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 Updated: 12/8/2004 |
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Legislative Affairs Committee Update
5 December 2004
The Sunset Advisory Commission held its public hearings in Austin on 16 and 17 November. TAPA was represented at the hearings by Linda Contreras, TAPA President; Michael Clark, TAPA President-Elect/LAC Chair; Sam Stone, TAPA Senior Political Consultant; and Lisa Jackson, TAPA Executive Director. The commission members were provided with verbal and written comments from reflecting the responses posted previously on this web site. A copy of the hearing testimony by Linda Contreras can be found here . In addition, a final written report of recommendations from TAPA was provided to the commission on 23 November. The commission legislative members and staff have been very receptive to our comments and recommendations. One recommendation we are pleased they are supporting is the continuation of the Texas State Board of Physician Assistant Examiners as a free-standing board. The commission will publish their final recommendations in mid to late December. Those recommendations will then move to the legislature where they will be introduced as a bill. This is of course just one of many steps TAPA will be monitoring and participating in as the Sunset process advances to the legislature.
It is with great pleasure that I inform you that TAPA has expanded its legislative and regulatory staff. Later this month Jaime Capelo, JD will join TAPA as our lobbyist. Mr. Capelo is a former Texas state representative from Corpus Christi who chaired the house Public Health Committee for two sessions and sponsored bills expanding PA practice. Mr. Capelo is well respected and known by members of the house and senate as well as the TMA, TOMA, TAFP, and TAPA. Mr. Capelo will join our current legislative staff of Sam Stone, Senior Political Consultant/Legal Consultant and Lisa Jackson TAPA Executive Director. In addition he and his family will relocate to Austin at the end of December.
The LAC will hold one more teleconference before the Christmas holidays to continue preparation for the 79th Texas Legislature (which will start 11 January 2005). Our legislative agenda is progressing well and we look forward to the new staffing and resources that will assist in advancing our profession.
Since this will probably be the last LAC update before the beginning of the year I would like to take this opportunity to wish all of you the best for this holiday season. I am personally thankful for the great committee members of our LAC as well as the tremendous TAPA staff. I look forward to a prosperous New Year to all. Merry Christmas all and have a Happy New Year!
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Legislative Affairs Committee Update - November 12, 2004
Dear Colleagues:
The TAPA BOD and LAC have made their final recommendations and comments on the Texas Sunset Commission Staff report and you can access these at www.tapa.org. These recommendations will guide the testimony TAPA will deliver to the Sunset Commission on 16 November. We will post a copy of the testimony delivered next week as well as update you on how it went.
As mentioned in previous updates, TAPA will be lobbying in the next legislature for statutory language that protects and promotes the utilization of the PA in the event of a disaster. A position brief was approved by the TAPA BOD and can be found at
In the last update I left one working legislative agenda item off of the list by accident. TAPA will be supporting the continuation of the prescription delegation waiver. Once again, here are the working legislative issues of 2005 that TAPA will be pursuing:
a. Supporting favorable legislation for the continuation of the Texas State Board of Physician Assistant Examiners and Texas Board of Medical Examiners.
b. Reinstatement of the Rural Physician Assistant Loan Reimbursement Program
c. Introducing legislation that protects and recognizes PA utilization in the event of a disaster.
d. Support the continuation of the prescription delegation waiver.
e. Support the following rural health issues:
i. Reinstatement of the Rural Loan Reimbursement Program for PAs,
ii. Support expanding existing governmental programs to PAs for funding establishment of rural clinics, and
iii. Support legislation that TAPA feels improves access to health care in rural areas and expands the abilities of the Physician-PA team to provide care.
f. Support legislation that recognizes and expands the utilization of Physician Assistants in providing mental health care,
g. Support legislation that advocates improved governmental funding for health care access especially the CHIP program and mental health,
h. Support improved funding for the TSBPAE, and
i. Supporting appropriate legislation that promotes the health of all Texans.
Take care and God Bless.
Michael G. Clark, Ph.D., PA-C
Legislative Affairs Committee Chair
Click here to view the Disaster Brief.
