Sprute, M.D., of Austin; and Neeta Gautam, M.D., of Houston.

Six days remain in the 81st Texas Legislative Session that need to be filled: April 16 and 20; and May 1, 18, 16 and 18. Even if you have already served as Physician of the Day, TAFP invites you to volunteer for a second day at the Capitol. For more information and to sign up, go to the Physician of the Day page of TAFP’s Web site, www.tafp.org/advocacy/physicianoftheday.