Print 🖨

The committee met to take up and consider new and pending business. This report focuses only on the bills listed below.
 
Pending Business
 
HB 2562 – Sheets, Relating to the care and unlawful restraint of a dog.

  • Committee substitute adopted
  • Voted favorably
  • Sent to local

 
HB 2703 – Simmons, Relating to the establishment of the Texas Board of Behavior Analyst Examiners and the requirement to obtain a license to practice as a behavior analyst or assistant behavior analyst.

  • Committee substitute adopted
  • Voted favorably

 
HB 3781 – Crownover, Relating to the creation of the Texas Health Improvement Network.

  • Committee substitute adopted
  • Voted favorably

 
HB 2602 – Coleman, Relating to the prescribing and ordering of Schedule II controlled substances by certain advanced practice registered nurses and physician assistants.

  • Committee substitute adopted
  • Voted favorably

 
 
New Business
 
HB 2330 – Zerwas, relating to the right of a dentist to contract for certain services.

  • Expressly prohibits dental board from interfering with DSO, closely mirrors other areas of code and dental board regulation
  • Helps identify what DSOs may and may not do during sunset process
  • Substitute defines dentist with existing board rules and clarifies what DSOs may do, also indentifies clear allowable contractual provisions and adds sunset language in accordance with other sunset deadlines (September 1, 2017)

 
Steve Bresnen, Association of Dental Support Organizations

  • Support
  • Bill seeks to demonstrate dental board overreach
  • Bill allows dental board to define things that are “clinical”
  • Excessive regulation will not replace appropriate enforcement
  • Board member – what is the impact on non-compete clause?
    • Texas law is very robust on non-compete clauses
  • Board member – are DSOs involved in non-compete clauses?
    • No, not in reviewed DSOs
  • Rep. Guerra – who owns DSOs?
    • Variety of parties, not always dentists
  • Guerra – does bill single out dentist-owned DSOs?
    • No
  • Guerra – so most DSOs are not wholly owned by dentists?
    • Unsure, investment firms and others participate
  • Guerra – do any DSOs require dental practices to meet quotas?
    • Quotas would be against the law
  • DSOs must contract with professional entity, those entities provide professional services
  • DSOs may not influence independent professional judgment

 
Karen Street, Herself

  • Support
  • Bill is important to dentistry industry in Texas
  • DSOs provide administrative support services and other business services, give dentists more time to devote to dentistry services
  • Chair Crownover – Could you address the fears of other dentists?
    • Common belief that all good dentists should be able to run their own businesses and that DSOs would control the dentist’s practice
  • Rep. Collier – is the DSO your employee?
    • Yes, has a contract with them
  • Collier – seems that DSOs would still interfere because they would cause practitioners to consider business issues, how do you ensure DSOs are employee and non-interfering?
    • DSOs simply do not, no one dictates use of practice funds
  • Crownover – how is pro-bono care paid?
    • Comes from practitioner’s funds
  • Rep. Coleman – confusion seems to be some think DSOs are like HMOs, no approval from DSOs is required for procedures, correct?
    • Yes, DSO approval is not required
  • Rep. Zedler – do practitioners hire or partner with DSOs?
    • Hire
  • DSOs have varying standards, work with varying practices and have varying standards regarding control over business aspects of practice

 
Jennifer Bryant, Pacific Dental Services

  • Support
  • Bill outlines exactly what DSOs are able to do and not do
  • DSO services are recent in Texas, demand is high nationwide
  • Dental board is currently acting in opposition to legislative intent and attempting to regulate DSO activity
  • Guerra – who are the bad actors in DSOs?
    • Statements have been made at dental board hearings and in discussions about Medicaid fraud, no specific knowledge as to bad actors

 
Bill Bingham, Texas Dental Association

  • Oppose
  • Current law protects dental patients, dictates that dentist determines best interest of patients
  • Law allow dentists to hire DSOs, but does not allow dentists to work for DSOs
  • State dental board should have power to regulate dentistry for the benefit of consumers
  • DSOs are not regulated by the state board, bill would punish dentists
  • Guerra – you said dentists should own the practice?
    • Dentists should make the clinical decisions, and should be allowed to contract for administrative matters
  • Guerra – could you clarify in relation to supportive dentist testimony?
    • Many types of DSO contracts between DSOs and dentists, dental board should be able to review
  • Guerra – is the problem the differing types of contracts and differing levels of control, would it be better with standard contract?
    • Standard contract is not necessary, rather allow dentists to dictate care decisions
  • Guerra – what is the issue with the current bill?
    • Concern is that safe harbor laws are not balanced by rules stipulating what DSOs shall not do
  • Crownover – so you want a bright line test?
    • There is a bright line, state board has determined
  • Crownover – does the state board have the teeth to enforce?
    • Not in the past, the last 2 to 4 years have seen extra resources given
  • Zedler – dentists can decide when to use DSOs, correct?
    • Yes
  • Zedler – so you are saying that dentists are being controlled by DSOs?
    • Have heard such complaints from dentists

 
Zerwas closed

  • DSO do not and should not control dentistry practices, bill respects this division
  • DSOs are a viable administrative function
  • Zedler – so bill is putting MSO model into statute for DSO?
    • Correct, non-clinical functions

 
HB 2330 left pending
 
HB 2240 – Turner, C., relating to the public's ability to access the results of a hospital inspection, survey, or investigation conducted by the Department of State Health Services.

