TSA The Journal 86th Regular Session, 2019

The Journal

The 2019 Scorecard for the 86th Texas Legislature

TSA The Journal 86th Regular Session, 2019

The Journal The Journal reflects Texas legislators’ overall score on legislation which was tracked by the Texas Society of Anesthesiologists (TSA) for the 86th Regular Session. Every session, the TSA connects with legislators on bills which will impact the medical practice of anesthesiology. The Journal is a valuable tool to hold legislators accountable. For a bill to be used on the TSA voting record, we ensure our stance was communicated to all the legislators and that every legislator in a chamber had an opportunity to vote on the legislation. This session the scorecard includes legislation covering the topics of access to physician care in rural areas, Medicaid reimbursement, tort liability for physicians, corporate practice of medicine, maintenance of certification, network adequacy and balance billing, and carrier accountability. In the House of Representatives, the legislators were graded on 20 record votes while the Senators were graded on 17 record votes. Explanations of all legislation are listed after the scorecard for each chamber. Legislators were only graded on the scorecard for votes they took. If they had an absence (excused or unexcused) or voted “present, not voting,” the vote was not graded. Please note that the Speaker or anyone who is in the Speaker’s chair at the time of a vote typically does not vote, so as to not influence the debate or outcome of the vote. The Speaker has no grade on the scorecard and anyone sitting in the Speaker’s chair at the time of a bill on the scorecard is listed as “C” and that vote was not graded for them in the scorecard. The TSA is excited to announce an unprecedented number of legislators who received a 100% voting record with 81% of the Senate and 60% of the House of Representatives. These individuals will be recognized for their achievement and their support of the medical subspecialty of anesthesiology.

HOW TO READ THE VOTES

+ Pro-Medicine Vote

0 Vote Against Medicine

E Excused Absence

A Absence (Unexcused)

C Chair

P Present Not Voting

* Physician Legislator

TSA The Journal 86th Regular Session, 2019

The Texas House of Representatives 2019 HB

278 HB 1065

HB 1112

HB 1273

HB 1504

HB 1532

HB 1832

HB 1880

HB 2041

HB 2151

HB 2327

HB 2387

HB 2632

HB 3345

HB 3911

SB 170

SB 670

SB 752

SB 1264

HB 2630

Allen 100% + + + + + + + + + + + + + + + + + + + + Allison 90% + + + + + + + + + 0 + + 0 + + + + + + + Anchia 100% + + + + + + + + + + + + + A + + + + + + Anderson 89% + + + + + + + + + 0 + + + A + + + + + 0 Ashby 100% + + + + + + + + + + + + + + A + + + + E

Bailes 100% + + + + + + + + + + + + + + + + + + + + Beckley 100% + + + + + + + E A + + A + + + + + + + + Bell, K 95% + + + + + + + + + + + + 0 + + + + + + + Bell,C 84% + + + + + + 0 + + 0 + + + + + + E + + 0

Bernal 100% + + + + + + + + + + + + + + A + + + + +

Biedermann 73% E E E + 0 + 0 + 0 0 + A + + + + E + + +

Blanco 100% + + + + + + + + + + + + + + + + + + + + Bohac 95% + + + + + A + + + 0 + + + + + + + + + + Bonnen, D As Speaker, Rep. Dennis Bonnen typically does not vote Bonnen, G * 100% + + + + + + + + + + + + E + + + + + + + Bowers 100% + + + + + + + + + + + + + + + + E + + + Buckley 95% + + + + + + + + + 0 + + + + + + + + + + Bucy 100% + + + + E + + + + + + + + + + + + + + +

Burns 90% + + + + + + + + + 0 + + + + + + + + + 0

Burrows 95% + + + + + + + + + + + + + + + + + + + 0 Button 95% + + + + + + + + + + + + + + + + + + + 0

