86th Legislative Session Update as of June 16

Bills signed into law

Senate Bill 670 by Sen. Dawn Buckingham, MD (R-Lakeway) requires Medicaid to cover telemedicine services.

Senate Bill 748 by Sen. Lois Kolkhorst (R-Brenham) establishes pregnancy medical homes, high-risk maternal care coordinated service pilot programs, telehealth programs for prenatal and postpartum and creates a dedicated Newborn Screening Preservation Account.

Senate Bill 1264 by Sen. Kelly Hancock (R-North Richland Hills) requires baseball-style arbitration for most surprise medical bills, effectively removing patients from the billing dispute resolution process. Patients who elect to go out-of-network for health care are not covered by this arbitration process.

Senate Bill 1742 by Sen. Jose Menendez (D-San Antonio) requires greater transparency with prior authorizations and mandates that utilization reviews be conducted by a Texas-licensed physician in the same or similar specialty as the physician requesting the service or procedure. It also requires health plan directories to clearly identify which physician specialties are in-network at network facilities.

Senate Bill 1834 by Sen. Carol Alvarado (D-Houston) authorizes a pilot incentive program for Supplemental Nutrition Assistance Program (SNAP) recipients to purchase fruits and vegetables.

House Bill 1 by Rep. John Zerwas, MD (R-Richmond) is the $250 billion state budget for the 2020-21 biennium.  Governor Abbott signed HB 1 with no line-item vetoes. The budget does not include any physician rate increases for Medicaid, and it requires the state to find $350 million in Medicaid savings. The budget does however, increase funding for programs and initiatives that will help improve maternal health, behavioral health, and graduate medical education. 

House Bill 170 by Rep. Diego Bernal (D-San Antonio) requires health plans to cover diagnostic mammograms at 100%, the same as screening mammograms.

House Bill 1063 by Rep. Four Price (R-Amarillo) requires Medicaid to cover home telemonitoring for specific pediatric patients. HB 1063 will prevent families from having to take very ill children to their physician’s office when the necessary care and monitoring can happen from home.

House Bill 1504 by Rep. Chris Paddie (R-Marshall) extends the life of the Texas Medical Board by 12 years – to 2031. The legislation also includes provisions to ensure that dismissed or frivolous complaints or disciplinary actions are removed from physicians’ profiles as quickly as possible. It also allows expedited licensing for physicians who hold a full license and are in good standing in another state.

House Bill 1576 by Rep. Dade Phelan (R-Beaumont) allows Medicaid to contract with a transportation network company, such as Uber or Lyft, for nonemergency transportation to or from a medical appointment.

House Bill 1941 by Rep. Dade Phelan (R-Beaumont) prohibits free-standing emergency facilities from charging “unconscionable” rates, defined as 200% or more of the average charge for the same or substantially similar treatment at a hospital emergency room.

House Bill 2041 by Rep. Tom Oliverson, MD (R-Cypress) requires freestanding emergency room facilities to post conspicuous notices that the facility or the physician might be out of network, along with written disclosure of possible observation and facility fees.

House Bill 2050 by Rep. Chris Paddie (R-Marshall) requires written consent for the administration of psychoactive drugs to patients in long-term care facilities. Frequently, residents in long-term care facilities have limited contact with family members, so allowing one-time written consent will save precious time when medications may need to be provided.

House Bill 2174 by Rep. John Zerwas (R-Richmond) limits the duration of opioid prescriptions, requires electronic prescribing beginning on Jan. 1, 2021, requires opioid-related CME, and prohibits prior authorization for medication-assisted treatment for opioid-use disorder. HB 2174 will help prevent “doctor shopping” by patients seeking opioids for non-therapeutic uses.

House Bill 2261 by Rep. Armando Walle (D-Houston) increases the Physician Education Loan Repayment Program’s allowable repayment assistance amounts by $5,000 each year, bringing the total amount of repayment assistance available to $180,000. The repayment program is designed to encourage new physicians to start their careers in underserved communities by helping them pay off student loans in return for a four-year practice commitment.

House Bill 2362 by Rep. Joe Moody (D-El Paso) ensures that physicians working in emergency rooms who face high-risk obstetrical cases requiring immediate and difficult decisions are protected from unwarranted lawsuits. Notable exceptions to the willful and wanton protection include instances in which the patient’s treatment is unrelated to a medical emergency, and for any physician whose negligent act or omission causes a stable patient to require emergency medical care.

House Bill 2536 by Rep. Tom Oliverson, MD (R-Cypress) requires vastly improved transparency regarding prescription drug costs, including posting drug price information on the Health and Human Services Commission’s website and explaining cost increases of greater than 40%.

House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville) delays the mandate to check the prescription monitoring program (PMP) until March 2020. TMA fought hard for the delay to give the PMP time to fully integrate with physicians’ electronic records systems.

House Bill 3285 by Rep. J.D. Sheffield, DO (R-Gatesville) permits telehealth treatment for substance-use disorder, develops and implements an opioid misuse public awareness campaign, and collects and analyzes data regarding opioid overdose deaths.

House Bill 3345 by Rep. Four Price (R-Amarillo) allows physicians to choose the best platform for providing services rather than having health plans dictate the platform. HB 3345 complements Senate Bill 1107 from the last 85^th legislative session, which stipulated that services provided via telemedicine are to be covered the same as any other service provided by a physician.

House Bill 3703 by Rep. Stephanie Klick (R-Fort Worth) updates the Compassionate Use Act adopted by the legislature in 2015, broadening the list of symptoms and illnesses for which patients can use low-THC cannabis.

House Bill 3911 by Rep. Hubert Vo (D-Houston) requires the Texas Department of Insurance to examine the network adequacy of preferred provider organizations (PPOs) and exclusive provider organizations (EPOs) at least once every three years. Inadequate or narrow networks contribute to higher costs for patients and frustration for physicians.

Bills that were vetoed

House Bill 448 by Rep. Chris Turner (D-Grand Prairie) would have required transporting a child younger than 2 in a rear-facing car seat unless the child meets certain height and weight thresholds. Governor Abbott vetoed this bill, saying it is overly prescriptive and micromanages parents.

House Bill 455 by Rep. Alma Allen (D-Dallas) would have directed the State Board of Education to develop recess policies that encourage outdoor play time and physical activity. While acknowledging the educational and health benefits of recess, Governor Abbott vetoed the bill, saying it’s another mandate and is bureaucracy for bureaucracy’s sake.

Bills allowed to become law without the Governor’s signature

Senate Bill 355 by Sen. Royce West (D-Dallas) directs the Department of Family and Protective Services to create a strategic plan so Texas can access new federal matching funds for services to help children at risk of entering foster care.

Senate Bill 952 by Sen. Kirk Watson (D-Austin) requires that child care facilities’ physical activity, nutrition, and screen time rules comply with American Academy of Pediatrics standards.

House Bill 1584 by Rep. Senfronia Thompson (D-Houston) prohibits step therapy protocols for stage-4 metastatic breast cancer.