Texas Legislative Update

June 2023

2023 Legislative Session: Success for Emergency Physicians

Now that Texas has reached the end of the regular 88th Legislative Session (Sine Die), the work to sort out what actually happened and how it impacts emergency medicine actually begins. The legislature worked up until the very end to pass the budget and other key pieces of legislation, but the Governor has indicated that he will call the legislature back for a series of special sessions to renew efforts to pass his high-priority issues that failed during the regular session. In fact, he called the first of these only hours after the legislature adjourned to take up property tax relief and border security.

Prior to the legislative session, TCEP had identified several policy areas that it wanted to focus on. Priorities included protecting physician liability, increasing psychiatric access in the emergency department, improving telemedicine capabilities, and curtailing scope of practice expansion. Overall, the organization aimed to address these policy areas through advocacy, education, and collaboration with stakeholders.

Physician Liability/Tort Reform: Successful Outcome – No bills were passed that are detrimental to physician liability.
One of the key areas that TCEP focused on during the session was protecting physician liability. This was an important issue for emergency medicine physicians, who often face significant legal risks when treating patients in high-pressure situations. To address this concern, TCEP worked in conjunction with other stakeholders to help protect physicians from bills that would have opened them up to frivolous lawsuits and other legal challenges. Successful protection of our Tort Reform law.

Increase access to psychiatric care in ED: Successful Outcome- Passed bill, awaiting Governors signature.
Another priority for TCEP was increasing access to psychiatric care in the emergency department. This was seen as a critical need, given the growing number of patients who present with mental health issues in emergency settings. TCEP worked closely with other stakeholders to develop new protocols and procedures for assessing and treating patients with psychiatric needs. Senate Bill 1624 by Senator Judith Zaffirini addresses this issue and is currently awaiting the governor's signature.

Telemedicine: Successful Outcome – Bill passed, awaiting Governor signature.
TCEP also focused on improving telemedicine capabilities in emergency medicine. This was seen as a key way to improve patient outcomes by enabling physicians to provide more timely and effective care, even in remote or underserved areas. House Bill 617 by Representative Darby aims to expand telemedicine services in Texas, including emergency medicine, through a pilot project. The bill has been sent to Governor Abbott and awaits his signature to become law.

Scope of Practice, Value Based care, ranking and tiering practices: Successful outcome – defeated all bills.
With over 8,300 bills filed this session, many of which touched healthcare, medicine had to play a lot of defense this session. However, we remained steadfast in our commitment to patient care. With a focus on defending against harmful measures, we were able to successfully defeat proposals such as value-based care, ranking and tiering practices, and scope of practice expansion. Through our tireless efforts, we ensured that patients would continue to receive the highest quality care from qualified healthcare professionals. We remain dedicated to advocating for policies that prioritize patient health and wellbeing.

Network Adequacy: Successful Outcome: Bill passed, awaiting Governor signature.
A priority bill for medicine and all physicians this session that has passed the legislature and is awaiting the Governor’s signature is House Bill 3359 by Representative Greg Bonnen. House Bill 3359 amends current law relating to network adequacy standards and other requirements for preferred provider benefit plans(PPOs).This bill was negotiated with stakeholders almost up until the point of final passage, and seeks to codify measurable network adequacy standards for PPOs while requiring carriers to meet these standards prior to offering the networks. It also increases the transparency of the waiver process by requiring public hearings for waiver requests and limits the number of waivers allowed to be issued by TDI and the reasons for issuing them.

Workplace Safety: Successful Outcome – Both bills passed and signed by Governor. Effective September 1st.
Senate Bill 240 by Senator Campbell and Senate Bill 840 by Senator West are two priority pieces of legislation that will have a significant impact on workplace safety. These bills are designed to address the issue of workplace violence, which has become a growing concern in recent years. Senate Bill 840 increases the penalty for committing assault against hospital personnel, which is a critical step in protecting those who work in healthcare settings. By increasing the penalties for these types of crimes, a clear message can be sent that violence against healthcare workers will not be tolerated. Additionally, Senate Bill 240 provides additional resources and training to help prevent workplace violence from occurring in the first place. This includes training for healthcare workers on how to recognize and respond to potential threats. Both bills have been signed by the Governor and take effect September 1st.

As the deadline for vetoing legislation approaches, Governor Abbott is faced with the task of reviewing the hundreds of bills that continue to reach his desk. The veto deadline is June 18th and the pressure is on for the Governor to make decisions on which bills to sign into law and which ones to reject. As of this writing, Governor Abbott has vetoed two bills, and this number will likely grow as he reviews each bill carefully. While some bills, like the network adequacy and emergency detention bill, are still awaiting determination, others have already been signed into law. Governor Abbott has made it clear that he will not hesitate to veto any legislation that he believes does not serve the best interests of Texans. The legislature's adjournment also gives the Governor the option to allow bills he has not signed or vetoed within 20 days to automatically become law.

In addition to the regular session, the interim period presents a crucial opportunity for legislators to continue their work. With directives given to committees to study specific policy issues, this time can be used to gather data and insights that will inform future legislation. The recommendations made by these committees can have a significant impact on the direction of policy in the years ahead.

This report was compiled by TCEP lobby firm, Imperium. Many thanks to the House of Medicine lobby team, TCEP membership and especially the TCEP Legislative and Advocacy Council who testified, studied the bills, and gave input.