  • Would require publishing health and safety status of hospitals to website for public consumption
  • Updates amount and type of information available from Texas hospital inspections
  • DSHS assures there is no fiscal impact on agency and any cost may adsorbed in current operations
  • Crownover – asks after fraud closures of rural hospitals
    • Bill was drafted in response to investigations into hospital violations, extreme examples led to closures

 
Charles Bailey, Texas Hospital Association

  • Support
  • Bill would make sure information from investigative reports is fully vetted and gives hospital to respond with a plan of corrections, helps consumers determine if they want to visit said hospitals

 
Allison Hughes, DSHS

  • Resource witness, no questions asked

 
Turner closed

  • Common sense bill

 
HB 2240 left pending
 
HB 1952 – Springer, relating to grants awarded by the Cancer Prevention and Research Institute of Texas.

  • CPRIT funding should only be research and preventative measuring, should not distribute to private companies
  • Crownover – do companies have a cap on return of investment?
    • 8x is the cap, state cut a bad deal with company investment as state cannot recover equity in similar amounts to funding provided

 
Wayne Roberts, CPRIT

  • On the bill
  • Legislature invested CPRIT with the mandate to provide funds, including the Product Development Research Fund
  • CPRIT may only fund research and preventative measures, research includes translational research
  • Rep. Coleman – last session the legislature went through CPRIT and discussed appropriate conduct, correct?
    • Yes
  • Coleman – so CPRIT was left with a “clean bill of health” with regards to its duty to taxpayers?
    • Yes
  • Coleman – so if the legislature wished to dissolve CPRIT the legislature could have, correct?
    • Yes
  • Coleman – the legislature discussed possibilities of academic investment and the concept of the legislature only focusing on CPRIT in this regard?
    • There was some talk of investigating other state development funds, interest in the interim was largely on other funds
  • Coleman – sometimes programs should move forward, and that is the decision I made regarding CPRIT

 
Springer closed

  • State should ensure they are comfortable picking “winners and losers” in private companies

 
HB 1952 left pending
 
HB 2908 – Parker, relating to authorizing patients with certain terminal illnesses or severe chronic diseases to access certain investigational drugs, biological products, and devices that are in clinical trials.

  • Amends current to authorize patients with chronic illnesses to access certain trial drugs
  • Patients will be qualified to receive treatment by the executive commissioner of the HHSC, they will sign a waiver of legal responsibility and bill specifically avoids a mandate that providers must provide these drugs
  • Crownover – so this is an addition to HB 21, taking the same steps for patients with terminal patients?
    • Correct, same standards and no mandate, bill only gives HHSC executive commissioner latitude

 
Mary Robinson, Texas Medical Board

  • Resource witness, no question asked

 
Parker closed

  • Important step to help protect terminally and chronically ill patients

 
HB 2908 left pending
 
HB 4062 – Coleman, relating to the allocation of funds for the Cancer Prevention and Research Institute of Texas.

  • Sets the minimum allowable funding dedication to cancer prevention up to 20%
  • Crownover – so CPRIT could spend 5%?
    • They could, but it was not intended to go below 10%

 
Wayne Roberts, CPRIT

  • On the bill
  • Belief that grant programs are very fair, will implement if this is the will of legislature
  • Caps for programs were discussed before, money is distributed based upon merit and peer review, hard caps may force allocation to program of less merit
  • Crownover – so the bill as substituted retains your flexibility?
    • Correct

 
Valerie Hawthorne, Herself

  • Support
  • Affordable Care Act has detrimentally affected preventative care for breast cancer, bill would help cure this issue

 
Coleman closed

  • Adjustments will need to made for the funding of prevention

 
HB 4062 left pending
 
HB 2978 – Bonnen, G., relating to the licensing and regulation of neurodiagnostic technologists.