Cain 50% + 0 + + 0 0 0 0 0 0 + + + + 0 0 + + + 0 Calanni 100% + + + + + + + + + + + + + + + + + + + + Canales 100% + + + + + + + + + + + + + + + + + + + + Capriglione 95% + + + + + + + + + + + + 0 + + + + + + + Clardy 94% + + + + + + + + + + + + 0 + A + E + + + Cole 100% + + + + + + + A + + + + + + + + + + + + Coleman 100% + + + + + + + + + + + + + + + + + + + + Collier 100% + + + + + + + + + + + + + + + + + + + +

Cortez 100% + + + + + + + + + + + + + + + + + + + + Craddick 95% + + + + + + + + + 0 + A + + + + + + + +

Cyrier 84% + + + + E + 0 0 + 0 + + + + + + + + + + Darby 100% + + + + + + + + + + + + + + + + + + + + Davis, S 100% + + + E + E + + E + + E E + E + + + E + Davis, Y 100% + + + + + + + + + + + + + + + + + + + +

Dean 90% + + + + + + + + + 0 + + 0 + + + + + + +

TSA The Journal 86th Regular Session, 2019

2019 HB 278

HB 1065

HB 1112

HB 1273

HB 1504

HB 1532

HB 1832

HB 1880

HB 2041

HB 2151

HB 2327

HB 2387

HB 2632

HB 3345

HB 3911

SB 170

SB 670

SB 752

SB 1264

HB 2630

Deshotel 100% + + + + + + + + + + + + + + + + + + + + Dominguez 100% + + + + + + + E + + + + + + + + + + + + Dutton 100% + + + + + + + + + + + + + + + + + + + + Farrar 100% + + + + + + + A + + + + E A + + A + + + Fierro 100% + + + + + A + + + + + + + + + + + + + + Flynn 95% + + + + + + 0 + + + + + + + + + + + + + Frank 80% + + + + + + 0 0 + 0 + + + + + + + + + 0 Frullo 100% + + + + + + + + + + + + + + + + + + + + Geren 100% + + + A + + + + + + + + + + + + + + + +

Gervin-Hawkins 100% E E E 1 E + + + + + + + + + + + + + + + Goldman 100% + + + + C + + + C C + C + C + + + C + + Gonzalez, J 100% + + + + + + + + + + + + + + + + + + + + Gonzalez, M 100% + + + + + + + + A + + + + + + + + + + + Goodwin 100% + + + + + + + + + + + + + + + + + + + + Guerra 100% + + + + + + + + + + + + + + + + + + + + Guillen 100% + + + + + + + + + + + + + + + E + + E + Guiterrez 100% + + + + + + + + + + + + + + + + + + + + Harless 84% + + + + + + 0 E + 0 + + + + 0 + + + + + Harris 80% + + + + + + 0 0 + 0 + + + + + + + + + 0

Hefner 75% + + + + + + 0 0 + 0 + + + + 0 + + + + 0 Hernandez 100% + + + + + + + + + + + + + + + + + + + + Herrero 100% + + + E E E + + E + + + E + E + + + + +

Hinojosa 100% + + + + + + + + + + + + + + + + + + + +

Holland 95% + + + + E + + + + 0 + + + + + + + + + + Howard 100% + + + + + + + E + E + + + + + + + + + + Huberty 100% + A + + + + + + + + + + + + + + + + + E Hunter 90% + + + + + + + + + 0 + + + + + + + + + 0

Israel 100% + + + + + + + + + + + + + + + + + + + +

Johnson, E 100% + + + + + + E E + E + + E E + E E E E E Johnson, Jarvis 100% + + + + + + + + + + + + + + + + + + + + Johnson, Julie 100% + A + + E + + + + + + + + + + + + + + + Kacal 95% + + + + E + + + + 0 + + + + + + + + + + King, K 100% + + + + + + + + + + + + E + + + + + + E King, P 79% + + + + A + 0 + + 0 0 + + + 0 + + + + + King, T 100% + + + + + + + E + + + + + + + + + + + + Klick 95% + + + + + + 0 + + + + + + + + + + + + + Krause 74% + 0 + + + + 0 0 + A + + + + 0 + + + + 0

