The clock is winding down on the Texas Legislature

Tags: legislative update, legislature, 84th, budget, medicaid, medicare, affordable care act, residency, graduate medical education, nelson, zerwas, family medicine residency program, preceptorship, bonnen, hancock, schwertner, crownover, direct primary care

The clock is winding down on the Texas Legislature

posted 5.27.15

With less than a week left in the 84th Texas Legislature, many bills TAFP has been tracking have passed the House and the Senate and the budget conference committee has published its report containing spending levels for the next biennium.

The 10-member budget conference committee reached an agreement last week, reconciling differences between the House and Senate versions of the state budget. The final plan would spend about $210 billion in state and federal funds in 2016-2017.

While the House budget would have authorized $460 million to increase Medicaid rates paid to primary care physicians—bringing those fees to parity with Medicare payments and in effect restoring the temporary bump those physicians received due to the Affordable Care Act—the Senate objected and the budget conference committee decided not to fund the primary care rate increases.

The Legislature adopted funding in the amount of $32.55 million to create new first-year residency training positions, funded at $75,000 per resident per year. Senate Bill 18 by Sen. Jane Nelson, (R-Flower Mound), and Rep. John Zerwas, MD, (R-Simonton), contains the statutory language directing the use of those funds and more in hopes of expanding the state’s graduate medical education capacity. The bill will establish a permanent trust fund to support GME, prioritize the creation of new GME positions for critical shortage specialties, and create an independent physician workforce resource center to conduct research on medical specialties in Texas that are determined to be in critical shortage.

The budget also increased funding for the Family Medicine Residency Program, a budgetary line item that allocates direct support to family medicine residency training programs. While the Senate’s version of the budget contained $28 million for the program over the next two years, the conference committee decided to allocate only $16.8 million, an increase of $4 million over the program’s current appropriation but still 20 percent less than the program received in 2010-2011.

Additionally, $3 million was allocated to revitalize the Texas Statewide Family Medicine Preceptorship Program.

A bill designed to improve patients’ ability to contract directly with physicians to receive medical care is also awaiting the Governor’s signature. House Bill 1945 by Rep. Greg Bonnen, MD, (R-Friendswood), and Sen. Kelly Hancock, (R-North Richland Hills), will improve access to direct primary care by recognizing these arrangements, protecting them, and defining them as outside the scope of state insurance regulation.  

Finally S.B. 195 by Sen. Charles Schwertner, MD, (R-Georgetown), and Rep. Myra Crownover, (R-Denton), eliminates the state’s Controlled Substance Registration Program. It would move the Prescription Drug Monitoring Program from the Texas Department of Public Safety to the Texas State Board of Pharmacy and broaden physicians’ authority to delegate who can access the information.

Stay tuned next week for a post-mortem perspective on the 84th Texas Legislature.