The 80th Texas Legislature adjourned on May 28 after passing only 1480 bills out of the 6190 bills introduced (not that this necessarily is a bad thing). Health care was a hot topic during the session, and many bills focused on technology, Medicaid, and cost transparency in the medical marketplace. Here are a few bills that affect the business of medicine and the practicing physician.

Technology
The session had a strong focus on promoting technological advancement throughout the practice of medicine. House Bill 522, effective immediately, encourages the development of a patient identification card pilot program. This bill requires the Texas Department of Insurance to create a technical advisory committee to make recommendations for a pilot program, set to begin May 1, as well as the identification card program. The committee will be comprised of physicians, hospitals, health plans, and consumers. This program is a solid first step toward requiring health plans to adopt real-time claims adjudication and eligibility. This could mean no more confusion over a patient’s benefit set or eligibility, and no more timely claims repricing processes.

HB 1066 takes affect Sept 1 and allows more physicians to voluntarily share data electronically. This will be promoted by the Texas Health Services Authority Corp through new information technology functions. This entity will create incentives to encourage physician involvement in the secure exchange of health information. This will make retrieving patient information much easier and more efficient. Real-time claims adjudication becomes a reality with this system, as well.

Medicaid
Medicaid patients and the physicians who treat them received quite a bit of attention this session. A number of bills vied to increase access to patients while rewarding physicians with higher payments and more incentives.

Senate Bill 10 creates additional tools to control spending and improve public health. The bill offers new products to Medicaid enrollees such as voluntary health savings accounts and incentives for living healthier lives. The health savings account could mean a change in the way Medicaid physicians collect money from patients while the incentives for the healthy lifestyle aim to decrease the expenditure of Medicaid dollars.

Two amendments to SB 10 that can have a tremendous positive effect on a physician’s practice are HB 2610 and HB 3471. Both focus on the implementation of information technology into the Medicaid program. HB 3471 creates a pilot program to provide health information technology, including electronic health records, to high-volume primary care physicians who participate in Medicaid.

Other strong positives from this session include bills that will increase enrollment in the Children’s Health Insurance Program by relieving some burdens that parents face when enrolling their children.

Physician reimbursement is looking up after the 80th session, as well. HB 1 increases physician payment for treating patients under children’s Medicaid by 25% and adult Medicaid by 10%. The Legislature also agreed to update Medicate Relative Value Units (RVUs) which hasn’t been done since 1993.

Contracting and Transparency
HB 1594 requires that a health plan considers as in-network a physician who joins a medical group that already is under contract as a network provider, while the new physician’s application is in process. This bill is effective Sept 1.

One buzzword that pops up in every healthcare reformation debate is “transparency.” The Legislature tackled this idea by passing SB 1731, which gives patients and employers access to healthcare cost information from the physician, hospital, other providers, and health insurers. This includes copayment amounts, deductibles, and all other out-of-pocket expenses. It is effective Sept 1.

Among the bills that didn’t pass were a few dealing with physicians disclosing network affiliation and balance billing information to patients. Those bills would have limited the ability of the physician to collect the balance owed by the patient for out-of-network services. If the physician is not allowed to bill the patient for the portion not paid by health plans, then health plans would not need to contract with any physician. The failure of these bills is a large victory for Texas medicine.

Not every healthcare bill passed in the 80th session will significantly impact the practice environment, but some will serve as precusors of what is to come in the next few years.