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A TDI spokesman said the agency could not respond to ap-

prehensions about the overall impact of the revisions before the agency finalizes them. In its preamble to the proposed regulations, TDI acknowl- edged concerns that the removal of certain provisions “relaxed requirements for insurers.” In response, “the department deter- mined that the best approach is to propose revised rules that more clearly express the department’s intent to require that insurers provide consumers complete networks, limit insurers’ reliance on alternatives to complete networks that provide only limited protections from balance billing, and provide ad- ditional substantive protections against balance billing for in- sureds obtaining out-of-network care in cases of emergency or because no network providers are available,” the preamble states.

WANTED: MORE DOCTORS Another budget fight will be

for additional GME funding, an area that took some of the biggest hits last session. Lawmakers cut by nearly 75

percent funding for the Family Practice Residency Program operated by the Texas Higher Education Coordinating Board (THECB). The statewide Prima- ry Care Preceptorship Program was not funded, and other pri- mary care GME programs ad- ministered by THECB suffered, as well.

Overall GME formula fund-

ing declined by about 40 per- cent, and the legislature elimi- nated one physician educa- tion loan repayment program, while cutting the other by 76 percent.

TMA officials warn that the slashes come at a time when Texas ranks far below the na- tional average in the number of physicians per capita, with shortages in primary care and other specialties.

The 2003 medical liabil-

ity reforms helped recruit new physicians to the state — an all-time high in 2012 — but barely enough to keep pace with the rapid population growth, Dr. Floyd says. And while Texas expands the num-

ber of medical school graduates, the number of residency slots available to train them continues to lag.

TMA continues to work with a consortium of the state’s

medical schools and teaching hospitals to push for GME posi- tions to exceed the total number of medical graduates by 10 percent. “We went bottom up last session. We graduated 50 or so medical students more than we had first-year residency po- sitions,” and class sizes since have grown to more than 100 students, Dr. Floyd said. “We still need more physicians, and the more secure way to do that is to train them in Texas and get them to stay in Texas.” Rep. Lois Kolkhorst (R-Brenham), chair of the House Pub-


The November general election delivered record victories to Texas members of the house of medicine, who all had at least one thing in common: the backing of the Texas Medical Association Political Action Committee (TEXPAC). Seven TMA and TMA Alliance members will fill seats in the Texas House and Senate combined, the most to serve at one time. Winners on the Senate side include Sen. Bob Deuell, MD (R-Green-

ville), in District 2; Rep. Charles Schwertner, MD (R-Georgetown), in Dis- trict 5; and Donna Campbell, MD (R-New Braunfels), in District 25. House victories went to Rep. John Zerwas, MD (R-Simonton), in

District 28; TMA Alliance member Susan King (R-Abilene) in District 71; Greg Bonnen, MD (R-Friendswood), in District 24; and J.D. Sheffield, DO (R-Gatesville), in District 59. Incumbent Democrat Sen. Wendy Davis bested Mark Shelton, MD, in a

tough Senate race in Fort Worth for the District 12 seat. Only 1,600 votes separated them. U.S. Rep. Michael Burgess, MD (R-Texas), reclaimed his congressional

seat in District 26. “One big reason these family-of-medicine candidates did so well is

just that — the family of medicine. They all had the financial and orga- nizational support of TEXPAC, and physicians and alliance members turned out in droves to help their campaigns,” said TEXPAC Board of Di- rectors Chair Joe M. Todd, MD. “It’s great that these men and women — who understand health care problems from the inside — will be serving in Austin and Washington next year.” Drs. Bonnen and Sheffield are among 49 freshman members entering the 2013 legislature — 43 in the House and 6 in the Senate.

January 2013 TEXAS MEDICINE 23

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