TMA Legislative News Hotline

Wednesday, Feb. 18, 2009

Only 103 days are left in the 81st legislative session.

Last Day to File Bills Nearing
The last day that legislators can file a bill is just three weeks away. Bills filed to date that support TMA's legislative agenda include these:

Public Health
Sen. Jane Nelson (R-Lewisville) has filed several TMA-backed bills. Today we are highlighting these two:

Senate Bill 899 would allow for a deduction under the franchise tax for physicians who administer vaccines; and

Senate Bill 891 would require each school district to establish specific objectives and goals the district intends to accomplish through the physical education curriculum.

Health Insurance Reform
Sen. Robert Deuell, MD (R-Greenville), filed two bills that would bring more transparency to health insurance companies' murky business practices:

Senate Bill 900 would prohibit data mining by health insurers; and

Senate Bill 901 would establish a legislative oversight committee to monitor the progress of health plan regulation reforms, including the fairness of rates, underwriting guidelines, and rating manuals.

Rep. Eddie Rodriguez (D-Austin) also filed these two bills yesterday that relate to out-of-network billing:

House Bill 1369 relates to unfair claim settlement practices by an insurer that issues a preferred provider benefit plan. The bill says that if a health plan doesn't calculate the coinsurance based on the amount of the billed charges for an out-of-network service, then it is an unfair claim settlement.

House Bill 1370 would find claim forms filed by patients for out-of-network services to be unjust and deceptive if the form does not contain a provision that computes the coinsurance based on the amount of the billed charges.

TMA Legislative Priorities: Health Insurance Code of Conduct 2009
To bring accountability to the multibillion-dollar health insurance industry, TMA is asking legislators to support the Health Insurance Code of Conduct 2009 and other legislation. We must hold health insurance companies accountable for the promises they make to the Texans who pay their premiums. The measures below would ensure transparency and accountability in the way health insurance companies conduct business.

Health coverage cancellations and rescission: Require insurers to notify patients that rescission of their policy is under consideration prior to the actual cancellation. In addition, the insurer would have to provide a patient all relevant information about why the policy is being revoked and how to initiate an independent review of the decision.

Calculation of premium quotes: Allow Texas' small businesses to challenge health insurance premium quotes, and have insurers provide information to justify a premium increase.

Calculation of medical loss ratio: Require health insurers to disclose how they spend the patient's premium dollar.

Unregulated secondary networks (silent preferred provider organizations): Regulate how a physician's contract information is sold, leased, or shared among health insurance companies.

Physician rankings: Require health insurance companies to use scientifically valid criteria to evaluate physicians' performance and disclose those criteria in advance.

Claims processing: Codify a number of the RICO settlement's provisions, which are set to expire in the near future, so health insurance companies don't revert to their old, unethical ways of processing claims.

See all of TMA's legislative issue briefs in the Governmental Affairs section of the TMA Web site.

First Tuesday: Only Two Weeks Away
Pack your white coat and head to Austin on March 3 to take part in First Tuesdays at the Capitol. (Check out our new First Tuesdays video on that page, too). Don't miss the chance to meet with lawmakers and their staff and present medicine's case in person. Hundreds of physicians in the galleries and hearing rooms have a powerful impact on the Texas Legislature. Sign up today.

Physician of the Day
The physician of the day at the capitol is David Watson, MD, of Yoakum. Dr. Watson graduated from The Baylor College of Medicine in 1957. He is a member of TMA, AMA, and Dewitt-Lavaca County Medical Society.

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