The year that was and the year to come

by Tom Banning, TAFP Director of Legislative Affairs

The passing of the holidays always gives us an opportunity to reflect on the past year and focus on the challenges facing us in the next. The TAFP had a great legislative year. The Texas House and Senate passed meaningful and landmark legislation for a better system of health care for all Texans.

The efforts of academy members resulted in the overwhelming passage of more than a dozen health care related bills. Included was legislation prohibiting the mandatory use of a hospitalist, a $50 million fee increase for targeted primary care codes in the Medicaid program, and legislation protecting patients’ medical privacy.

The Legislature heard our call and responded, unanimously passing our prompt pay bill, Medicaid managed care reform bill, and locum tenens bill. Unfortunately, these and a host of other bills were condemned to die under the force of veto.

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Read the Legislative Update from the last issue

Looking ahead to the next legislative session, medicine will be faced with numerous challenges and opportunities. Our agenda will primarily focus on five areas:

• Assure fair managed care practices—prompt payment of claims, standardization of forms and contracts, further refinement of state antitrust laws to permit physician communications and negotiations, and due process in credentialing matters;

• Assure fair malpractice insurance practices, tough sanctions for lawsuit abuse and tighter screening of claims brought against physician defendants;

• Restore and preserve funding to Medicaid;

• Restore and preserve funding to public health systems, with emphasis on childhood immunizations and bioterrorism preparations; and

• Oppose taxing medical practices or other forms of economic restraint that exacerbate an already fragile medical practice environment.

TAFP will use the interim and election cycle to persuade and support incumbents and candidates who back our policy positions. The academy needs your help in advancing our goals. The most successful legislative programs are those with active participation at the grass roots level.

TAFP will be aggressively identifying family physicians to serve as legislative ambassadors to their elected officials and candidates running for office. Part of an ambassador’s responsibility is to be available to discuss health care issues and how they affect your patients. Please contact TAFP legislative staff at (512) 329-8666 for more information on how you can become involved. 

 Contact the TAFP Legislative Department:

 Tom Banning, Director of Legislative Affairs

Greg Herzog, 
Legislative Aide

Visit the Member Advocacy section of the Web Site

Legislative Brain Drain

The political landscape of the Texas Legislature is sure to undergo some dramatic changes. Fostered by early retirements, the reshuffling of legislative districts by the redistricting process, and the statewide game of musical chairs instigated by U.S. Sen. Phil Gramm’s retirement, the Capitol will be replete with new faces in 2003.

Already more than a dozen committee chairmen have announced their plans to retire from the Texas Legislature next year. Others are leaving to seek higher office. And some, because of redistricting, are paired against each other.

As many as 50 new representatives may be among the 150 members of the House, and the Senate could have seven or eight new members in its 31 seats when the Legislature reconvenes. Texas will also elect a new lieutenant governor next year to run the Senate, and the House may likely have a new speaker if the Republicans win the majority in that chamber.

What this all means is that there will be a significant drain of political experience and institutional memory from the Legislature. The next Legislature, however, will be faced with arguably one of the most challenging sessions in decades. Early budget forecasts are projecting a $5 billion shortfall, though that number could easily rise to $12 billion as the demand for state services increase and revenue sources remain flat.

HOUSE INTERIM STUDIES

House Committee on Insurance—charged to:

1. Review the status of the medical liability insurance market and all aspects of the market that affect the cost of coverage. The study should include, but is not limited to, the number of carriers and their financial condition, the extent of market regulation, the frequency and severity of claims and claims handling practices, and regulation of medical providers to ensure patient safety;

2. Review the major state administered health insurance plans including Medicaid, state employee, public school employee and retiree, CHIP, SKIP, and higher education, to assess the reasonableness of costs to the state and the insured. The review should consider overall premium levels, coverages, out-of-pocket costs, health and utilization characteristics of the insured populations, health care provider reimbursement rates, administration of the plans (third party administrators, use of various forms of managed care) and any other factors affecting costs. To the extent feasible, comparisons to similar plans in the private sector and other governmental jurisdictions should be made. (Joint with House Committee on Appropriations); and

3.  Actively monitor agencies and programs under the committee’s oversight jurisdiction, including the effect of HB 2159, 77th Legislature, on credit life insurance rates, and efforts by the Texas Department of Insurance to enforce the prompt payment of clean claims by insurers.