Health Care

Overall

SB 916 (Johnson/Zerwas) Relating to supportive palliative care. The bill would define supportive palliative care in statute and directs a study of potential use of and Medicaid reimbursement for supportive palliative care. SB 916 was sent to the Governor on 5/28.

HB 1504 (Paddie/Nichols) Relating to the continuation and functions of the Texas Medical Board; authorizing a fee. HB 1504 is the TMB Sunset bill following up on the larger review conducted during the 85th Session. HB 1504 was sent to the Governor on 5/28. Recommendations implemented by HB 1504 include:

Authorizing TMB to adopt a risk-based approach for assessing anesthesia providers
Outlining the process by which TMB can appeal administrative law judge findings and setting out deadlines for action
Providing for removal of information regarding investigations if no action is taken against a licensee and allowing for a good cause extension of the preliminary investigation by 15 days
Adding failure to make reasonable efforts to transfer patients to comply with a directive to the list of prohibited practices
Requiring TMB to adopt expedited process for out-of-state physicians
Continuing TMB for an additional 12 years

HB 1742 (Smithee/Johnson) Relating to the mediation of the settlement of certain health benefit claims involving balance billing by out-of-network laboratories. The bill would allow patients to use Texas’ surprise medical bill mediation system when specimens are taken at preferred provider offices or facilities but tested by out-of-network laboratories. HB 1742 was sent to the Governor on 5/29.

HB 1941 (Phelan/Watson) Relating to unconscionable prices charged by certain health care facilities for medical care. The bill seeks to regulate unconscionable prices by freestanding emergency rooms and certain Chapter 241 hospitals through restraining and injunctive actions by the Consumer Protection division of the Office of the Attorney General. Also sets out guidelines for the division bringing an action and provides for possibly awarding attorney’s fees, court costs, and reasonable expenses incurred in bringing the action. HB 1941 was sent to the Governor on 5/29.

HB 2048 (Zerwas/Huffman) Relating to the repeal of the driver responsibility program and the amount and allocation of state traffic fine funds; eliminating program surcharges; authorizing and increasing criminal fines; increasing a fee. The bill eliminates the Driver Responsibility Program and establishes an alternate funding mechanism for lost trauma funding from repeal of the program through certain insurer fees and moving violation fines. HB 2048 was sent to the Governor on 5/29.

HB 2261 (Walle/Hinojosa) Relating to the physician education loan repayment program. The bill increases the amount available for physician loan repayment under the program to $180,000, up from $160,000. The program will pay up to $30,000 in the physician’s first year of service, $40,000 in the second, $50,000 in the third, and $60,000 in the fourth. HB 2261 was sent to the Governor on 5/29.

HB 39 (Zerwas/Nelson) Relating to the repeal of certain time limitations on the award of grants by the Cancer Prevention and Research Institute of Texas Oversight Committee was signed by the Governor on 4/24 and is effective immediately.

HB 2570 (Zerwas/Nelson) Relating to the award of grants by the Cancer Prevention and Research Institute of Texas Oversight Committee and to the payment of claims related to those grants by the comptroller of public accounts was signed by the Governor on 4/24 and is effective 9/1/19.

HJR 12 (Zerwas/Nelson) Proposing a constitutional amendment authorizing the legislature to increase the maximum bond amount authorized for the Cancer Prevention and Research Institute of Texas was filed with the Secretary of State on 5/14.

SB 2011 (Buckingham/Sheffield) Relating to a study and report regarding streamlining physician licensing requirements for advanced practice registered nurses was sent to the Governor on 5/25.

HB 1899 (Bonnen, Greg) Relating to the revocation or denial of certain health care professional licenses and the reporting of the grounds for revocation or denial was sent to the Governor on 5/26.

HB 1532 (Meyer/Hughes) Relating to the regulation of certain health organizations certified by the Texas Medical Board; providing an administrative penalty; authorizing a fee was sent to the Governor on 5/28.

