Thursday, February 16, 2017

Texas Doctors’ Prescription for the 2017 Legislature

By Ray Callas, MD
Beaumont Anesthesiologist
Chair, Texas Medical Association Council on Legislation

Growing state and federal government regulations and insurance company mandates are stealing time Texas physicians should spend with our patients. This is unacceptable. Every minute my colleagues and I spend with a patient is a minute that matters. This is why we have dedicated ourselves to tirelessly advocating for legislation that allows us to spend more quality time with our patients, foster the critical patient-physician relationship, and provide care in the manner in which we were trained.
With the 85th Texas legislative session underway, the Texas Medical Association (TMA), comprised of more than 50,000 doctors and medical school students who are caring for our state’s 27 million citizens, is urging lawmakers to take specific actions to help improve patient care. We encourage you to join us in making state legislature calls and/or to write to or call your legislator to push for the quality care that all Texans deserve.

Our 2017 prescription to keep Texas healthy includes:

1. Enact a Texas-Run Health Care Solution for Our Low-Income Families, Seniors, and Texans with Disabilities
  • Protect coverage and access to health services for our most vulnerable populations.
  • Set physicians’ Medicaid payment rates at least equal to Medicare.
  • Cover Texas’ one million-plus uninsured with private insurance that includes copays, tailored benefits, and health savings accounts.
  • Modernize the Medicaid Vendor Drug Program and improve Medicaid prior authorization requirements to cut regulative red tape.

2. Stop Health Insurance Tactics That Cause Surprise Medical Bills
  • Require health plans to comply with current network adequacy requirements and provide accurate directories of their network providers.
  • Expand the current mediation process, while maintaining the $500 threshold, to all physicians and providers providing out-of-network services at certain in-network facilities, and to certain out-of-network scenarios where patients are receiving surprise bills for emergency care.
  • Allow physicians to override health plans’ use of “step therapy” to substitute prescribed drugs for chronically ill patients.

3. Invest Wisely In Mental Health, Public Health, and Public Safety Programs
  • Ensure parents’ right to know about vaccination exemption rates at their children’s schools. 
  • Improve access to quality mental health care services.
  • Increase minimum age to buy tobacco products to 21.
  • Ban texting while driving.
  • Make state higher education and state agency campuses tobacco free.

4. Use Technology — Not Mandates — To Address “Doctor Shopping” and Opioid Diversion
  • Require prescriber licensing boards to automatically register their licensees for Texas’ Prescription Drug Monitoring Program.
  • Authorize the Board of Pharmacy to “push out” electronic notifications to prescribers and pharmacies when data suggests “doctor shopping.”
  • Add wholesaler delivery data to the Drug Monitoring Program database in order to match dispensing and delivery data by geographic area.

5. Require Same Standard of Medical Care Whether In-Person or by Telemedicine 
  • Physicians providing care to Texans must be licensed in Texas.
  • Ensure that physicians have access to the patient’s relevant clinical information in order to make a diagnosis and conform to the standard of care. 
  • A medically necessary, covered service should be paid for regardless of how it is provided.

6. Support a Strong and Fair Texas Medical Board (TMB) and Stop Diverting Physician License Fee Revenue
  • Continue and improve the TMB to ensure appropriate and safe regulation for the practice of medicine.
  • Medical Board discipline procedure needs to protect patients and guarantee physicians a transparent, fair process.
  • Stop diverting physician license fee revenue to the general fund. Instead, reduce the fee and use all funds collected to improve the Medical Board and speed up Texas medical licensing, which can take more than 12 months for the entire application process.

7. Require Medical School Training and Licensure for All Who Practice Medicine
  • Diagnoses and prescriptive authority must remain the purview of medical-school-trained, licensed physicians.

8. Protect Our State’s Medical Liability Tort Reform Caps
  • Since statewide voter approval of non-economic medical liability damage caps in 2003, Texas has gained 21,000 new physicians. Protecting these caps will help our state continue to improve upon our national ranking of 41st in active patient care physicians per capita. 

9. Keep Our Texas-Trained Doctors in Texas
  • Ensure we have 1.1 Texas residency slots for every one Texas medical school graduate.

The TMA and our physician members are fighting every day to ensure that we are putting patients first and are working to protect the personal health of all Texans. We are ready to provide counsel and advice or answer any questions you may have on these issues or others. We encourage you to reach out at (800) 880-7955 or connect with us on Facebook or Twitter @TexMed to engage and learn more.

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