Click here to view the Final Sunset Commission Highlights
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Legislative Affairs Committee Update - November 2004
Dear Colleagues:
It has been two month since I have been able to update the LAC web site and I apologize for that. Unfortunately I had a family emergency that has kept my wife and I out of town most of the month. We are still attending to the emergency and appreciate the prayers and good thoughts from all of you.
Here are the activities that have been occurring with your Legislative Affairs Committee:
1. Despite my absence the LAC continued to pursue our mission to increase your visibility, promote legislative action that protects and advances our profession, and promote one clear voice that represents all PA's in Texas. During the month of October members of the LAC, TAPA BOD, and involved colleagues visited Sunset Commission legislators and their staff in the legislator's home districts throughout Texas to discuss TAPA's position on the Sunset for the TSBPAE/TSBME. Issues discussed at the meetings included
a. supporting the administrative efforts of the TSBPAE in regulating the PA profession,
b. advocating for a continued strong, statutory definition of a PA,
c. opposing any efforts to consolidate the TSBPAE with any other board,
d. advocating for fair statutes and rules that protect the safety and welfare of all Texans,
e. recommending increased TSBPAE board member meeting times to improve the efficiency of the board,
f. advocated for the reinstatement of PA statute for funding the Rural Physician Assistant Loan Reimbursement Program,
g. advocated statutory language to protect and promote PA utilization in the event of a disaster, and as always
h. provided the legislator and their staff facts on PA practice in Texas.
The visits were also an opportunity for TAPA to start laying down the groundwork of your legislative agenda to legislators prior to the legislative session. Overall the visits were received well and our message sent. Currently TAPA leaders are preparing their statements to represent Texas PA's at the mid-November public hearing of the Sunset Commission. In addition, during the next two months before the legislative session begins, TAPA will continue reach out to legislators all across Texas to promote those legislative issues important to PA's and to the health and welfare of their patients.
2. The Sunset Commission staff has published their recommendations for the Texas State Board of Physician Assistant Examiners and the Texas State Board of Medical Examiners. The LAC has developed the first draft highlighting the issues discussed in the publication that most directly affect the TSBPAE and your practice. A final draft will be posted in two weeks. You can access the highlights on the TAPA web site at Sunset Highlights.
3. To improve the efficiency of your LAC, several LAC members have agreed to expand their role in the committee. Julie Bighouse of Austin will chair the 2005 TAPA Legislative Summit and will be responsible for coordinating the activities of that important function. Coby Phillips of Austin will assist Julie by coordinating the student activities during the Legislative Summit. Frank Ambriz of Weslaco will take on the role of LAC liaison to the TAPA Mental Health Task Force. Jubel Reed of Midland will become the LAC liaison to the Rural Health Committee. Thanks to these members as well as all the LAC members for their sacrifice and efforts.
4. During recent LAC teleconferences the committee members discussed the primary working legislative issues TAPA will pursue during the 2005 Texas Legislative session. Those dynamic issues are:
a. Supporting favorable legislation for the continuation of the Texas State Board of Physician Assistant Examiners and Texas Board of Medical Examiners.
b. Reinstatement of the Rural Physician Assistant Loan Reimbursement Program
c. Introducing legislation that protects and recognizes PA utilization in the event of a disaster.
d. Support the following rural health issues:
i. Reinstatement of the Rural Loan Reimbursement Program for PA's,
ii. Support expanding existing governmental programs to PA's for funding establishment of rural clinics, and
iii. Support legislation that TAPA feels improves access to health care in rural areas and expands the abilities of the Physician-PA team to provide care.
e. Support legislation that recognizes and expands the utilization of Physician Assistants in providing mental health care,
f. Support legislation that advocates improved governmental funding for health care access especially the CHIPs program and mental health,
g. Support improved funding for the TSBPAE, and
h. Supporting appropriate legislation that promotes the health of all Texans.
5. By 1 January TAPA will have additional legislative staffing to assist us in improving our visibility and promoting our progressive legislative and professional agenda. We are very excited about this new addition and will announce who this individual will be in a future posting.