HB 1065 (Ashby/Kolkhorst) Relating to the establishment of a rural resident physician grant program was sent to the Governor on 5/26.

HB 278 (Oliverson/Perry) Relating to the frequency and location of certain meetings required by a prescriptive authority agreement was signed by the Governor on 5/16 and is effective on 9/1/19.

HB 80 (Ortega/Rodriguez) Relating to a study and report regarding shortages in certain health professions was sent to the Governor on 5/21.

SB 1264 (Hancock/Oliverson) Relating to consumer protections against certain medical and health care billing by certain out-of-network providers was sent to the Governor on 5/25.

SB 1564 (West/Klick) Relating to access to certain medication-assisted treatment was sent to the Governor on 5/26.

HB 3148 (Parker/Bettencourt) Relating to the administration and oversight of investigational adult stem cell treatments administered to certain patients was sent to the Governor on 5/29.

SB 1565 (Fallon/Smith) Relating to the medical authorization required to release protected health information in a health care liability claim was signed by the Governor on 5/22 and is effective 9/1/19.

SB 21 (Huffman/Zerwas) Relating to the distribution, possession, purchase, consumption, and receipt of cigarettes, e-cigarettes, and tobacco products was sent to the Governor on 5/25. The bill seeks to raise the minimum legal age to access tobacco products from 18 years old to 21 years old. Language in the bill also creates an exception to prosecution for active duty personnel with presentation of a valid military identification card.

Telemedicine

SB 670 (Buckingham/Allison) Relating to telemedicine and telehealth services. The bill removes the requirement for a health care professional to be present to ensure reimbursement, directs MCOs to not deny payment solely because services are provided via telemedicine, allows for FQHC services to include physician provider and site of the visit, allows FQHCs to be added to possibilities for telepharmacy services, requires HHSC to confirm MCOs implement a monitoring process that ensures telemedicine services promote patient health and care coordination, modifies definition of direct primary care to incorporate telemedicine, and repeals the Sunset date for Medicaid reimbursement of home telemonitoring services. SB 670 was sent to the Governor on 5/25.

HB 3345 (Price/Hughes) Relating to health benefit coverage provided by certain health benefit plans for telemedicine medical services and telehealth services. The bill requires health benefit plans to cover telemedicine or telehealth services in a similar manner to in-person services and procedure and was sent to the Governor on 5/28. HB 3345 also sets out restrictions on limitations, denials, and reductions of coverage, annual or lifetime maximums, and deductibles for telemedicine and telehealth services.

HB 4455 (Miller/Campbell) Relating to the provision of mental health services through a telemedicine medical service or telehealth service. The bill authorizes health professionals to provide mental health services within their scope of practice through telemedicine or telehealth services to patients located outside of Texas. HB 4455 was sent to the Governor on 5/29.

HB 1063 (Price/Buckingham) Relating to telemedicine medical, telehealth, and home telemonitoring services under Medicaid was sent to the Governor on 5/29.

Opioids

SB 340 (Huffman/King, Phil) Relating to the creation of a grant program to assist law enforcement agencies with the purchase of opioid antagonists. SB 340 establishes the program under the Criminal Justice division of the Governor’s office and requires applicants to adopt a policy for use of opioid antagonists and provide proof of purchase for the antagonists after receiving the grant. The bill was sent to the Governor on 5/25.

SB 435 (Nelson/Price) Relating to recommendations by local school health advisory councils regarding opioid addiction and abuse education in public schools. SB 435 directs each local school health advisory council to recommend appropriate opioid addiction and abuse curriculum for the district including methods of administering an opioid antagonist and was sent to the Governor on 5/17.

SB 436 (Nelson/Price) Relating to statewide initiatives to improve maternal and newborn health for women with opioid use disorder. The bill directs the Department of State Health Services to work with the Maternal Mortality and Morbidity Task Force to develop tools and best practices necessary to assess and treat opioid use disorders among pregnant women and to prevent opioid-related overdose among pregnant and post-partum women. SB 436 was sent to the Governor on 5/21.

