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as well as a 6% increase for labor and delivery, including
Physicians, students, and Alliance members
advocate for medicine at the Capitol.
maternal health, address maternity care deserts throughout
the state, and sustain hospitals in rural areas.
Significant progress was also made to reduce insurance
burdens including the passing of:
• House Bill 755, which limits prior authorizations
for patients with autoimmune diseases to only
one annually;
• House Bill 1367, which gives Texas Medicaid authority
to pay for medication-assisted opioid or substance
use disorder treatment without prior authorization;
• House Bill 1647, which prevents the practice of
white bagging. White bagging requires patients with
complex or chronic conditions to obtain certain
treatments - especially infusion therapies for
cancer—from specialty pharmacies;
• House Bill 999, which bans co-pay accumulators that
limit the impact of manufacturer contributions on a
patient’s deductible and out-of-pocket expenses; and medicine this session, the battle for physician and patient
• House Bill 3359, which provides network adequacy
protections and restricts insurers from making
unilateral contract changes.
Additionally, several bad insurance bills were
defeated, including:
• House Bill 2414, which would have allowed
insurance companies to steer patients to the
physicians of their choosing;
• Senate Bill 1581, which would have established an
advisory committee to analyze any regulation-
imposing legislation for health plans;
• House Bill 3351, which would have reduced
physician protections in insurers’ ranking-and-tiering
programs; and
• House Bill 1001, which would have reduced
consumer protections and the value of health care
coverage for patients.
In addition to easing insurance hassles for
physicians, the legislature passed a 6% Medicaid
physician reimbursement increase for pediatric care,
TCMS 2023 July • August
cesarean sections and any other procedures performed
during delivery. This was the first Medicaid payment
increase for physicians in over a decade. On the litigation
front, the medical liability reforms achieved in 2003—
namely the $250,000 cap on non-economic damages—
were preserved.
In the public health space, funding was increased or
maintained for behavioral health services, school safety
measures, cancer awareness and research, epidemiology
and surveillance, childhood vaccines, the prevention of
HIV and sexually transmitted infections, and nicotine
cessation and prevention efforts. In addition, Senate
Bill 629 requires school districts to make overdose
reversal medications (i.e., naloxone) available on
campuses beginning in grade six, while House Bill 3908
allows for fentanyl abuse prevention and awareness
education in public schools. House Bill 4758 prohibits
e-cigarette containers from including images designed
to appeal to minors, such as cartoon-like characters or
candy. Regarding end-of-life care, House Bill 3162
protects the state’s existing statute governing
advance directives and do-not-attempt-resuscitation
(DNAR) orders.
Advocacy is at the core of TMA and TCMS’
mission to stand up for Texas physicians and their
practices. While many advancements were made for
rights continues, and we urge you to join us in the fight.
Preparations are already underway for the next legislative
session in 2025.
For more information about our legislative advocacy
efforts, visit the TCMS advocacy page at www.tcms.com
or TMA’s page at www.texmed.org.
Drs. John Hellerstedt and David Fleeger discussing
the issues with legislators.
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