Well, that is all for now. We welcome any input you have on the working issues TAPA is representing you on. Please note the LAC member and/or board member who are in your area and utilize them to bring issues to the attention of your professional organization. And please remember your LAC members are working very hard to make your practice environment the best it can possibly be. As always, I am available to you as your LAC chair and President-Elect. Thank you for your support of TAPA and your support for the future of PA's in Texas. Your support is important! Take care and God Bless
Michael G. Clark, Ph.D., PA-C
Legislative Affairs Committee Chair
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Legislative Affairs Committee Update
Legislative Affairs Committee Update
5 May 2004
The Legislative Affairs Committee has been actively discussing and acting on issues important to our profession. The committee meets primarily by teleconference but members of the committee and TAPA staff are continuously involved in meetings and discussions with legislators, regulators, health care organizations, and others important to our efforts. The following represents past and on-going LAC activities as well as information of note:
1. During the 2005 Texas Legislature the Texas State Board of Physician Assistant Examiners, as well as the Texas State Board of Medical Examiners, will undergo the regular legislative assessment of state agency's as directed by law and the process termed Sunset. This year the Sunset Commission, legislators and public members appointed by the Lt. Governor and House Speaker, will meet to discuss issues and make recommendations for our TSBPAE. The LAC is charged to participate in this process and represent our profession and organization to the commission. The process and representation on our part will be acting as liasion to and educating the commission members and staff on TAPA's position on the Sunset. Members of the LAC and TAPA staff have already met on three occasions with several members of the commission staff in preparation for this process. The meetings have been very beneficial and the staff appreciates our counsel on questions and issues dealing with the TSBPAE. As well the LAC and TAPA BOD members will schedule meetings with the individual members of the commission over the next few months. The LAC will also testify at the commission public meetings scheduled in November. If you would like to read more about this process you can access the Texas Sunset Commission web site at http://www.sunset.state.tx.us/.
2. Recently the TAPA BOD unanimously approved the following legislative position in our approach to Sunset and legislative activities. They are:
a. TAPA finds the Physician Assistant Act to be sound and that it meets the needs of our profession.
b. TAPA supports and is committed to the state maintaining a separate, regulatory board for Physician Assistants. We do not support combining the TSBPAE with any other board.
c. TAPA supports the continuation of the waiver process in the Medical Practice Act that allows consideration of expanding on-site physician supervision requirements to underserved clinical practices.
3. Under discussion at this writing is the introduction of statutory language in the PA Practice Act during the next legislature that will allow effective utilization of PAs in the event of a disaster. The LAC has approved this and it will be brought to the TAPA BOD for approval in the very near future. The Texas Homeland Security director, TMA, and TAFP have been very positive on this issue. Currently the LAC chair and TAPA legal counsel are developing a brief on this effort.
4. The LAC now has a membership that represents most of the regional areas of Texas. Regional LAC members are charged with acting as liaisons between the LAC and their respective regional groups. The LAC represents the continuing efforts of TAPA to improve communication between our colleagues throughout Texas. Please note your volunteer LAC members on the committee membership page of this web site. I encourage you to seek out your LAC representative if you have questions.
5. The LAC and TAPA staff is planning for the next TAPA Texas Legislative Summit in February 2005. As well as educating legislators on our legislative agenda and the PA profession, we are expanding our activities to include the addition of a health care theme and placing PA program and TAPA display's in the capitol extension. The legislative summit represents a resource TAPA coordinates in Austin to improve our visibility and voice in the legislature as well as to all Texans. More information on the summit to come.
6. A non-partisan health care policy web site link was created as a service to TAPA members. The site is sponsored by the Kaiser Family Foundation and supports this news site on current national health issues important to health care professionals and your patients. The site also provides news on health issues around the world. Please take a moment to access the link and check this site out.
7. A subcommittee of the LAC focusing on practice issues in mental health (titled the Mental Health Task Force) was approved by the TAPA BOD last year. The mental health task force membership consists of PAs in psychiatric medicine. Those members are Cathy Judd, co-chair, Joseph Murphy, and Thomas Van Horn. The primary focus of this task force is to provide counsel to the TAPA BOD on issues that affect our colleagues in psychiatric medicine and to create liaisons with groups with like concerns. The task force is currently coordinating a collaborative meeting with psychiatric physicians and APN's to discuss regulatory issues that create barriers in accessing mental health care.