TSA The Journal 86th Regular Session, 2019

2019 HB 278

HB 1065

HB 1112

HB 1273

HB 1504

HB 1532

HB 1832

HB 1880

HB 2041

HB 2151

HB 2327

HB 2387

HB 2632

HB 3345

HB 3911

SB 170

SB 670

SB 752

SB 1264

HB 2630

Kuempel 100% + + + + + + + + + P + + + + + + + + + +

Lambert 100% + + + + + + + + + + + + + + + + + + + +

Landgraf 85% + + + + + + 0 + + 0 + + + + + + + + + 0

Lang 55% + 0 + + 0 + 0 0 + 0 + + 0 + 0 0 + + + 0 Larson 95% + + + + + + + + + 0 + + + + + + + + + + Leach 90% + + + + + + 0 + + 0 + + + + + + + + + + Leman 85% + + + + + + 0 + + 0 + + + + + + + + + 0 Longoria 100% + + + E + E + A E + + + + + E + + + + + Lopez 100% E E E + + + + + + + + + + + + + + + + + Lozano 100% + + + + + + + + + + + + + + + + + + + + Lucio III 100% + + + + + + + + + + E + A + + + + + + + Martinez 100% + + + + + + + + + + + + + + + + + + + + Martinez-Fischer 100% + + + + E + + + + A + + + + + + + + + +

Metcalf 75% + + + + + + 0 0 + 0 + + + + 0 + + + + 0

Meyer 100% + + + + + + + + + + + + + + + + + + + + Meza 100% + + + + + + + + + A + + + + + + + + + + Middleton 63% + 0 + + 0 + 0 0 + 0 + + + + 0 + E + + 0 Miller 88% + + + E + E + + E 0 + + + + E + + + + 0

Minjarez 100% + + + + + + + + + + + + + + + + + + + + Moody 100% C + C + A + + + + + + + C + + A C + + C Morales 100% + + + + + + + + + + + + + + + + + + + + Morrison 95% + + + + + + + + + 0 + + + + + + + + + + Munoz, Jr 100% + + + + + + + + + + + + + + + + + + + + Murphy 100% E E E + + + + + + + + + + + + + + + + +

Murr 80% + + + + + + 0 0 + 0 + + + + + + + + + 0

Neave 100% + + + + + + + + + + + + + + + + + + + + Nevarez 100% + + + A + A + E + + + + + + + + + + + + Noble 90% + + + + + + + 0 + 0 + + + + + + + + + +

Oliverson * 100% + + + + + + + + + + + + + + + + + + + +

Ortega 100% + + + + + + + + + A + + + A + + + + + + Pacheco 100% + + + + + A + + A + + + + + + + A + + + Paddie 95% + + + + + + + + + 0 + + + + + + + + + + Parker 95% + + + + + + + + + 0 + + + + A + + + + + Patterson 70% + 0 + + + + 0 0 + 0 + + + + 0 + + + + 0

Paul 80% + + + + + + 0 0 + 0 + + + + + + + + + 0

Perez 100% + + + + + + + + + + + + + + + + + + + +

Phelan 85% + + + + + + 0 + + 0 + + + + + + + + + 0

TSA The Journal 86th Regular Session, 2019

2019 HB 278

HB 1065

HB 1112

HB 1273

HB 1504

HB 1532

HB 1832

HB 1880

HB 2041

HB 2151

HB 2327

HB 2387

HB 2632

HB 3345

HB 3911

SB 170

SB 670

SB 752

SB 1264

HB 2630

Price 95% + + + + + + + + + 0 + + + + + + + + + + Ramos 100% + + + + + + + + + + + + + + + + + + + + Raney 100% + + + + + + + + + + + + + + + + + + + + Raymond 100% + + + + + + + + + + + + + A + + + + + + Reynolds 100% + + + + + + + + + + + + + + + + + + + + Rodriguez, E 100% + + + + + + + + + + + + + + + + + + + +

