1 / 18

2009 Texas Legislative Session – The Highlights

2009 Texas Legislative Session – The Highlights . Dan Stultz, M.D., FACP, FACHE President/CEO Texas Hospital Association dstultz@tha.org www.tha.org. 2009 Texas Legislature - Themes. Filed 7,404 bills – THA tracked 1,202 “Bad blood” over voter ID bill in Senate Slow start in the House

yeshaya
Download Presentation

2009 Texas Legislative Session – The Highlights

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. 2009 Texas Legislative Session – The Highlights Dan Stultz, M.D., FACP, FACHE President/CEO Texas Hospital Association dstultz@tha.org www.tha.org

  2. 2009 Texas Legislature - Themes • Filed 7,404 bills – THA tracked 1,202 • “Bad blood” over voter ID bill in Senate • Slow start in the House • New Speaker of the House • New committee chairmen/members • Rep. Lois Kolkhorst – Public Health • Initial $10 billion shortfall projected • Federal stimulus funds saved the day • Rainy Day Fund intact

  3. Impact of Stimulus Package in Texas • Allowed Texas to balance budget without penalizing our economy • Texas “spent” all but $550 million of $16 billion available (unemployment insurance) • Texas Health and Human Services: - $1.5 billion Medicaid shortfall for ’09 - $1.5 billion growth in caseload, costs • $150 million to repair UTMB • $9 billion in “escrow” for 2011 (Rainy Day Fund)

  4. State Budget • Healthy Texas - reinsurance pool to help small businesses ($35 million) • Largest-ever investment in nursing education ($30 million in new funds – total $49.7 million) • $75 million per year in trauma funds • Community Mental Health Crisis services ($109.4 million) • No Medicaid rate cuts for doctors, hospitals • Smokeless tobacco tax: physician loan repayment program, margin tax exemption

  5. State Budget - Riders • Children’s hospitals’ Medicaid UPL program • Cost-based reimbursement for rural hospitals • Study on the need for additional trauma facilities • THHSC update of Medicaid SDA amounts • $107 million “savings” from Medicaid initiatives • D-FW integrated model of Medicaid managed care for ABD (preserves UPL payments) • DSH and UPL reporting requirements

  6. State Budget - Supplemental • House Bill 4586 - $2.36 billion • Used funds from 2009 FMAP enhancement • $150 million for repairs to UTMB Galveston • $2 million each for M.D. Anderson and the UNT Health Science Center at Fort Worth to costs related to Ike • $6 million from the Designated Trauma and EMS Account to the UT Health Science Center at Houston for increased uncompensated trauma care due to UTMB’s closure

  7. Affordable, Accessible Health Coverage • S.B. 78 - TexLink to Health Coverage Program at TDI to improve awareness, education and technical assistance about health care coverage options • S. B. 6 - Healthy Texas reinsurance pool for small employers (added to S.B. 78) • H.B. 2064 - Texas Health Insurance Risk Pool subsidies (200-300% poverty) • H.B. 103 - Large universities must offer health coverage to students (20,000+ students)

  8. Physician Employment • 31 bills were filed that would have allowed the employment of physicians by hospitals • S.B. 1500 would have allowed employment by hospitals in counties of less than 50,000 or sole community or CAHs • H.B. 3485 was amended to allow hospitals in counties of less than 50,000 operated by a government entity to employ physicians • Dallas County Hospital District (S.B. 1705)

  9. Rural Hospital Issues • H.B. 2154 – authorizes a change in the tax on smokeless tobacco to fund physician loan repayment in medically underserved areas • H.B. 1924 – allows a nurse in rural hospitals to withdraw drugs when the pharmacists is not on duty or the pharmacy is closed

  10. Nursing Staffing and Practice • S.B. 476 – places existing flexible nurse staffing requirements currently in the hospital licensing rules in statute • Standing nurse staffing committee • Prohibits mandatory overtime, with some exceptions • H.B. 1489 – union-backed ratio bill died in cmte. • S.B. 1415 – additional disciplinary options for BON for minor violations • S.B. 3961 – codifies BON administrative rules

  11. Nurse Education Funding • State budget invests a total of $49.7 million – an increase of $35 million • Nursing Workforce Shortage Coalition • Creates new mechanism for up-front funding • H.B. 4471 – complements funding in S.B. 1 • authorizes the THECB to offer grants to nursing schools with graduation rates of less than 70 percent

  12. Driver Responsibility Program • Several attempts were made to repeal or seriously undermine the program which provides funding for uncompensated trauma care • Ultimately, H.B. 2730 (DPS Sunset Bill) was amended with a provision to protect indigent drivers from excessive fines or surcharges – not effective until Sept. 1, 2011

  13. Hospital Business Practices • H.B. 2256 – establishes a dispute resolution process for out-of-network claims by facility-based physicians in excess of $1,000 • H.B. 4029 – sets a maximum retrieval / processing fee of $75 for digital or EMRs (hospitals not required to reformat) • Killed numerous pieces of legislation related to information provided to TPAs, billing disclosures, debt collection & hospital liens

  14. Patient Safety and Quality • H.B. 1218 – became a vehicle for S.B. 7 provisions • THHSC health information exchange • Quality-based confidential exchange of readmission information with no immediate reimbursement impact • S.B. 203 – reporting the causation pathogen for certain hospital acquired infections + S.B. 7 provisions added • preventable adverse events added to health-care associated infection reporting system • Never event reimbursement denials or reductions same as CMS for hospital-acquired conditions

  15. Emergency / Law Enforcement • H.B. 1357 – requires licensure of freestanding emergency medical facilities • H.B. 2626 – brings Texas into compliance with the federal Violence Against Women Act • S.B. 328 – liability protections for hospital professionals drawing a blood sample for law enforcement; not subject to disciplinary action; not considered a “patient” under EMTALA

  16. The Best Offense Is a Good Defense • Bad bills THA kept from passing • No material modifications to the Texas Advance Directives Law • Changes to charity care averted • Attempts to weaken tort reform failed • Bills weakening the enforcement authority of the Texas Medical Board died • Dilution of ER coverage requirements failed

  17. Missed Opportunities • CHIP Expansion / Buy-in • 12-month continuous Medicaid • Restoration of Adult Medically Needy Pgm. • Texas Department of Insurance sunset – protect health care consumers • Regulation of PPOs • More transparency for health plans (where your premium dollar goes, coverage cancellation oversight, consumer “labeling”)

  18. Questions? Dan Stultz, M.D., FACHE, FACP President/CEO Texas Hospital Association dstultz@tha.org 512/465-1012

More Related