8. Most PA's would not think the current special session of the Texas Legislature on public school financing would effect our profession. But recently TAPA was asked by the Texas Medical Association and the Texas Academy of Family Physicians to assist them by alerting our members on a critical issue being considered by the Texas House of Representatives. The alert was in reference to a payroll/employee tax that was introduced in the legislature under House Bill 1 that would affect medical practices across Texas. This tax would create an additional burden on medical practices especially those already encumbered by tight budgets. The tax would ultimately tax the health care provided to all Texans. The LAC produced an e-mail legislative alert that was sent out to the membership requesting they contact their legislators and encourage them not to pass this tax. Because of the hard work of many such as you, on Tuesday 4 May, the House of Representatives amended HB1 to delete the revenue measures based upon a payroll/employee tax (as well as a video lottery). Both of these revenue measures are very likely to come up again in the Senate when that body begins its work on HB1. The LAC will keep you informed if there are any changes in this process but thanks to all our colleagues that responded and were pro-active in this process.
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Legislative Affairs Committee Update - August 2004
LAC Update
1 August 2001
Welcome to the first web site update for the Legislative Affairs Committee 2004-2005. This is an important year because we will once again participate in the legislative process during the 2005 79th Texas Legislature. The committee has transitioned positively over the past year and has made a successful effort in composing a committee that reflects and is represented by PAs in different regions of Texas. Visit the LAC member page to view your 2004-2005 Legislative Affairs Committee members. The LAC held a teleconference meeting on 26 July to discuss working legislative issues for our profession. Here is a synopsis of whats going on:
1. The committee discussed the current working legislative agenda for the 2004-2005 cycle. Those issues include participating in the Sunset process, inclusion of statutory language for PA utilization in the case of a disaster, reinstating the Rural Physician Assistant Loan Reimbursement Program (RPALRP), supporting health related legislative issues such as those affecting patient access, mental health, CHIPs, etc., and support for improved funding for the Texas State Board of Physician Assistant Examiners. This agenda is of course going to expand somewhat over the next few months but we will provide you some insight on these issues in this print and in future postings.
2. The committee wishes to express its thanks to the tremendous work of departing members John Drobnica, Gordon Lee, and Ann Teal. Thank you folks for your time and expertise. Good luck and best wishes.
3. As of this writing all committee seats are filled. New members to the committee include Hank Lemke (Past President) - Ft Worth Sarah Toth (PPC Chair) Houston, Linda Contreras (Ex-Officio, President) Jubel Reed Midland/Lubbock/Amarillo Matt Menger Fort Worth. We would also like to welcome Coby Phillips of Austin to the committee. She will fill a new committee seat assigned to new PA graduates.
4. LAC and TAPA board members met with the Sunset Commission staff in June to provide TAPAs first formal comments to the Sunset Commission. The session included our official position on the Texas State Board of Physician Assistant Examiners (TSBPAE) as well as answering multiple questions from the staff. The response and interaction was overwhelmingly positive. Some of the key issues discussed include:
a. TAPA official position comments are (in brief):
i. The TSBPAE is an efficient and effective regulatory agency of Physician Assistants.
ii. The TSBPAE has met its statutory obligation and developed a regulatory process that effectively protects the safety and welfare of Texans.
iii. The TSBPAE protects a strong definition of who can be a PA.
iv. TAPA opposes any movement to consolidate the TSBPAE with any other regulatory board.
v. Additional comments expressed to the commission included support for expanding the amount of time the TSBPAE has to conduct business and timely appointment of board members to the TSBPAE.
b. Answered questions from the commission staff on
i. the history of the PA profession in Texas and the history of our PA Practice (Licensing) Act,
ii. the licensure and certification process of PAs,
iii. the educational process of PAs, and
iv. the practice demographics of PAs.
The commission staff is expected to post their working comments and suggestions some time in August or September. TAPA BOD and LAC members will be meeting with commission legislative members over the next three months to promote our position. The public hearing date for the TSBPAE is in November at which TAPA will once again deliver its position comments. In regard to the TAPA position paper on the Sunset of the TSBPAE, we will post on this web site a more extensive commentary on the points mentioned above in the near future.
