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LEGISLATIVE WRAP-UP

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Several other insurance bills important to
medicine also reached the governor’s desk.
Medicine scored • House Bill 170 (Bernal) requires certain health plans that cover
Among them:

solid legislative a screening mammogram to provide at least the same level of
coverage for a diagnostic mammogram.
wins that will make • Senate bills 747 and 748 (Kolkhorst) collectively provide and set
up funding for newborn genetic screening tests. SB 747 requires
it easier for patients HMOs to cover newborn genetic screening tests as part of a
well-child exam, and also prohibits plans that provide maternity
coverage from excluding or limiting coverage for those tests.
and physicians to • House Bill 2041 (Oliverson) will require freestanding emergency
centers to post conspicuous notices that let patients know the fa-
know who’s in network, cility or the physician may be out of network, and to provide a
disclosure statement listing possible observation and facility fees.
and provide needed • House Bill 3041 (C. Turner) requires health plans to allow a
physician to request renewal of a prior authorization at least 60
transparency on days before it expires.

preauthorization Triumph Over Tobacco
Texas physicians got the kind of huge win on tobacco issues they
requirements. haven’t seen in decades – a law to keep tobacco products away from
young people.
The Tobacco 21 measure, or Senate Bill 21, raises the minimum
age to purchase tobacco and vape products to 21 years, except for
military personnel.
craft an imperfect but improved replacement bill, featuring an arbi- “It’s going to be one bite out of the elephant to help eliminate
tration process that takes the patient out of surprise-billing battles tobacco addiction among some of our youth,” said Rep. John Zer-
while giving physicians a fairer shake on payment. was, MD (R-Richmond), who carried the legislation with Sen. Joan
On a significant issue contributing to balance billing – network Huffman (R-Houston).
shortfalls – House Bill 3911 (Vo and Campbell) requires the state The law takes the critical step of keeping young people away from
insurance commissioner to examine PPO plans for network ade- tobacco products, Representative Zerwas says. Research shows that
quacy at least once every three years. about 95% of smokers become addicted to tobacco before age 21,
Sen. Donna Campbell, MD (R-New Braunfels), said discussions and areas that raise the age for tobacco purchases usually see de-
on balance billing during the past few sessions typically have cen- clines in sales to young people.
tered on out-of-network practitioners and facilities, without consid- Representative Zerwas says the goal of the law, which takes effect
ering the role health plans and network adequacy play. She says with Sept. 1, is to prevent teens 17 and younger from smoking because
HB 3911, PPOs will be held accountable to the Texas Department “kids who become addicted at a very young age have a dismal op-
of Insurance the same way HMOs have been. portunity for kicking the habit ultimately.”
“We pay our insurance premiums every month to get the care Texas joins 14 other states and more than 475 cities and counties
that [we] need if we need it. Insurance companies are supposed to across the country in raising the age for purchasing tobacco products.
pay,” she said.
“Insurance companies have gotten more onerous for providers “We’re the first major ‘conservative’ state to pass this
trying to get paid. This is just a small thing, but if it helps in any big for sure,” Representative Zerwas said. “That will help
way, then that’s what we need.” blaze the trail for others to follow suit.”

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14 San Antonio Medicine • August 2019