Texas Doctors Call for Laws to Support Telemedicine

(TNS) — The Texas Medical Association and the Bexar County Medical Society are looking to Texas lawmakers for help cutting red tape and relieving financial pressure worsened by the coronavirus pandemic.

Their most pressing concerns for 2021 will be addressing the state's growing uninsured and underinsured population — calling for legislation expanding Medicaid, improving patient access through telemedicine payment parity and reducing constraints on providers by eliminating time-consuming "prior authorization" requirements.

Representatives of the two groups met with San Antonio Express-News Editorial Board on Thursday to outline their goals for the 87th Texas Legislature, which began Jan. 12. They'll be tracking the bills related to health care and any changes made to proposed legislation. Bills have to be filed by March 12.

Texas already had the highest percentage of uninsured in the nation even before the pandemic left millions of Texans without jobs and many without access to primary care doctors.

San Antonio radiologist  Rajeev Suri  says he's already seen uninsured patients end up in the emergency room because they delayed needed medical care.

Not only do such delays means reduced treatment and recovery options for the patient, they're also costing the state more money in the long run, he said.

Researchers found the state could achieve a net savings of $110 million over the next biennium by expanding Medicaid, according to a recent study sponsored by the Episcopal Health Foundation.

On the telemedicine front, TMA points out that during the COVID-19 public health emergency, Gov.  Greg Abbott  implemented waivers so that virtual health care visits were paid by insurance companies at the same rate as in-person visits. TMA wants the state to ensure these online visits won't go back to the lower reimbursement rates that were being paid.

The group also is calling for legislation that cuts down on the need to get prior authorizations.

Dan Finch , TMA's vice president for advocacy, says it used to be that prior authorizations were required by insurance companies for experimental treatments, but now nearly every medical service goes through the "prior authorization" process.

He says insurance companies use this as a way to control costs, but it's become a "horrendous situation" for medical practices — even delaying needed care by weeks and causing some patients to abandon medical treatment entirely.

Suri says he's had to ask for prior authorization even when it's about covering a medication that the patient has been on for a year.

Many medical offices have hired a full-time employee just to process these requests.

Another legislative priority is the need to strengthen funding for public health departments, which advocates say have faltered during the pandemic as a consequence of years of underfunding.

For example, some public health departments across the state rely on fax machines to keep up with updated COVID-19 data, said Dr.  Diana Fite , a Houston emergency physician and president of TMA.

"A lot of these things have come to light with this pandemic and we want to correct them before the next pandemic," she said.

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