SB 437 (Nelson/Price) Relating to prohibited practices by a life insurance company relating to an individual’s prescription for or obtainment of an opioid antagonist. The bill prohibits life insurance companies from denying coverage, limiting coverage available, or charging a different rate to individuals who have been prescribed an opioid antagonist or have obtained an opioid antagonist through a standing order. SB 437 was sent to the Governor on 5/25.

HB 2088 (Dean/Hughes) Relating to providing information regarding safe disposal of controlled substance prescription drugs. The bill requires persons dispensing Schedule II controlled substances to provide written notice upon safe disposal and was sent to the Governor on 5/26. The Texas State Board of Pharmacy (TSBP) will adopt rules on the form of the notice, which is to include locations for safe disposal locations or a reference to TSBP’s searchable database of safe locations.

HB 2174 (Zerwas/Kolkhorst) Relating to controlled substance prescriptions and reimbursement for treatment for certain substance use disorders. After Jan. 1, 2021, HB 2174 would require electronic prescriptions for controlled substances subject to certain exceptions, including: for veterinarians, when due to temporary technology failure, when the prescription will be dispensed out of state, and when it would interfere with timely care or adversely impact a patient, among others. The bill also sets out guidelines for practitioners, such as 10-day limits on prescriptions for acute pain with no refill, and provides for a potential waiver to the electronic prescribing requirement, with waiver criteria to be established by State Board of Pharmacy work group. HB 2174 was sent to the Governor on 5/29.

HB 2454 (Price/Hughes) Relating to continuing education requirements for certain health professionals regarding pain management and the prescribing of opioids. The bill requires that prescribing physicians complete two hours of continuing medical education regarding reasonable standards of care of prescribing these drugs, effectively communicating with patients regarding the prescription of an opioid or other controlled substance, and how to identify drug-seeking behavior in patients. HB 2454 was sent to the Governor on 5/26.

HB 3284 (Sheffield/Nelson) Relating to prescribing and dispensing controlled substances under the Texas Controlled Substances Act. The bill modifies existing State Board of Pharmacy prescription information standards through guidelines for access to information for law enforcement, CMS certified facilities, and patients. HB 3284 also establishes an advisory committee for recommendations regarding prescription information submitted and access to that information, as well as providing for administrative and criminal penalties for prohibited disclosure. The bill was sent to the Governor on 5/29.

HB 3285 (Sheffield/Huffman) Relating to programs and initiatives to prevent opioid addiction, misuse, and abuse in this state. HB 3285 was sent to the Governor on 5/29. Implements recommendations from the interim Select Committee on Opioid and Substance Abuse, including:

Overdose awareness training for residential advisors and student organization officers
Support of research on substance abuse disorders by health-related institutions
Directing rules to increase telehealth treatment of substance abuse disorders
An opioid antagonist grant program through the Governor’s Criminal Justice Division (same as in SB 340)
Reimbursement for medically assisted treatment without PA in certain circumstances
Information measures such as inclusion of substance abuse treatment provisions in the Statewide Behavioral Health Strategic Plan, a public awareness campaign, and data collection regarding overdose deaths and co-occurring disorders

HB 2594 (Holland/Paxton) Relating to disposal of controlled substance prescription drugs by hospice service providers was sent to the Governor on 5/24.

Pharmacy

SB 1780 (Paxton/Parker) Relating to value-based arrangements for prescription drugs in Medicaid. The bill was signed by the Governor on 5/28 and authorizes HHSC to enter into a value-based arrangement for the Medicaid vendor drug program by written agreement with a manufacturer of prescription drugs. The agreement may include a variety of cost provisions, including rebates, contributions, risk sharing, deferrals, etc. The bill becomes effective on 9/1.

