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TCEP2019 Legislative Session Update

Dear TCEP Member,

With the session behind us, we are currently engaged in the rule making processes that pertain to new laws that have been passed.  For example, last month TCEP provided written commentary to the Texas Department of Insurance relating to the state’s new balance billing law.

The following outline recaps the bills which were signed into law, and which we will be working on throughout the interim.

As always, please contact me with any questions or comments.

Theresa Q. Tran, MD, MBA, FACEP
Chair, Government Relations Committee

BILLS REGARDING OUT OF NETWORK/ NETWORK ADEQUACY/ COST TRANSPARENCY THAT TCEP SUPPORTED:

Hancock (SB 1264) / Whitmire (SB 1591) / Martinez-Fischer (HB 3933) / Oliverson (HB 2967)

  • Key points: combined legislation regarding prohibition of balance billing, regulation, introducing arbitration process, and payment standards 
  • TCEP Position: Support
  • Outcome: SB 1264 was signed by the Governor and takes effect January 1, 2020. 

Campbell (SB 2252) / Vo (HB 3911) 

  • Key points: More frequent examination of plans for adequacy by insurance commissioner (every 2 years instead of every 5)
  • TCEP Position: Support
  • Outcome: HB 3911 was signed by the Governor and takes effect September 1, 2019.

Menendez (SB 1742) / J. Johnson (HB 2630)

  • Key points: related to required information the health plans must include in their provider directories. Added to this bill were stricter requirements on health plans regarding pre-authorization, utilization review, independent review, and peer review. Utilization review must be conducted under the direction of a licensed Texas physician.
  • Creates a joint interim committee to study utilization review.
  • TCEP Position: Support
  • Outcome: SB 1742 was signed by the Governor and takes effect September 1, 2019. 

BILLS REGARDING WILFUL AND WANTON STANDARD/ TORT / LIABILITY

Hughes (SB 2378) / Moody (HB 2362)

  • Key points: Following TAPA approved negotiations, the bill would clarify current “wilful and wanton” language
  • TCEP Position: Started Opposed and moved to Support
  • Outcome: HB 2362 was signed by the Governor and takes effect September 1, 2019. 

Meyer (HB1532): 

  • Key points: creates a process at the Texas Medical Board that physician employees of a health organization can use to file complaints against a hospital or other health organization.
  • TCEP Position: Monitor
  • Outcome: HB 1532 was signed by the Governor and takes effect September 1, 2019. 

BILLS RELATED TO OPIOID/SUBSTANCE ABUSE AND PRESCRIPTION MONITORING PROGRAM

Kolkhorst (SB 1233) / Zerwas (HB 2174)

  • Key Points: Comprehensive bills from the Attorney General’s Office regarding opioids that would mandate e-prescribing in 2021 (with applicable exemptions), create a 10-day limitation for acute pain prescriptions, and require 2 hours of CME for pain management that can count towards ethics education requirement.
  • TCEP Position: Monitor
  • Outcome: HB 2174 was signed by the Governor and takes effect September 1, 2019. 

Sheffield (HB 3284)

  • Key points: is his version of comprehensive opioid bill, mostly recommendations from the interim studies on the issue. Amended with language from SB 2316.
  • TCEP Position: Support 
  • Outcome: HB 3284 was signed by the Governor and takes effect September 1, 2019. 

Sheffield (HB 3285)

  • Key points: Relating to programs and initiatives to prevent opioid addiction, misuse, and abuse in this state. 
  • TCEP Position: Support 
  • Outcome: HB 3285 was signed by the Governor and takes effect September 1, 2019. 

BILLS RELATING TO SCOPE OF PRACTICE

Minjarez (HB 29)

  • Key points: ability for a physical therapist to treat without a referral for limited duration.
  • TCEP Position: Started Opposed and moved to Neutral
  • Outcome: HB 29 was signed by the Governor and takes effect September 1, 2019.

BILLS RELATING TO MENTAL HEALTH

Huffman (SB 362)

  • Coalition of physician groups and the hospital association have been working over the interim to identify ways to reform process for obtaining an order of protective custody (OPC). We worked with Sen. Huffman and the Office of Court Administration to include language in their bills to establish an online portal where a physician could seek an OPC in a much more expedited manner—similar to the way warrants are for DWI blood draws. 
  • After working with the Office of Court Administration, it was determined that the best path forward would be through the rulemaking process at the agency and language was inserted into SB 362 to allow for rulemaking authority to create consistency and increase access to the judicial branch for mental health services.
  • TCEP Position: Support 
  • Outcome: SB 362 was signed by the Governor and takes effect September 1, 2019. 

BILLS RELATING TO TEXAS MEDICAL BOARD SUNSET REVIEW

Nichols (SB 610) / Paddie (HB 1504)

  • TCEP Position: Support 
  • Outcome: HB 1504 was signed by the Governor and takes effect September 1, 2019. 

BILLS RELATING TO TRAUMA CARE FUNDING

Huffman (SB 918) / Zerwas (HB 2048)

  • Key points: Modifies the unpopular driver responsibility program (DRP) while continuing to fund trauma care by increasing fines for most traffic offenses
  • TCEP position: Monitor 
  • Outcome: HB 2048 was signed by the Governor and takes effect September 1, 2019.