5. In collaboration with the Rural Health Committee, the LAC will pursue reinstating the Rural Physician Assistant Loan Reimbursement Program (RPALRP). This program was placed in our Act in 1993. The program is designed so that funds are collected from our licensure and registration fees and deposited with the Office of Rural Community Affairs for administration of the program. During the last legislative session the Appropriations Bill created a mechanism where the TSBPAE/TSBME could access those funds and direct them for other administrative uses. As we all know our professions impact to rural medicine in Texas has been tremendous and this program provides an important recruitment tool for those considering a practice in rural Texas. This program is still in statute and we are dedicated to its funds used for what it was designed to do.
6. LAC members delivered TAPAs position paper entitled “Utilization of Physician Assistants in Response to Disasters in Texas” to the Governor, Texas Homeland Security Director, Texas Sunset Commission, Texas Medical Association, Texas Academy of Family Physicians, Texas Osteopathic Medical Association, and the Health and Human Services Commission. So far all responses to this effort have been positive. This position paper will be our basic talking points as we lobby other legislators and organizations to have statutory language placed in our Act that protects and promotes PA utilization in the event of a disaster. To see the position paper please go to the “Documents and Links” prompt on the TAPA home page.
7. In collaboration with the Professional Practice Committee, LAC members met in July with Dr. Albert Hawkins, Commissioner of the Texas Health and Human Services Commission, and Dr. Charles Bell, Deputy Executive Commissioner of the Texas Health and Human Services Commission. Topics of discussion included promoting an option for PAs to have Medicaid numbers, recognition of PAs as providers in the Medicaid managed care program, placing PAs on HHSC committees, and approaching HHSC rules that create barriers for PA utilization such as mental health. Dr. Hawkins expressed an interest in working on these issues with TAPA and requested we maintain a regular dialogue on these issues. Less than one week after our discussions TAPA was contacted to provide HHSC with a recommendation for a chair on a HHSC Medicaid committee. As an adjunct to this, the TMA has offered TAPA an opportunity to participate in an on-going discussion group composed of representatives from TAFP and HHSC on Medicaid issues. The LAC will continue to assist the PPC on any and/or all of these issues.
8. The LAC will once again host the TAPA Texas Legislative Summit on 27-28 February 2005. The summit will consist of representation from throughout Texas of graduate PAs, student PAs, and supervising physicians. The summit will consist of a one-half day workshop on our legislative agenda, training on how to approach legislators and their aides, and a tour of the capitol. This is followed by one day of visits to legislators at the capitol promoting our agenda issues. The summit will have some new additions this time with TAPA and the PA programs staffing booths in the capitol extension and promoting a health-care theme.
9. The LAC is now constructing the TAPA Legislative Tree. The legislative tree consists of willing PAs who will function as an informed, reactionary tool for TAPA to address important legislative issues and alerts in a timely fashion. Those who participate in this process will be provided periodic updates on the legislative agenda, associated legislative issues of interest, and a copy of the most recent LAC meeting minutes. All members of the LAC are tasked to identify colleagues in their regions who would be willing to participate. If you have an interest in participating please contact your regional member or Kristina Haley (TAPA Administrative Assistant). The master list of the legislative tree will be maintained at TAPA headquarters in Austin.
10. The TAPA BOD has approved funding to hire additional lobbying staff for TAPA. Currently the TAPA President, LAC Chair, PPC Chair, TAPA Legal Counsel, and TAPA Executive Director are working to identify and interview potential candidates. It is our expectation to have someone on board by mid-fall 2004. The new lobbying staff will greatly expand TAPAs visibility and representation for legislative and regulatory efforts.
11. The LAC discussed the current committee charges at its meeting in July. The charges were deemed appropriate and no changes were recommended.
Well, if you made it this far….congratulations! As you can tell there are a lot of issues and such going on. I hope to have a posting to you at least monthly and as needed. Any questions please feel free to contact me at any time. Best wishes to all!