HB 1455 (Hunter/Buckingham) Relating to the audit of wholesale invoices during certain audits of pharmacists and pharmacies was sent to the Governor on 5/22. The bill adds language requiring health plans and PBMs to reverse findings of a discrepancy based on certain tangible evidence and to use invoices or state agency reports as evidence to support pharmacy claims.

HB 2536 (Oliverson/Hancock) Relating to transparency related to drug costs. HB 2536 was sent to the Governor on 5/29 and enables HHSC and TDI to collect data from drug manufactures, PBMs, and health plans regarding pricing, system of rebates, and discounts within a supply chain. For drug manufacturers, increases in wholesale acquisition cost of 40% in 3 years or 15% over the preceding calendar year trigger detailed reports to HHSC on cost factors, including whether the drug is brand-name or generic, R&D costs, and a statement on factors causing the increase. PBMs are required to report aggregate rebates, fees, and pricing information subject to prohibitions against disclosing certain specific information. Health benefit plan issuers are required to submit a report on the 25 most frequently prescribed drugs, increase in annual net spending, premiums attributable to prescription drugs, and specialty drug utilization.

HB 3703 (Klick/Campbell) Relating to the dispensing, administration, and use of low-THC cannabis. HB 3703 was sent to the Governor on 5/28 and expands access to the Compassionate Use Act program to treat patients with specific conditions, including certain incurable neurodegenerative diseases, terminal cancer, spasticity, and autism. Maintains THC limit of .5%, retains DPS oversight, and changes requirement for two neurologists to sign off on a prescription to one board-certified specialist.

HB 1264 (Thompson, Senfronia/ Buckingham) Relating to pharmacist communications to prescribing practitioners regarding certain dispensed biological products was signed by the Governor on 5/7 and is effective immediately. The bill makes permanent the pharmacist communication to prescribers when an interchangeable biologic is dispensed instead of the branded biologic.

HB 1584 (Thompson, Senfronia/Buckingham) Relating to health benefit plan coverage of prescription drugs for stage-four advanced, metastatic cancer was sent to the Governor on 5/29. The bill prohibits use of priori authorizations so cancer patients with stage IV cancer have access to life-saving medications.

HB 2453 (Thompson, Senfronia/Buckingham) Relating to pharmacist communications to prescribing practitioners regarding certain dispensed biological products. The bill was passed out of House Human Services but was not placed on a House calendar.

SB 683 (Buckingham/Allison) Relating to the licensing and regulation of pharmacists and pharmacies was sent to the Governor on 5/25.

Managed Care

SB 1105 (Kolkhorst/Frank) Relating to administration and operation of Medicaid, including Medicaid managed care. After passing out of the Senate, the bill saw 15 amendments on the House floor, including many other health care related bills that were procedurally dead. The Senate refused to concur on these amendments and a conference committee was appointed, but the committee did not issue a report so SB 1105 did not pass.

SB 1207 (Perry/Krause) Relating to the coordination of private health benefits with Medicaid benefits. The bill seeks to bolster provisions relating to the Medically Dependent Children Program and was sent to the Governor on 5/28. SB 1207 modifies notice requirements for coverage denials to include explanatory information, requires publishing of PA information by MCOs, adds a dedicated help line, access to third party to review MCO denials, enhancements for program assessments, and provides for wraparound services. In addition, the bill requires HHSC to conduct a study of the risk-adjustment applied to data under the Potentially Preventable Errors (PPE) quality program.

SB 1991 (Buckingham/Klick) Relating to claims and overpayment recoupment processes imposed on health care providers under Medicaid. The bill relates to electronic visit verification (EVV) and the standards by which providers comply with Medicaid EVV requirements and the process for MCO recoupment of payment. The bill recognizes provider use of purchased or developed EVV systems and directs HHSC to lessen administrative burden through developing an open model system and allowing providers to use a variety of emerging technologies. The bill also requires MCOs intending to recoup payment send written notice of intent and to allow 60 days to cure defects in claims. In addition, the bill seeks to standardize the process of MCO audits leading to recoupments, including a 30-day timeline to send the intent notice and limiting duration of audits to 24 months and was sent to the Governor on 5/28.

