Physician-Led Results: Prior Auth Relief, Other TMA-Backed Bills Signed Into Law
By Joey Berlin

For the House of Medicine, it’s a time for celebrating, but also a little more waiting. 

Celebrating because an impressive number of medicine's priorities already have been penned into law thanks to physicians’ hard work at the Capitol in person, virtually, and at the grassroots level. At the top of the list of victories: Now enshrined into law is House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood), which allows physicians to earn a “gold card” out of insurers’ prior authorization requirements for certain services, and requires peer-to-peer calls for utilization reviews to be conducted by a physician in the same or similar specialty as the patient’s physician.   

“Despite it being the most challenging year for doctors, we had more engagement than ever before, leading to a very successful session,” said Austin oncologist Debra Patt, MD, who served as chair of the Texas Medical Association’s Council on Legislation during the 2021 session and testified more than a dozen times. 

Also new law: Senate Bill 248 by Sen. Nathan Johnson (D-Dallas) requires those who sell vaping products to obtain a permit from the state comptroller, just as those who sell tobacco products do. The comptroller’s office can impose fines on those who violate the law. 

As for the waiting part, some of the Texas Medical Association’s championed legislation still await action by Gov. Greg Abbott, who still has until today to veto a bill, sign it into law, or let it become law without his signature. 

Meanwhile, here’s a look at other important TMA-backed measures that Governor Abbott has signed thus far from the just-completed legislative session. Be sure to read Texas Medicine Today for more updates.  

Telemedicine 

• House Bill 4 by Rep. Four Price (R-Amarillo) makes permanent many of the COVID-19-era relaxations on telemedicine in Medicaid that allowed physicians and patients to adopt it quickly.
• House Bill 5 by Rep. Trent Ashby (R-Lufkin) establishes a state broadband development office to award financial incentives for helping to expand broadband in areas of the state that lack it.
• House Bill 1616 by Representative Bonnen authorizes Texas’ participation in the Interstate Medical Licensure Compact, allowing physicians an easier path to being licensed in multiple states, including for those wanting to practice telemedicine. 

Medicaid and Maternal Care 

• House Bill 133 by Rep. Toni Rose (D-Dallas) grants women in Medicaid six months of coverage postpartum. 
• Senate Bill 672 by Sen. Dawn Buckingham, MD (R-Lakeway), requires payment for collaborative care in Medicaid. 
• House Bill 2658 by Rep. James Frank (R-Wichita Falls) was amended during the session’s final weekend to include House Bill 290 by Rep. Philip Cortez (D-San Antonio), which means HB 2658 includes a required six months of coverage for children in Medicaid, with the potential for an additional six months of coverage following a household eligibility check. 

Insurance 

• House Bill 1445 by Rep. Tom Oliverson, MD (R-Cypress), adjusts state insurance law to prevent a tax on outsourced medical billing services.
• House Bill 1763 by Representative Oliverson outlaws pharmacy benefit managers’ “clawbacks” of certain fees, such as rebates, after an insurance claim is complete.
• House Bill 2090 by Rep. Dustin Burrows (R-Lubbock) funds an all-payer claims database, which will increase insurer transparency and provide physicians useful health plan-related data. 
• Senate Bill 827 by Sen. Lois Kolkhorst (R-Brenham) generally caps patient cost-sharing for prescription insulin at $25 per prescription for a 30-day supply. 
• Senate Bill 1028 by Sen. Joan Huffman (R-Houston) lowers the minimum age at which health plans are required to cover colorectal cancer screenings to 45, instead of 50. 
• Senate Bill 1065 by Sen. Carol Alvarado (D-Houston) requires dense breast tissue screens to be covered at the same level as mammography. 

Liability 

• Senate Bill 6 by Sen. Kelly Hancock (R-North Richland Hills) increases liability protections for physicians during a pandemic.

Education  

• Senate Bill 1490 by Sen. Brandon Creighton (R-Conroe) regulates out-of-state postsecondary education programs to prioritize in-state students and help keep those physicians-to-be in Texas.