Romero 100% + + + + + + + + + + + + + + + + + + + + Rose 100% + + + + + + + + + + + + + + A + + + + + Rosenthal 100% + + + + + + + + + + + + + + + + + + + + Sanford 88% + 0 + + A + 0 E + E + + + + + + + + + PNV Schaefer 70% + + + + + 0 0 0 + + + + + + 0 0 + + + 0

Shaheen 95% + 0 + + + + + + + E + + + + + + + + + + Sheffield * 100% + + + + + + + E + + + + + + + + + + + + Sherman 100% + + + + + + + + + + + + + + + + + + + + Shine 100% + + + + + + + + + + + + + + + + + + + + Smith 100% + + + + + + + + + + + + + + + + + + + + Smithee 100% + + + + + + + + + + + + + + + + + + + + Springer 90% + + + + + + 0 + + + + + + + 0 + + + + + Stephenson 95% + + + + + + + + + + + + + + 0 + + A + + Stickland 47% + 0 + + 0 0 0 0 0 0 0 + + 0 + 0 E + + +

Stucky 100% + + + + + + + + + + + + + + + + + + + +

Swanson 60% + 0 + A + + 0 0 + 0 + + 0 + 0 + + + + 0 Talarico 100% + + + + + + + + + + + + + + + + + + + +

Thierry 100% + + + + + + + P + + + + + + + + + + + + Thompson, E 95% + + + + + + + + + + + + + + + + + + + 0 Thompson, S 100% + + + + + + + + + A + + + A + + + + + +

Tinderholt 50% + 0 + + 0 0 0 0 + 0 + + 0 + 0 0 + + + 0 Toth 83% + + + + E + 0 0 + 0 + + + + A + + + + + Turner, C 100% + + + + + + + + + + + + + + + + + + + + Turner, J 100% + + + + + + + + + + + + + + + + + + + +

Van Deaver 100% + + + + + + + + + + + + + + + + + + + + Vo 100% + + + + + + + + + A + + + + + + + + + + Walle 100% + + + E + E + + E + + E + + E + + + + + White 80% + + + + + + 0 + 0 0 + + + + 0 + + + + +

Wilson 69% + 0 + E + E 0 0 E + + + + + E 0 + + + 0

Wray 95% + + + + + + + + + 0 + + + + + + + + + + Wu 100% + + + + + + + + + + + + + + + + + + + +

TSA The Journal 86th Regular Session, 2019

2019 HB 278

HB 1065

HB 1112

HB 1273

HB 1504

HB 1532

HB 1832

HB 1880

HB 2041

HB 2151

HB 2327

HB 2387

HB 2632

HB 3345

HB 3911

SB 170

SB 670

SB 752

SB 1264

HB 2630

Zedler 65% + 0 + + 0 + 0 0 + 0 + + 0 + 0 + + + + + Zerwas * 95% + + + + A + + + + 0 + + + + + + + + + +

Zwiener 100% + + + + + + + + + + + + + + A + + + + +

HOUSE VOTES All votes are 3

rd reading votes

Vote #1 – HB 278 (RV # 320) Rep. Tom Oliverson, MD (R - Cypress) and Sen. Charles Perry (R - Lubbock) HB 278 allows a physician who delegates to utilize technology to perform supervision meetings rather than requiring face-to-face meetings with a physician assistant or an advanced practice registered nurse under a prescriptive authority agreement, while maintaining documentation requirements and increasing the regularity of the meetings to monthly. This allows for greater access to medically directed care through physician extenders without the supervision requirements being overly burdensome.

Vote #2 – HB 1065 (RV #322) Rep. Trent Ashby (R – Lufkin) and Sen. Lois Kolkhorst (R – Brenham) HB 1065 creates a state grant program for graduate medical education through rural training tracks as an additional incentive for the development of rural residency training opportunities to address a shortage of physicians in rural areas.