Michael G. Clark, Ph.D., PA-C
TAPA Legislative Affairs Committee Chair
President-Elect
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1 December 2003 Legislative Affairs Committee Update
The LAC recently conducted its first teleconference of the full committee for the 2003-2004 year. The meeting agenda consisted of discussions on working and anticipated legislative issues. Some of the highlights of the meeting included:
1. Expanding current LAC membership to include representation of Texas regional areas. (Almost all of these have been appointed and all are expected to be appointed by the beginning of the year. In addition to participating in standing LAC charges, regional representatives will act as liasons to local groups on LAC issues)
2. Appointment of TAPA representatives to the Collaborative Practice Committee (Also to be completed by the beginning of the year)
3. Discussion of Sunset for the Texas PA Act (Texas State Board of Physician Assistant Examiners) in 2005 (The discussion included monitoring and approach to the sunset commission. In addition the LAC will monitor the commission for activities related to the TSBME. It is anticipated public hearing will occur in the spring of 2004. LAC members will be providing public comment as well as conducting private meetings. TAPA public testimony will be published on the TAPA web site)
4. Preparation for the 2005 Legislature (The discussion included developing and conductiong the TAPA Legislative Summit for 2005, increased visability of TAPA during the Legislative summit including increased student participation, and developing a program (similar to the TAFP/TMA physician of the day) where a PA and/or Physician-PA team are scheduled to be on the hill during the legislature and recognized by the house.)
5. Making final amendments to the LAC charges (Those will be posted after approval by the TAPA BOD on 4 December. The new LAC charges primarily direct the LAC to exclusively legislative activities.)
6. Creation of an ad hoc Mental Health Task Force (This task force will provide insite and representation for issues impacting PAs in psychiatric medicine and mental health care issues. The Task Force is slated to have its first teleconference on 1 December)
The LAC will meet again in January by teleconference and in February at the TAPA spring CME to continue their discussions and planning.
Last for this update, the LAC team has been active in meeting with the TMA, TOMA, TAFP, TSBPAE, legislative aides to the Governor and Lt. Governor Senator Nelson, Speaker Craddick, and Rep. Capelo. In addition the LAC team has had meetings with the Texas Sunset Commission staff. These meetings included discussions in regards to the upcoming Sunset, Texas health care concerns of the legislators, and promoting a working environment for future legislative activities.
Thanks for looking in and if you have any questions please feel free to contact the LAC chair.
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DEA RECOGNITION CLEARS WAY FOR APPLICATIONS
Congratulations Texas PAs!! The last hurdle for implementation of the Scheduled Medication law for Texas PAs was achieved on 9 September 2003. The DEA has finished their review and now recognize a PAs ability to prescribe scheduled medications as a delegated medical act in Texas. What this means is those Texas PAs who are delegated this authority can submit their application for their DEA number or for address changes in regard to those colleagues who already possess a DEA number (submit all DEA applications to the Washington address). Below is a synopsis of the law but for more info please check the TAPA web site at http://www.tapa.org/ or the TSBME/TSBPAE site at http://www.tsbme.state.tx.us/.
Additional information on the process for prescribing scheduled medications can also be found on the TAPA web site. DEA information can be found at www.deadiversion.usdoj.gov/.
SCHEDULED MEDICATION AUTHORITY
The supervising physician may:
1. Delegate prescriptive authority to a Physician Assistant for
Schedule/Controlled III-V medications;
2. The prescription may be for no more than 30 days;
3. Refills of a scheduled/controlled medication requires consultation with
the supervising physician and documentation in the patient's chart of
such consultation;
4. A prescription for a Schedule/Controlled medication to a child less
than two years of age requires consultation with the supervising
physician and documentation in the patient's chart of such
consultation.
5. Before you can write, and before a pharmacist can fill the prescription,
for a scheduled medication you must have a Controlled Substance
Registration Certificate registered through the Texas Department of
Safety and a DEA number.
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2003 LEGISLATIVE REPORT 4 SEPT 2003
TAPA Legislative Rundown for 2003
During a legislative year the first of September is an important time for all people in Texas. Even though some successful legislative efforts take effect at the end of the session in June, September 1 still remains a common time for laws to come to fruition. Overall it was a good legislative year for the Texas Physician-Physician Assistant team and many bills will impact positively on your ability to provide health care. But there was some disheartening legislation that will take away health care to many Texans, maybe some who are your patients. It is assuring to know our profession, and your professional organization, will continue to be a dynamic advocate for the care of our patients no matter the legislative trends.
