UNDER THE ROTUNDA
Coming off some recent success moving important pieces of legislation (more on that later), the house of medicine hopes to continue that roll this week.
Busy committee schedules in the early part of the week will include the Texas Medical Association’s first priority bill to get a hearing outside its parent chamber. The Senate Finance Committee is scheduled to take a look today at House Bill 1445 by Rep. Tom Oliverson, MD (R-Cypress), which classifies outsourced medical billing services as not being insurance services. If HB 1445 ultimately becomes law, it would protect billing companies from a tax currently scheduled to begin in October – and protect physicians and patients from any of those costs billing organizations pass on to them. The House passed HB 1445 on April 6.
Prior auth and telemedicine: Keep an eye on the House Insurance Committee hearing on Tuesday, where TMA plans to testify on several bills up for consideration, including a pair of bills geared toward navigating and (when possible) knocking down insurers’ prior authorization roadblocks.
House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood) contains two key tenets of medicine’s strategy: It would allow physicians who achieve a certain percentage of prior authorization approvals to be “gold-carded” out of prior authorizations going forward. The bill also would require utilization reviews to be conducted by physicians of the same or a similar specialty as the doctor who requested approval for the treatment.
House Bill 4012, also by Representative Bonnen, would require health plans to provide cost estimates to the patient on services that require preauthorization.
TMA strongly supports both measures.
TMA needs your help in sending a strong message to lawmakers about prior auth burdens. Check out TMA’s social media toolkit, which includes messages, sample posts, and articles that you can share on your personal or practice social media channels. Find the prior auth toolkit in the “Advocacy Toolkits” section of the TMA website.
A key medicine-backed telemedicine payment parity measure is also on Tuesday’s House Insurance docket. House Bill 980 by Rep. Arthur Fierro (D-El Paso) would require health plans to pay for a covered service provided by telemedicine at the same rate the insurer pays for the service delivered in-person.
BILLS ON THE MOVE
With less than two months to go until the legislature adjourns, HB 1445 isn’t the only TMA priority bill to take big incremental steps to becoming law. Here’s a look at other TMA-supported measures that have moved out of committee – and beyond – thus far.
Passed one chamber
- Senate Bill 248 by Sen. Nathan Johnson (D-Dallas) establishes licensure requirements for retailers selling electronic cigarettes and vaping products, setting up a framework to regulate them in a way similar to other cigarette products. The Senate signed off on SB 248 on April 8.
- Senate Bill 672 by Sen. Dawn Buckingham, MD (R-Lakeway), which requires payment for Medicare behavioral health services that are classified as collaborative care. The bill’s parent chamber passed it on March 25.
Advanced out of committee
- HB 4 by Rep. Four Price (R-Amarillo) would make permanent some of the allowances for expanded telemedicine use that were put in place during the COVID-19 pandemic, such as payment for telemedicine for early childhood intervention services and Medicaid waiver programs.
- HB 5 by Rep. Trent Ashby (R-Lufkin) would provide for expanded broadband service across Texas.
- HB 133 by Rep. Toni Rose (D-Dallas) would provide pregnant women on Medicaid with continuous coverage under the program for 12 months postpartum.
- HB 907 by Representative Johnson generally would bar prior authorization requirements on prescriptions for patients with autoimmune diseases.
- SB 290 by Rep. Philip Cortez (D-San Antonio) would improve continuity of care for children on Medicaid by streamlining eligibility checks.
- SB 1490 by Sen. Brandon Creighton (R-Conroe), would ensure the availability of clerkships for Texas medical school students by addressing the Texas Higher Education Coordinating Board’s process by which it grants authorization to private, out-of-state medical and other professional schools to operate in the state.
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