  • Establishes a licensure process in Texas for these technologists
  • Substitute moves licensure to Texas Medical Board, requires technologists to be under the supervision of physicians
  • Does not seek to change the standard, licensure would require fee and be testing based, would require continuing education

 
Catherine Boldery, Texas Neurodiagnostic Society

  • Support
  • Currently president of Texas Neurodiagnostics Society
  • Many technologists do not hold boards and comply with national standards, no registry exists to track and monitor
  • Some of these are unqualified and work without physician supervision
  • Untrained personal result in poor health outcomes and litigation

 
Jeremiah Vance, Texas Neurodiagnostics Society

  • Support
  • No way for consumer to know if technologists have achieved an appropriate level of competency
  • Neurodiagnostic technologists provide valuable services to physicians in determining unsafe conditions in patients

 
Craig Schweitzer, Texas Neurodiagnostics Society

  • Support
  • Agrees with former testimony, neurodiagnostic technologists provide a valuable service to physicians and important to know that technologists are qualified

 
Karen Pursley, Texas Neurodiagnostics Society

  • Support
  • Impact on Texas practice will be “immeasurable”

 
Kim Monday, Texas Neurodiagnostic Society and Texas Medical Association

  • Support
  • Supports the oversight of neurodiagnostic licenses by the Texas Medical Board
  • Neurodiagnostic services are incredibly complicated and involved in surgical procedures

 
Carry McDaniel, Himself

  • Support
  • Lack of neurodiagnostic technologist possibly led to harm during his procedure

 
Maggie Marsh-Nation, Texas Neurological Society

  • Support
  • Neurodiagnostics has expanded greatly and become vastly more complicated in recent years
  • Availability of neurodiagnostic education will make transition to licensure easier

 
Brian Markley, ASET and Texas Neurodiagnostic Society

  • Support
  • Mandates for education and licensure are vital for patient care

 
Jim Mallios, Texas Neurodiagnostic Association

  • Oppose
  • Bill currently requires direct doctor oversight whenever neurodiagnostic needle sticks are performed, thousands of such procedures have occurred and Texas Medical Board requires credentials from national organizations and requires oversight from competent doctor
  • Doubling on these standards is not appropriate
  • Grandfather provision allowing neurodiagnostic technologists who have been working for over one year to continue is inappropriate, should require credential procedure for these technologists

 
Laurie Laird, Texas Neurodiagnostic Society

  • Support
  • Gives time back due to other supporters

 
James Jackson, Texas Neurodiagnostic Associates

  • Oppose
  • Generally for measures that advance neurophysiology field
  • Takes issue with needle test restrictions on technologists

 
Bonnen, G. closed

  • Only concerns come from those who are worried bill could interfere with business
  • Longstanding dispute exists over who may perform a needle EMG

 
HB 2978 left pending
 
HB 3651 – Coleman, Relating to the manufacture, sale, distribution, possession, and use of drugs not approved by the United States Food and Drug Administration and the false representation that a substance is a drug.

  • Committee substitute laid out
  • Some drugs that are not FDA approved but are available in other countries fall through the cracks of current law prohibiting misbranded drugs
  • Drugs are not sold through a pharmacy or prescribed by a physician
  • Bill would close the loophole allowing persons to sell FDA unapproved drug; incorrect labeling of a drug that may not be up to FDA standards
  • Makes use or possession of such a Class A misdemeanor
  • Substitute ensures good actors are not caught in the crosshairs and that bad actors do not escape prosecution
  • Sheffield asked what type of drugs this happens with
    • Probably antidepressants, Viagra, birth control, ; stuff people want to get ahold of but don’t want to go to the doctor and get a prescription for

 
Cheyenne Cook, Boehringer Ingelheim

  • Blood thinners, antidepressants, infusion drugs and many more are all commonly used in situations like this

 
Bill left pending
 
HB 2523 – Collier, Relating to the continuation of certain public benefits, including medical assistance, for individuals after release from confinement in a county jail.

  • Provides an avenue for adults receiving Medicaid to have their benefits suspended as opposed to terminated when they are confined in county jails
  • Does not mandate sheriff’s office to participate in notifying HHSC
  • Would reduce the amount of uncompensated care for hospitals because it takes a while to get back on Medicaid after your enrollment has been terminated

 
Andy Keller, Meadows Institute

  • Support
  • This is important for continuity of care as well as the uncompensated care issue

 
Bill Kelly,

  • Support
  • The bill is not Medicaid expansion
  • Will help save taxpayers money by saving on indigent care costs

 
Donald Lee, Conference of Urban Counties

  • Support
  • Will help to keep people who cycle through jails on their medications and will help to end that cycle
  • No sheriff will have to do anything; this is voluntary

 
Katherine Liggan, CPPP

  • Support
  • Important to maintain continuity of care

 
Bill left pending
 
HB 2503 – Zerwas, Relating to examination requirements for certain applicants for a license to practice medicine.

  • Current law allows candidates to attempt each part of the licensing exam three times; also allows out of state licensed physicians in good standing to take the exam three times
  • Bill would require out of state physicians using multiple attempts to be board certified and serve an underserved area
  • Will address the physician shortage and ensure Texas has the most highly skilled physicians

 
Bill left pending
 
HB 711 – Raymond, Relating to the creation of a childhood health program grant.

  • Currently more than 15% of Texas children age 2-5 are obese and more are overweight
  • The state should support programs aimed at reducing these numbers
  • Bill creates a grant program administered by DSHS intended to improve child health
  • DSHS will study proposals by child health organizations and make grant awards to the best programs
  • Would not be funded by state dollars rather with funds received by DSHS as gifts or grants

 
Bill left pending