Prior authorization is a disease that takes a wide range of medications and modalities to treat. The Texas House of Representatives took one of the house of medicine’s prescriptions for the disease on Monday.
The lower chamber passed House Bill 907 by Rep. Julie Johnson (D-Farmers Branch), which severely restricts insurers’ ability to impose preauthorization requirements for prescriptions for autoimmune diseases.
HB 907 limits insurers to one prior authorization per patient per year on autoimmune prescriptions, although it has some exceptions, including exempting Medicaid and Children’s Health Insurance Program (CHIP) plans.
HB 907 is the first of the Texas Medical Association’s preauthorization-fighting bills to make it through one chamber, but TMA still is hoping for some of its other prior auth prescriptions to generate legislative action, including:
- House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood), to “gold-card” physicians out of the prior authorization process, meaning a high prior authorization success rate for a service/procedure would exempt them from preauthorization for that service the following year. HB 3459 would also require utilization reviews to be conducted by physicians in the same or similar specialty as the requesting physician.
- House Bill 2142 by Rep. Hubert Vo (D-Houston) to require the Texas Department of Insurance to conduct examinations of certain insurers at least once per year to make sure the health plans are following their prior authorization-related obligations under the law.
- House Bill 410 by Representative Johnson, which would prohibit prior authorizations on procedures, tests, and diagnostic treatments for which the state requires coverage, including mammograms and diabetes equipment.
Monday’s passage of HB 907 capped a banner day for TMA that began early that morning, when legislation to prevent a tax on medical billing services went to Gov. Greg Abbott’s desk.
Protecting patients from the unvaccinated
A physician’s right to turn away patients who aren’t vaccinated is in the crosshairs of House Bill 2856 by Rep. Valoree Swanson (R-Spring). So TMA is turning to a veteran defender of vaccinations to oppose the bill when it’s heard Wednesday in the House Public Health Committee.
HB 2856 would bar physicians in Medicaid or CHIP from limiting their practice to families who choose to immunize for infectious or communicable diseases. The bill would require the state to “disenroll” from the programs physicians who refuse to open their private practice to unvaccinated patients.
Mai Duong, MD, co-chief of pediatrics at Austin Regional Clinic, is scheduled to testify against the bill on behalf of TMA and the Texas Pediatric Society (TPS). Dr. Duong told the committee in written remarks that HB 2856 violates her rights as a business and would endanger vulnerable patients in waiting rooms who may be susceptible to infectious diseases, such as children with leukemia and those too young to be vaccinated.
Dr. Duong testified for TMA, TPS, and others to oppose an identical measure during the 2019 session.
Just one First Tuesdays left
This year’s final virtual First Tuesdays at the Capitol is less than two weeks away, on May 4. By then, only 27 days will remain in this session. Register for free today to get an update from TMA’s lobby team on what issues and bills are still in play, and what you can do to help in the final stretch before the legislature adjourns.
Easy ways to get involved in TMA advocacy
Your participation is a vital component of our legislative success. Join our advocacy efforts today. Besides taking part in First Tuesdays, here are some other ways you can help.
Stay up to date on bills TMA is following closely. And take advantage of other opportunities to get involved with our advocacy efforts.