Legislators have begun filing bills to be considered in the upcoming 82nd Texas Legislative Session; many of the bills already filed address health care issues.
The Budget. Texas faces a shortfall in the range of $25 billion, and health care comprises about one-third of the budget. While the majority of Republicans as well as many Democrats say they will not raise taxes, new provider fees and revenue-generating regulations are more palatable options for some policy makers, not to mention provider reimbursement rate reductions. Managed care in Medicaid will likely be expanded, and many grant and pilot programs scrapped or scaled back. The Driver Responsibility Program, which provides significant trauma care funding, is once again on the chopping block.
Federal Health Care Reform. The state’s lawsuit seeking to invalidate the insurance mandate and prohibit expansion of Medicaid, coupled with the fervor of newly elected legislators who ran promising to prevent implementation of the new federal law in Texas will keep provider compliance plans in limbo. How legislators choose to set up the state insurance exchange is just one of many questions to be addressed.
Payment Reform. A recent agency report discouraged talk of opting-out of the Medicaid program, but encouraged efforts to rework the program and once again seek flexibility from federal regulators. Legislators will take another run at legislation to establish outcome-and performance-based pay in state programs, limit unnecessary hospital visits and admissions, adjust payments for potentially preventable readmissions, and develop quality-based payment initiatives. We also may see legislation designed to promote formation of Accountable Care Organizations and to address any potential legal obstacles.
Workforce. Primary care provider shortages paired with federal efforts to cover the uninsured spells scope-of-practice debates. Nurses in advanced practice are emboldened and ready to make their case, and more members are starting to listen. We may see efforts to increase residency slots and pressure higher education institutions to find more creative ways to quickly and better educate future health care providers. Hospitals will work again to obtain the ability to directly employ physicians, aided by a recent interim study finding that removing this prohibition will help rural and underserved areas to recruit providers.
Privacy. Increased use of health information technology, electronic health records, and the continued push to expand health information exchange has many lawmakers nervous; proposals to require additional safeguards for personal health information, as well as patient consent, disclosure, and access requirements, are possible. New questions around state agency data collection practices and use of newborn screening specimen have further spurred privacy concerns.
For more information about these and related topics, please contact Vinson & Elkins partner Elizabeth Rogers. If you are interested in joining V&E’s Texas Legislative Compliance Group, please review and fill out the Participation Form.