Vote #3 – HB 1112 (RV# 320) Rep. Sarah Davis (R – Houston) and Sen. Lois Kolkhorst (R – Brenham) HB 1112 amends current law to require a freestanding emergency medical care facility to remove outdoor signage if they cease operations to avoid any unnecessary delay in critical patient care.

Vote #4 – HB 1273 (RV# 937) Rep. Bill Zedler (R – Arlington) HB 1273 would have prohibited a health benefit insurance carrier from denying or reducing payment for preauthorized health care services, except in the cases of fraud. Ultimately, the bill died in the Senate.

Vote #5 – HB 1504 (RV# 443) Rep. Chris Paddie (R – Marshall) and Sen. Robert Nichols (R – Jacksonville) HB 1504 contained the recommendations from the Sunset Advisory Commission for the Texas Medical Board, including continuing the agency for 12 years, adopting a risk-based approach to inspecting office-based anesthesia providers, requiring Texas Medical Board to adopt an expedited licensing process for qualified out-of-state physicians and creating a new certificate for Radiology Assistants.

Vote #6 – HB 1532 (RV# 939) Rep. Morgan Meyer (R – Highland Park) and Sen. Bryan Hughes (R – Mineola) HB 1532 addresses the corporate practice of medicine for employed physicians by creating a complaint process at the Texas Medical Board and grants the Board the authority to assess administrative penalties against a health organization and or the Chief Medical Officer.

TSA The Journal 86th Regular Session, 2019

Vote #7 - HB 1832 (RV# 1051) Rep. Julie Johnson (D – Carrollton) and Sen. Donna Campbell, MD (R – New Braunfels) HB 1832 would have prohibited a retroactive review of an emergency care claim for the purposes of determining whether the patient actually had an emergency issue. This bill was directly in response to the practices of Blue Cross Blue Shield which has been performing retroactive reviews on care at emergency facilities and then denying coverage if the care diagnosis was ultimately not of an emergency nature. Unfortunately, this bill died in the Senate.

Vote #8 – HB 1880 (RV# 1287) Rep. Sarah Davis (R – Houston) HB 1880 was an omnibus bill on improvements to network adequacy and provider directories. The bill would have required network directories to list specialties and be electronically searchable by specialty and enhanced the requirement that they correct reported errors. The bill also required the carriers to log and report to the Texas Department of Insurance all reported inaccuracies and allows the commissioner to perform an examination of the carrier’s compliance with network adequacy (the cost of which is to be paid by the carrier) if a pattern of frequent inaccuracies appear. The bill subjected Preferred Provider Organizations to the same audits for network adequacy as Exclusive Provider Organizations and increased the frequency of the audits. The bill also created automatic audits of carriers with the highest number of mediation requests for balance billing by patients. Although this bill failed to pass the Senate, several provisions passed as amendments to other bills.

Vote #9 – HB 2041 (RV# 901) Rep. Tom Oliverson, MD (R – Cypress) and Sen. Larry Taylor (R – Friendswood) HB 2041 requires freestanding emergency medical facilities to clarify their network status in a disclosure to patients and on their website, which will include their facility and observation fees. The bill further prohibits the facilities from advertising that they “take” or “accept” insurance unless they are in-network with that carrier and may not post the name or logo of a health benefit plan in signage or marketing materials.

Vote #10 – HB 2151 (RV# 1209) Rep. Sergio Munoz, Jr. (D – Palmview) HB 2151 would have prohibited recoupment attempts by a carrier based on an extrapolation of the results of an audit of a few claims and restrict recoupment attempts to only claims that are actually overpaid. Although this bill died in the Senate, it was added as an amendment to SB 1742, but was then removed in a conference committee.

