Bills that aim to insure more Texans, reform health insurance abuses, improve health care information transparency, increase the use of health information technology, and launch worksite wellness plans all became law Sept. 1, according to information from the Texas Medical Association.
“Texas lawmakers really stepped up to the plate for Texas patients and we couldn’t be more thrilled about that,” said William W. Hinchey, MD, TMA president.
Prior to the 2007 legislative session, TMA’s Healthy Vision 2010 Summits assembled physician, business, government and other health care leaders to prioritize urgent health care issues, including the number of Texas’ uninsured and the need for wellness promotion and disease prevention. The more than 40 participants developed and shared their recommendations with state legislators.
“Texas is a national leader of uninsured children and adults. It’s an issue that’s languished on the table for too long, so we decided somebody — Texas physicians and enlightened legislators — had to do something to help solve it,” Hinchey said.
Patient-friendly bills that become law on Sept. 1 include the following.
Medicaid and Children’s Health Insurance Program Reforms
Senate Bill 10 by Sen. Jane Nelson, R-Flower Mound, maximizes state and federal aid to help insure more low-income Texans; trims Medicaid costs by promoting illness prevention and healthier lifestyles; shares costs among business, government and health care groups to help expand insurance coverage to small-business employees; directs the state health department to create positive incentive programs such as smoking cessation or weight loss to promote healthier lifestyles among Medicaid clients; and urges health maintenance organizations and other Medicaid health care payment plans to provide more preventive health services to their enrollees.
SB10 also adopted provisions of House Bill 2610 by Rep. Dianne Delisi, R-Temple, that modernize the Medicaid system by implementing health information technology and HB3471, also by Delisi, creating a pilot program to provide health information technology, including electronic health records, to high-volume primary care physicians participating in Medicaid.
HB2042 by Rep. Dawnna Dukes, D-Austin, provides for an electronic database of physicians and health care professionals who participate in Medicaid.
HB109 by Rep. Sylvester Turner, D-Houston, and Sens. Kip Averitt, R-McGregor, and Leticia Van de Putte, D-San Antonio, restores many of the enrollment and eligibility restrictions placed on CHIP in 2003. The bill also extends 12 months’ coverage to eligible children. More than 120,000 Texas children should gain health insurance as a result.
Health Insurance Reform
SB1731 by Sen. Robert Duncan, R-Lubbock, ensures that employers, their employees and Texas patients have access to health care information about medical service costs and patient out-of-pocket expenses. The bill is an important first step toward ensuring transparency in the health care market.
HB1594 by Rep. John Zerwas, MD, R-Richmond, requires physicians joining a medical group established in a health plan’s network to be recognized as network members while the plan is processing their credentials to ensure patients are not billed as if they had seen an out-of-network physician while the new physician is being credentialed.
SB1255 by Averitt reinstates the ability of large and small employers to participate within the same health cooperative. Such co-ops of large and/or small employers of an industry can be considered a single employer for insurance underwriting purposes, cutting costs.
HB3064 by Delisi regulates discount health care programs that offer patients direct access to health care products and services.
HB1297 by Delisi creates a statewide worksite wellness advisory committee to help public and private companies implement programs and also creates a worksite wellness program for state employees.
SB811 by Sen. Kyle Janek, MD, R-Houston, requires the Texas Department of State Health Services to allow physicians in the federal Vaccines for Children Program to select any influenza vaccine from the federal list.
Health Information Technology
HB1066 by Delisi allows more doctors to participate voluntarily in electronic data sharing. It also initializes a system of data exchanges including patient insurance verification; coverage; physicians’ network coverage; and eventually, real-time claims adjudication.
TMA is the largest state medical society in the nation, representing more than 42,000 physician and medical student members. Located in Austin, TMA has 120 component county medical societies around the state.