HB 2894 (Collier/Buckingham) Relating to the prosecution of health care fraud; creating a criminal offense. The bill seeks to modify the current Medicaid fraud statute to include health care fraud generally that can be prosecuted by the Attorney General and District Attorneys and was sent to the Governor on 5/21. HB 2894 modifies certain evidentiary standards to conform with the expanded scope and shifts references in the fraud statute generally to apply to state oversight of health care programs rather than HHSC oversight of Medicaid.

HB 4533 (Klick/Kolkhorst) Relating to the administration and operation of Medicaid, including Medicaid managed care and the delivery of Medicaid acute care services and long-term services and supports to certain persons. The bill contains the text of SB 1105 as it passed the Senate. HB 4533 was sent to the Governor on 5/29.

HB 3441 (Lucio/Schwertner) Relating to reimbursement under certain health benefit plans for certain services and procedures performed by pharmacists was sent to the Governor on 5/16.

SB 1742 (Menendez/Johnson, Julie) Relating to physician and health care provider directories, preauthorization, utilization review, independent review, and peer review for certain health benefit plans and workers’ compensation coverage was sent to the Governor on 5/28.

SB 1096 (Perry/Flores) Relating to the Medicaid managed care program, including the provision of pharmacy benefits was sent to the Governor on 5/28.

SB 1283 (Miles/Wu) Relating to the availability under Medicaid of certain drugs used to treat human immunodeficiency virus or prevent acquired immune deficiency syndrome was sent to the Governor on 5/25.

HB 170 (Bernal/Alvarado) Relating to coverage for mammography under certain health benefit plans was sent to the Governor on 5/29.

HB 2327 (Bonnen, Greg/Buckingham) Relating to preauthorization of certain medical care and health care services by certain health benefit plan issuers and to the regulation of utilization review, independent review, and peer review for health benefit plan and workers’ compensation coverage. The House adopted the conference report for HB 2327, but the Senate did not take it up.

Women’s Health/Maternal Health

SB 750 (Kolkhorst/Button) Relating to maternal and newborn health care and the quality of services provided to women in this state under certain health care programs. The bill was sent to the Governor on 5/25 and directs HHSC to undertake a variety of efforts to improve maternal care in Texas, including:

Apply for federal funds to implement a model of care to improve quality and accessibility of care for certain pregnant women and their children
Assess providing Healthy Texas Women services through Medicaid if the 1115 waiver is approved
In collaboration with MCOs, implement improved prenatal care services for high-risk pregnant women under Medicaid and a postpartum treatment network
Evaluate postpartum care after the first 60 days postpartum and develop an improved postpartum care package for the period beginning after the first 60 days postpartum and not more than 12 months after Healthy Texas Women enrollment
Develop or enhance statewide initiatives to improve maternal health care and require MCOs to implement specified initiatives
Renames the Maternal Mortality and Morbidity Task Force to the Maternal Mortality and Morbidity Review Committee and continues it until Sept 1, 2027

SB 2132 (Powell/Button) Relating to the provision of information to certain women enrolled in the Healthy Texas Women program. The bill requires HHSC to provide certain information to women automatically enrolled in the Healthy Texas Women Program following a pregnancy covered under Medicaid. Information includes information about the program, services provided under the program, and a list of providers in the enrollee’s area. The bill was signed by the Governor on 5/20 and is effective immediately.

SB 2150 (Kolkhorst/Thierry) Relating to the reporting of certain information on maternal mortality to the Department of State Health Services and the confidentiality of that information. Authorizes DSHS to allow voluntary and confidential reporting of pregnancy-related deaths by health care professionals, requires DSHS to post information on the agency’s website, and allows DSHS to receive grants or gifts to reduce maternal mortality and morbidity. This bill went to conference committee but no report was published or adopted so the bill failed to pass.