Vote #11 – HB 2327 (RV# 786) Rep. Greg Bonnen, MD (R – Friendswood) and Sen. Dawn Buckingham, MD (R – Lakeway) HB 2327, at the time of record vote #786, required carriers to post the preauthorization process and requirements in plain English and to post statistics for each approval or denial by physician specialty, medication, diagnostic test, procedure, and reason for denial. As it ultimately passed as an amendment to SB 1742, it requires disclosure of the preauthorization process and requirements or a summary of requirements if disclosure includes proprietary information, including statistics for approval or denials. Further, it requires utilization review to be performed by a Texas licensed physician.

Vote #12 – HB 2387 (RV#786) Rep. Greg Bonnen, MD (R – Friendswood) HB 2387 would have required utilization to be performed under the supervision of a Texas licensed physician of the same specialty and a determination of medical necessity must be given before an adverse determination. While this bill did not pass, an amendment to SB 1742 requires utilization review to be performed by a Texas licensed physician.

Vote #13 – HB 2632 (RV#962) Rep. Julie Johnson (R – Carrollton) HB 2632 would have required current notices of changes in contract rates by a carrier to contracted physician to be delivered in a trackable methodology (certified mail or a read receipt email). The bill died in the Senate and while it was briefly revived as an amendment onto SB 1742, it was stripped off in conference committee.

TSA The Journal 86th Regular Session, 2019

Vote #14 – HB 3345 (RV#1096) Rep. Four Price (R – Amarillo) and Sen. Bryan Hughes (R – Mineola) HB 3345 requires a carrier to cover telemedicine services and prohibits an annual or lifetime maximum for teleservices.

Vote #15 – HB 3911 (RV#905) Rep. Hubert Vo (D – Houston) and Sen. Donna Campbell, MD (R – New Braunfels) HB 3911 requires a Preferred Provider Organization to be examined for network adequacy like an Exclusive Provider Organization and changes the requirement from every 5 years to at the Texas Department of Insurance Commissioner’s discretion but at least every 2 years.

Vote #16 – SB 170 (RV# 1374) Sen. Charles Perry (R – Lubbock) and Rep. Four Price (R – Amarillo) SB 170 establishes the intent of the Texas Legislature that rural hospitals should be reimbursed at cost for Medicaid patients with update of costs annually to attempt to shore up rural hospital sustainability.

Vote #17 – SB 670 (RV# 1374) Sen. Dawn Buckingham, MD (R – Lakeway) and Rep. Four Price (R – Amarillo) SB 670 requires telemedicine services to be covered in the Medicaid system and ensures that physicians have a choice of platform.

Vote #18 – SB 752 (RV#1074) Sen. Joan Huffman (R – Houston) and Rep. Tom Oliverson, MD (R – Cypress) SB 752 provides physicians and healthcare providers immunity for voluntarily providing healthcare after a natural or man-made disaster.

Vote #19 – SB 1264 (RV#1533) Sen. Kelly Hancock (R – North Richland Hills) and Rep. Tom Oliverson, MD (R – Cypress) SB 1264 bans balance billing for out-of-network physicians, providers and facilities in emergency situations and for out-of-network physicians and providers in an in-network facility for scheduled care. The bill sets up a two-prong dispute resolution process for out-of-network claims with facilities going to mediation and physicians and providers going to a document review only arbitration with certain criteria for floor and ceilings for payment.

Vote #20 – HB 2630 (RV# 1466) Sen. Jose Menendez (D – San Antonio) and Rep. Julie Johnson (D – Carrollton) This is the House vote on HB 2630 reflected the vote on the companion for the original language in SB 1742 which ultimately passed into law. The bill required carrier network directories to be sorted by facility for facility-based physicians.

