|
Legislative update
| |
 |
| |
Texas capitol |
Important hospital issues are decided in final days of regular legislative session
by Rosie Valadez-McStay
State budget
(SB 1)
The 2006-2007 state budget totals $139.4 billion (all funds) – an
increase of $12.8 billion or 10 percent higher than the previous
biennium. Spending on health and human services represents 36
percent of the state’s total budget. As the session came to a
close, competing priorities such as public school financing,
workers’ compensation and CPS reform made funding for health
care programs scarce.
Funding for health and human services will total $50 billion for
the coming biennium. While this is a 13 percent increase from
the last session, funding was drastically reduced in 2003
because of the state’s significant budget shortfall.
Below are some of the program and funding highlights made by the
79th Legislature for Medicaid and CHIP.
Medicaid
-
$37.9 billion was
allocated to Medicaid programs in Texas. This funding includes
anticipated increases in client caseloads as proposed by the
commission.
-
Benefits that were
restored include mental health, podiatric, hearing and vision for
adults and the budget partially restores the Adult Medically Needy
Spend-down program contingent on meeting savings targets
-
Reimbursement rates to
providers for acute-care client services were maintained at fiscal
year 2005 levels.
-
Creates an office of
medical technology within the Texas Health and Human Services
Commission (THHSC) to evaluate new developments in medical
technology that could be beneficial in the medical assistance
program.
-
Authorizes a pilot
program to provide Medicaid reimbursement for a medical
consultation by a physician or other health care professional
delivered via the Internet.
-
Directs THHSC to
develop a proposal by Dec.1, 2006, to provide higher reimbursement
rates to primary care case management providers who treat program
recipients with chronic health conditions according to
evidence-based, nationally accept best practices and standards of
care.
-
Requires THHSC to spend
$12.5 million in general revenue in each fiscal year to provide
Upper Payment Limit reimbursement to children's hospitals to cover
the actual costs incurred in providing Medicaid inpatient and
outpatient services and graduate medical education at children's
hospitals. (Article II, HHSC Rider 73)
What was not
restored:
-
Funding for graduate
medical education at teaching hospitals ($40 million in general
revenue)
-
Provider rate
restorations - cuts remain at 5 percent for fiscal year 2006-2007
-
Adequate funding for
projected caseload levels
CHIP
-
The budget for
fiscal year 2006-2007 restores CHIP vision, dental, hospice
and mental health benefits and places a new premium policy
that is more suitable and convenient for families at the
lowest incomes (less than 133 percent of the federal poverty
level) to pay.
-
Rider language to
require HHSC to request additional funding from the
Legislature if there is a CHIP shortfall before imposing a
wait list, enrollment cap, or cuts to eligibility or benefits.
-
Additional $12.4
million for enrollment levels that are higher than in fiscal
year 2005.
What was not
restored:
-
Our final push for
12-month continuous eligibility did not succeed. This
provision was taken out of HB 3540 at the last minute, and the
six-month coverage was made permanent in SB 1863.
-
Ninety-day
wait for coverage, income offsets for work related expenses
and the removal of the asset test
-
Provider rate cuts
Other health care issues
Niche hospitals and infection control
S.B. 872 directs the Texas Department of State Health
Services to study the impact of niche hospitals on the state’s
health care delivery system. It also requires disclosure of
physician ownership of niche facilities to patients and the
Department of State Health Services. SB 609, authored by Sen.
Jane Nelson, was amended to SB 872. The amendment creates a
multidisciplinary panel to study and recommend definitions and
methodologies for collecting and reporting evidence-based data
on infection rates and process measures. The advisory panel
would be required to consider differences in patient
populations, data collection and reporting standardization, as
well as data collection and reporting systems from entities such
as the Centers for Disease Control (CDC) and JCAHO related to
infection rates and process measures. This bill also requires
the Department of State Health Services to report on the
advisory panel's recommendations for legislation concerning the
collection and reporting of infection rates and process
measures, or both, by Nov. 1, 2006.
The CDC recently
reported that nearly 2 million patients annually acquire an
infection while being treated for another illness or disease,
and nearly 88,000 die as a direct or indirect result of the
secondary infection. Moreover, nearly $5 billion is added to
U.S. health care costs every year. Supporters of this amendment
feel consumer access to information regarding health
care-associated infection rates will enable consumers to make
more informed choices on health care. However, the state must
ensure that mandatory public reporting will provide useful
information to the public and include process measures that
benefit a facility's quality improvement efforts.
Child passenger
safety
HB 183 by Rep. Fred
Brown (R-Bryan) requires that all children younger than age 5
and less than 36 inches in height be secured by a child
passenger safety seat. If signed by the governor, the bill will
increase the current age requirement from 4 to 5 years.
SB 419 by Sen. Jane Nelson addresses the sunset review of the
Texas State Board of Medical Examiners. The bill renames the
agency as the Texas Medical Board and continues its existence
for 12 years. An amendment drafted by the Texas Hospital
Association was added to address hospitals’ concerns about the
need for continued confidentiality of medical peer review and
other information in the board’s possession when a disciplinary
action involving a physician is appealed to the State Office of
Administrative Hearings or a court. Two controversial abortion
amendments were added to the bill. One relates to parental
consent and the other restricts third-trimester abortions.
Rosie
Valadez-McStay is director of Government Relations.
Back to top
|
