CAPITOL UPDATE: Clock ticks down as important measures hang in the balance

The Texas House has all but ground to a halt as debate on some of the session’s most contentious issues wages. Changes to the “top 10 percent” rule for college admissions and the question of whether to accept federal stimulus dollars for unemployment took up many hours of the House’s time on Thursday, while the voter ID bill and the sunset of the Texas Department of Insurance are both set for floor debate on Saturday. The deadline for the House to take up Senate bills is midnight on Tuesday, May 26, and with these highly charged issues still to be decided, bills are dying left and right.

Senate Finance Committee to take up TAFP’s loan repayment initiative Sat., May 23

House Bill 2154 by Rep. Al Edwards, D-Houston, was referred to the Senate Finance Committee this week after being passed by the House on May 13, as TAFP reported last week. Since then, proponents of the measure have been scrambling to get the bill on the committee’s schedule. Late yesterday, several news outlets reported that Senate Finance Chair, Sen. Steve Ogden, R-Bryan, had placed a “favorable tag” on the bill and set it for a hearing at 5 p.m., Sat. May 23.

Tagging a bill is a way that a lawmaker can stall legislation, but Ogden’s favorable tag prevents other members of the committee from tagging it themselves. The move means Ogden has breathed a bit more life into a measure that has faced tall odds throughout the session.

Recent analysis shows that the bill could raise as much as $105 million over the biennium to fund a new loan repayment program for primary care physicians agreeing to practice in health professional shortage areas.

TAFP and the Texas Association of Community Health Centers have been joined in the effort by the Texas Association of Business. TAFP conducted a statewide poll that showed strong support among Texas voters for the new loan repayment program. Sixty-three percent of poll respondents favored the loan repayment plan and according to a press release from the three groups, the support increases when respondents consider that the funding will come from tobacco tax revenue.

“Texas faces a current and growing crisis in health care—we’ve got a shortage of primary care physicians. Chief among the multiple factors contributing to Texas’ shrinking supply of physicians is the fact that the average medical school graduate carries a debt of more than $130,000,” said TAFP CEO Tom Banning in the release. “The Legislature has within its means to solve this problem by passing HB 2154. Our poll clearly shows that Texans overwhelmingly support a loan repayment program; the only opposition is from the tobacco lobbyists.”

For more information, read TAFP’s issue brief on H.B. 2154 and this editorial by TAB Executive Director Bill Hammond.

APNs fail to attach broad expansions of practice to retail health clinic bill

On Wednesday, the House passed Senate Bill 532 by Sen. Dan Patrick, R-Houston, a measure that maintains physician supervision over nurse practitioners and ensures the Texas Medical Board retains the responsibility for overseeing the delegation of prescriptive authority to nurse practitioners at retail health clinics. TAFP has worked for months on this bill in coordination with representatives of the major retail health clinics as a way to stave off aggressive efforts by advanced practice nurses to gain independent practice.

When those bills failed to make it out of committee, the APNs packaged them as amendments and attempted to attach them to S.B. 532 during debate on the House floor. Those amendments were defeated—one by a sustained point of order and the other was voted down overwhelmingly by a 35-100 margin. The bill now heads back to the Senate for final approval.

TAFP’s instant verification of benefits bill heads to the governor

H.B. 1342 by Rep. José Menendez, D-San Antonio, and Sen. Chris Harris, R-Arlington, has made it through the legislative gauntlet and awaits the governor’s signature. The bill would require health plans to provide information to physicians at the point of care about 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.

TAFP CEO Tom Banning said this bill represents a first step toward real-time claims adjudication. “With the increase in high-deductible, low-benefit health plans physicians are seeing these days, this bill should help clear up confusion for patients while helping doctors keep their accounts receivable under control,” he said.

The governor has until June 21 to sign or veto bills. Bills that he chooses not to sign or veto become law without his signature after that date.

To read more about the bill and the problems that drove TAFP to pursue this legislation, check out the cover story of the latest issue of TEXAS FAMILY PHYSICIAN.

Thanks to the Physicians of the Day

Thank you to the physicians who volunteered as Physicians of the Day this week: John Redman, M.D., of Humble; C. Mark Chassay, M.D., of Austin; Mary Helen Morrow, M.D., of Bryan; Bruce Scaff, M.D., of Clifton; and John Egerton, M.D., and Judith Egerton, M.D., of Austin.