The following is a synopsis of critical legislation passed during the 2003 Texas Legislature:
Delegated Authority for Scheduled Medications HB 1095
This bill authored by Rep. Jaime Capelo in the House and Sen. Jane Nelson in the Senate allows physicians the ability to delegate scheduled medication prescriptive authority for Schedule III-V to PAs. Even though the bill technically took effect at the end of the legislative session in June and rules for its implementation have been passed by the TSBPAE/TSBME it is still going through federal review with the Drug Enforcement Administration. For updates on the progress of this new law please check the TAPA web site.
Prompt Pay Bill SB 418
This bill authored by Sen. Jane Nelson had a multitude of Senate and House co-authors and co-sponsors. This bill requires prompt pay by health plans to health care providers. Highlights of the bill is it mandates that all clean claims filed electronically be paid within 30 days, a health plan must pay for service it says it will pay for, and decreases the bureaucracy (and paperwork) of the definition of clean claim and requested additional documentation for a claim. This version of the prompt pay bill is stronger than the one vetoed in the 2001 legislative session. The bill became effective 1 June 2003.
Liability Reform Bill HB 4
This bill was authored by Reps. Joe Nixon, Ray Allen, Jaime Capelo, Beverly Woolley, and Robert Cook and sponsored by Sen. Bill Ratliff. Even though this bill was controversial it received wide support from both houses. The bill struck at the heart of lawsuit abuse in Texas. It is designed to diminish frivolous lawsuits and limit the severity of judgments especially against providers and health care institutions. The essentials of the bill are: its sets caps on noneconomic damages per occurrence at $250,000 for providers; sets caps for noneconomic damages for institutions; and includes procedural reforms on expert witness reports and pretrial depositions.
Even though the bill takes effect on 1 September 2003 there is a referendum (Proposition 12) that all Texans must vote on. The referendum allows Texas citizens to decide if the legislature can place caps on damages. By voting yes on this referendum it allows the bill to take effect and decrease the risk of legal challenges to the bill that could put it in limbo for years.
Immunization Bills for Texans SB 40, SB 43, SB 486 HB 1920, HB 1921
These bills, sponsored by Sen. Jane Nelson and Rep. Jaime Capelo, greatly improve the state and the provider's ability to promote and provide immunizations to the children of Texas. The bills establish a statewide education program on immunizations, creates an outreach program to enlist physician's in the state's immunization registry, will make participation in the Vaccines for Children program easier, and will create less paperwork for those enrolled in the immunization registry. These bills take effect 1 September.
Medicaid and CHIP Program Cuts
One of the downsides of this legislative year, both at the federal and state level, are cuts in state services especially Medicaid and the CHIP program. Despite efforts by our U.S. Senators Hutchinson and Cornyn to improve federal funds to these programs, the health safety net for Texans shrunk significantly with state budget cuts. The federal assistance will hopefully negate any cuts to providers for Medicaid and CHIP payments but thousands of Texans, especially children and pregnant women, will lose their coverage in these programs.
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Update on Delegated Scheduled Medications and the DEA
Update on Delegated Scheduled Medications and the DEA
26 August 2003
The DEA continues to review the Texas law on delegated scheduled medication prescriptive authority for PAs. The good news is they are reviewing our law but how long this will take is still in question. The DEA will not accept new applications or changes in current DEA number addresses at this time until the review is complete. As we are provided news on this we will keep you informed.
For those colleagues who currently hold DEA numbers from other states you must request in writing a change of address for your scheduled medication prescriptive authority in Texas. The DEA though will not accept these letters until the review is complete. In addition, even if you have a DEA number from another state you should not be writing for scheduled medications until the DEA has given Texas PAs the "GO" sign.
