|CNAP Legislative Update # 13
Lynda Woolbert, Executive Director
Coalition for Nurses in Advanced Practice
May 15, 2011
In this issue:
CSHB 1266 does not survive House deadlines
PA business bill: HB 2098
TNA successful in amending HB 1013
FTC finds APRN bills would be good for Texas consumers
HB 1266’s Second Life Short-lived
As reported in last week’s update, the House Public Health Committee substituted HB 1266 with a version of the bill that would require an interim study. The committee recommended passage by the full House on a 7-2-2 vote with the two physicians, Representatives Schwertner and Zerwas, voting against and Representatives Sarah Davis and Vicki Truitt identifying themselves as “present, not voting.”
CSHB 1266 was reported out of the committee by the May 10th deadline. However, the House Calendars Committee failed to set the bill. CSHB 1266, like thousands of other House bills, officially died at midnight Thursday, May 12th, the last day for the House to consider House bills on Second Reading.
PA Business Bill is Bad Business for APRNs
One bill that made it past the House legislative deadlines is HB 2098 by Rep. John Davis (R-Houston, HD #129) which would allow physician assistants (PAs) to form business entities with physicians. At first glance, many APRNs might wonder why APRNs are not part of this bill.
Allowing physicians and APRNs to form partnerships, professional associations and various corporate entities, has been a goal for CNAP since the 1990s. (Click the link to se CNAP’s position statement on physicians and APRNs owning business entities.) However, more than one concern prevented us from trying to add APRNs to this bill.
During the 2009-2010 Interim, the PA Board asked the Texas Medical Board (TMB) for guidance on whether a PA could own a practice and contract with a physician to provide medical supervision. In testimony before the Senate State Affairs Committee on HB 2098’s companion bill, SB 961 by Senator Carlos Uresti (D-San Antonio, SD #19), TMB Executive Director Mari Robinson stated the bill would settle the issues surrounding PA ownership. She explained that, if the bill did not pass, the TMB would have to adopt rules to regulate PA ownership. She also said the bill’s committee substitute would include provisions that would prohibit a PA from being an officer in the corporation and prevent contracting with a physician for supervisory services.
Even in the introduced version, this bill had some significant restrictions that made us hesitant to try to include APRNs in the bill, such as limiting a physician assistant or a combination of PAs to only having a minority ownership interest. Then listening to the hearings on the bill and its companion convinced us that APRNs should stay as far away from this bill as possible. Sure enough, as H.B. 2098 passed the House (engrossed version), the bill included the provisions Mari Robinson predicted.
Obviously, provisions that prevent APRNs from being an officer or prevent APRNs from contracting with physicians to delegate prescriptive authority would be devastating to APRNs who own their own practices. We will continue to monitor the bill and, if it becomes law, we will carefully follow TMB’s rule adoption process to be sure that APRNs are not included in those rules.
Congratulations TNA Again
As you may remember, nurses responded quickly to TNA’s request to contact House members about HB 1013, relating to the powers and duties of the Texas Medical Board. The bill would have eliminated a nurse’s right to remain anonymous if the nurse filed a complaint against a physician to the Texas Medical Board. I am delighted to report that Rep. Donna Howard’s amendment was adopted on the House Floor during Second Reading on May 9th. The bill will now be considered by the Senate.
FTC Weighs In
Despite failure of our APRN prescriptive authority bills to pass, APRNs in Texas are still making progress. On May 11th the Federal Trade Commission (FTC) published an announcement concerning its letter to two Texas Senators. The announcement and letter highlight the fact that independent prescriptive authority for APRNs would be good for health care consumers in Texas.
Senators Royce West and Rodney Ellis wrote a joint letter to the Federal Trade Commission (FTC) asking the agency to evaluate their APRN independent prescriptive authority bills, SB 1339 and SB 1260, for their potential impact on health care for consumers in Texas. The FTC’s 5-0 vote supporting the staff’s opinion highlights the fact that independent prescriptive authority for APRNs in Texas is inevitable.
The FTC letter is the kickoff of our 2011-2013 campaign to remove physician delegation for APRN’s authority to diagnose and prescribe. Help yourself by sending this notice to your legislators with a note thanking them for all their hard work this session and explaining that the FTC letter is just one more reason that they should vote for APRN independent prescriptive authority in 2013.
TNP members can log on to the TNP website at www.texasnp.org to review the specifics of the letter.