TSA The Journal 86th Regular Session, 2019

The Texas Senate

2019 SB 170

SB 670

SB 752

SB 1264

SB 1742

SB 1882

SB 2040

HB 278

HB 1065

HB 1112

HB 1504

HB 1532

HB 2041

HB 2327

HB 3345

HB 3911

Alvarado 100% + + + + + + + + + + + + + + + +

Bettencourt 94% + + + + + + + + 0 + + + + + + +

Birdwell 100% + + + + + + + + + + + + + + + +

Buckingham * 100% + + + + + + + + + + + + + + + +

Campbell * 94% + + + 0 + + + + + + + + + + + +

Creighton 100% + + + + + + + + + + + + + + + +

Fallon 94% + + + + + + + + + + + + + + + 0

Flores 100% + + + + + + + + + + + + + + + +

Hall 100% + + + + + + + + + + + + + + + +

Hancock 100% + + + + + + + + + + + + + + + +

Hinojosa 100% + + + + + + + + + + + + + + + +

Huffman 100% + + + + + + + + + + + + + + + +

Hughes 100% + + + + + + + + + + + + + + + +

Johnson 100% + + + + + + + + + + + + + + + +

Kolkhorst 100% + + + + + + + + + + + + + + + +

Lucio 93% + + + + E E E + + + + + + + + +

Menendez 100% + + + + + + + + + + + + + + + +

Miles 100% + + + + + + + + + + + + + + + +

Nelson 100% + + + + + + + + + + + + + + + +

Nichols 100% + + + + + + + + + + + + + + + +

Paxton 94% + + + + + + + + 0 + + + + + + +

Perry 100% + + + + + + + + + + + + + + + +

Powell 100% + + + + + + + + + + + + + + + +

Rodriguez 100% + + + + + + + + + + + + + + + +

Schwertner * 88% + + + 0 + + 0 + + + + + + + + +

Seliger 100% + + + + + + + + + + + + + + + +

Tayor 100% + + + + + + + + + + + + + + + +

Watson 100% + + + + + + + + + + + + + + + +

West 100% + + + + + + + + + + + + + + + +

Whitmire 100% + + + + + + + + + + + + + + + +

Zaffirini 100% + + + + + + + + + + + + + + + +

TSA The Journal 86th Regular Session, 2019

Senate Votes All votes are 3

rd reading votes

Vote #1 – SB 170 Sen. Charles Perry (R – Lubbock) and Rep. Four Price (R – Amarillo) SB 170 establishes the intent of the Texas Legislature that rural hospitals should be reimbursed at cost for Medicaid patients with update of costs annually to attempt to shore up rural hospital sustainability.

Vote #2 – SB 670 (RV# 1374) Sen. Dawn Buckingham, MD (R – Lakeway) and Rep. Four Price (R – Amarillo) SB 670 requires telemedicine services to be covered in the Medicaid system and ensures that physicians have a choice of platform.

Vote #3– SB 752 Sen. Joan Huffman (R – Houston) and Rep. Tom Oliverson, MD (R – Cypress) SB 752 provides physicians and healthcare providers immunity for voluntarily providing healthcare after a natural or man-made disaster.

Vote #4– SB 1264 Sen. Kelly Hancock (R – North Richland Hills) and Rep. Tom Oliverson, MD (R – Cypress) SB 1264 bans balance billing for out-of-network physicians, providers and facilities in emergency situations and for out-of-network physicians and providers in an in-network facility for scheduled care. The bill sets up a two-prong dispute resolution process for out-of-network claims with facilities going to mediation and physicians and providers going to a document review only arbitration with certain criteria for floor and ceilings for payment.

Vote #5 – SB 1742 Sen. Jose Menendez (D – San Antonio) and Rep. Julie Johnson (D – Carrollton) SB 1742 requires carrier network directories to be sorted by facility for facility-based physicians.

Vote #6 – SB 1882 Sen. Dawn Buckingham, MD (R – Lakeway) and Rep. Greg Bonnen, MD (R – Friendswood) SB 1882 would have required hospitals to provide written notice to the organized medical staff of an upcoming vote and process to allow the hospital to differentiate between physicians, based on a physician’s maintenance of certification. The bill passed the Senate and House Committee but died in House Calendars.