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TAPA LAC NEWS 19 AUG 2003
18 August 2003
SCHEDULED MEDICATION AUTHORITY RULES PASS
Rules for HB 1095 allowing delegation for Scheduled Medication to PAs was passed by The Texas State Board of Medical Examiners on 15 August. This completes another important step in implementing this new law. The new rules can be found on the TSBME web site at: http://www.sos.state.tx.us/texreg/archive/July42003/PROPOSED/22.EXAMINING%20BOARDS.html
The last step to complete this process though is still in process at the federal level. The DEA continues its procedures in reviewing our new law and has not started accepting new applications from Texas PAs. Unfortunately we do not known how long this process will take. The DEA is apparently aware of the new changes in Texas and hopefully with the passage of the new rules this will expedite the process. TAPA continues to lobby and monitor this process and appreciates the assistance of AAPA in this matter. We will post any progression on this procedure as soon as we receive any news.
One last item on scheduled medications, I recommend for those who will be delegated scheduled medication authority spend some time becoming familiar with Chapter 481 of the Health and Safety Code, the Texas Controlled Substance Act. The laws in this act will also regulate your prescribing as it does with any practitioner prescribing a scheduled medication. The Act can be found through the Texas State Board of Pharmacy web site at http://www.capitol.state.tx.us/statutes/he/he0048100toc.html.
LASER RULES FOR PA'S PASS
The TSBME passed new rules allowing a physician the option to delegate non-ablative laser treatments to PAs. The new rules would not require the physician to be on-site for the delegation, requires specific training of the physician and PA, and also would allow the physician to delegate supervision authority of non-ablative laser therapy to the PA. The rule can be found on the TSBME web site at: http://www.sos.state.tx.us/texreg/archive/July112003/PROPOSED/22.EXAMINING%20BOARDS.html. The new laser rule will also require a physician (or a PA delegated supervision authority) be on-site if a nurse, technician, or other trained personnel deliver laser therapy. Even though this new rule is favorable for the Physician-PA team, it is very controversial considering its impact on laser treatment centers throughout Texas and will no doubt invoke legal and legislative attempts to reverse it. Kudos to Tom Yturri worked very hard to make sure that any rules passed were favorable to PAs and we appreciate his hard work.
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current activities message 9 August 2003
9 August 2003
Greetings Colleagues:
My name is Michael Clark and I have been appointed as Chair of the Legislative Affairs Committee for 2003-2004. It is my personal charge to continue the great progress and hard work laid down by those before me. This committee will continue its dynamic mission to improve the practice environment for Texas PAs and encourage increased utilization of PAs in all practice disciplines. This will be accomplished through a proactive approach to progressive legislative and regulatory laws for the Physician-Physician Assistant team, advancing and strengthening the visability, credibility, and viability of TAPA in Austin, and encouraging a collegial working relationship with medical, nursing, governmental, and civic organizations.
As you are all aware one of the important legislative accomplishments of the last TAPA administration was the passage of scheduled medication delegation in HB 1095. Last week the Texas State Board of Physician Assistant Examiners passed the rules to guide this new statute. The next step will occur on 15 August when the Texas State Board of Medical Examiners review the rules and make their final approval and/or recommendation. The DEA has now acknowledged the recent change in Texas law but are awaiting the final state process and attorney general recommendations. So for the moment the DEA is still not processing any applications. The Message to PAs section contains the current process for obtaining scheduled medication delegation. We hope the process will be complete within the next 30 to 45 days. We will keep you updated.
Even with the success of HB 1095 there are other legislation important to PA's and their patients. A summary of those bills will be posted to this site by mid-September.
Also at the TSBME meeting on 15 August, the board will be reviewing new rules that allow physician's to delegate non-ablative laser therapy to PAs. Tom Yturri, TAPA treasurer and a Derm PA, has been representing TAPA in negotiating the most optimal ruling possible and Tom's effort has met with great success. We will keep you updated with the progress of this rule.
As all are aware the next legislative session in 2005 will see our PA Practice Act go through the Texas Sunset process. We anticipate no problems but we will be monitoring and proactively participating in the sunset process during the off-legislative year and during the 2005 Legislature.
At this writing the TAPA Legislative Affairs Committee is being restructured. We appreciate and congratulate the 2002-2003 LAC committee for their great work and accomplishments. The new LAC committee will be appointed within the next 30 days. In the next 2 weeks I will be discussing the restructure and will also provide information on how you can be an important part of this committee.
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Legislative Affairs Committee - CURRENT ACTIVITIES 