The Texas Medical Association has long beat the drum for cutting red tape that hinders patient care, promoting transparent insurance markets, preventing unqualified health pro- fessionals from delivering care outside their expertise, and bolstering graduate medical education (GME). Those and other messages got through to lawmakers in the 2013 session of the Texas Legislature and paid off in long-sought, even precedent-setting victories. “With a combination of hard work, good timing, and more money in the budget, we got re-
sults,” TMA President Stephen L. Brotherton, MD, said, adding that medicine’s success also was due in large part to seeds TMA planted early on. “We did a lot of grassroots work from the county level on up. Doctors and alliance members were talking with their local legislators back home. And we did our homework.”
For instance, the first-ever “silent PPO” legislation that TMA won this session took eight years because “for a long time, those ac- tivities were difficult to sort through and understand, even for legislators. So part of what TMA had to do was make sure ev- erybody understood what was happening,” Dr. Brotherton said.
“Just like when we got Proposition 12 [tort reform] passed (that was a 16- to 18-year project), we did our homework. We took it to the state. We got it accomplished. Now this [silent PPO law] will make companies negotiate in good faith and stop others from stealing physicians’ discounted contract rates.” Dr. Brotherton added that TMA’s victories this session are good not just for physicians. “Putting money back in GME and women’s health that never should have been taken out in the first place; refunding the deductible for dual-eligible [Medic- aid and Medicare] patients; and expanding vaccinations — all of that is good for everyone who lives in the state of Texas.” The 2013 session began with an unprecedented number of medicine’s candidates entering the House and Senate with support from the Texas Medical Association Political Action Committee (TEXPAC) and the association’s volunteer force, the TMA Alliance. It ended in numerous wins for physicians and their patients with the help of lawmakers who pushed medicine’s key bills to the finish line, as well as dozens of phy- sicians who testified at the Capitol and more than 1,000 physi- cians, medical students, and alliance members who lobbied in force at TMA’s monthly “First Tuesdays at the Capitol” events. (See TMA’s legislative report card between pages 40 and 41.)
Key milestones in legislation that TMA officials say will solve problems and prevent crises include:
• Landmark regulation of third-party payers or “silent PPOs” that take physician-contracted discounts without doctors knowing about it;
• A new standard for physician-led, team-based care and for future legislative scope-of-practice discussions;
• Widespread reductions in practice red tape, including a streamlined process for renewing Controlled Substances Registration (CSR) permits and development of uniform prior authorization forms across payers;
• Due process protections in Medicaid fraud investigations; • Increased access to immunizations; • More money for GME, mental health, and women’s health; and
• Preservation of tort reforms and a strong Texas Medical Board (TMB).
Even though not all of medicine’s bills succeeded, no
ground was lost, thanks to TMA’s ongoing vigilance at the Capitol, leaders add.
Additional money to boost Medicaid physician payment rates never materialized, but the rates were not reduced. Heated debates halted compromise end-of-life legislation on which TMA collaborated with prominent pro-life and religious groups, hospitals, and disability groups. But physicians still
August 2013 TEXAS MEDICINE 21
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