Vote #7 – SB 2040 Sen. Jose Rodriguez (D – San Antonio) and Rep. Mary Gonzalez (D – EL Paso) SB 2040 would have required the Texas Health and Human Services Commission to report on provider reimbursement rates and access to care in the Medicaid program to reveal the factors used to determine how and at what level services are reimbursed so the resulting information could be used to address issues associated with low reimbursement rates. The bill passed the Senate and House Committee but died in House Calendars.

Vote #8 - HB 278

Rep. Tom Oliverson, MD (R - Cypress) and Sen. Charles Perry (R - Lubbock) HB 278 allows the delegation and supervision of a physician assistant or an advanced practice registered nurse under a prescriptive authority agreement to utilize technology to perform supervision meetings rather than requiring face-to-face meetings, while maintaining documentation requirements and increasing the regularity of the meetings to monthly. This allows for greater access to medically directed care through physician extenders without the supervision requirements being overly burdensome.

TSA The Journal 86th Regular Session, 2019

Vote #9 – HB 1065 Rep. Trent Ashby (R – Lufkin) and Sen. Lois Kolkhorst (R – Brenham) HB 1065 creates a state grant program for graduate medical education through rural training tracks as an additional incentive for the development of rural residency training opportunities to address a shortage of physicians in rural areas.

Vote #10 – HB 1112 Rep. Sarah Davis (R – Houston) and Sen. Lois Kolkhorst (R – Brenham) HB 1112 amends current law to require a freestanding emergency medical care facility to remove outdoor signage if they cease operations to avoid any unnecessary delay critical patient care.

Vote #11 - HB 1504 Rep. Chris Paddie (R – Marshall) and Sen. Robert Nichols (R – Jacksonville) HB 1504 contained the recommendations from the Sunset Advisory Commission for the Texas Medical Board, including continuing the agency for 12 years, adopting a risk-based approach to inspecting office-based anesthesia providers, requiring Texas Medical Board to adopt an expedited licensing process for qualified out-of-state physicians and creating a new certificate for Radiology Assistants.

Vote #12 – HB 1532 Rep. Morgan Meyer (R – Highland Park) and Sen. Bryan Hughes (R – Mineola) HB 1532 addresses the corporate practice of medicine for employed physicians by creating a complaint process at the Texas Medical Board and grants the Board the authority to assess administrative penalties against a health organization and or the Chief Medical Officer.

Vote #13 – HB 2041 (RV# 901) Rep. Tom Oliverson, MD (R – Cypress) and Sen. Larry Taylor (R – Friendswood) HB 2041 requires freestanding emergency medical facilities to clarify their network status in a disclosure to patients and on their website, which will include their facility and observation fees. The bill further prohibits the facilities from advertising that they “take” or “accept” insurance unless they are in-network with that carrier and may not post the name or logo of a health benefit plan in signage or marketing materials.

Vote #14 – HB 2327 (RV# 786) Rep. Greg Bonnen, MD (R – Friendswood) and Sen. Dawn Buckingham, MD (R – Lakeway) HB 2327, at the time of record vote #786, required carriers to post the preauthorization process and requirements in plain English and to post statistics for each approval or denial by physician specialty, medication, diagnostic test, procedure, and reason for denial. When it ultimately passed as an amendment to SB 1742, it required disclosure of preauthorization process and requirements, or a summary of requirements if disclosure was proprietary information, including statistics for approval or denials. Further, it required that utilization review must be performed by a Texas licensed physician.

Vote #15 – HB 3345 (RV#1096)

Rep. Four Price (R – Amarillo) and Sen. Bryan Hughes (R – Mineola) Requires a carrier to cover telemedicine and prohibits an annual or lifetime maximum for teleservices.

Vote #16 – HB 3911 (RV#905) Rep. Hubert Vo (D – Houston) and Sen. Donna Campbell, MD (R – New Braunfels) HB 3911 Requires a Preferred Provider Organization to be examined for network adequacy like an Exclusive Provider Organization and changes the requirement from every 5 years to at the Texas Department of Insurance Commissioner’s discretion but at least every 2 years.