(The Center Square) – Companion bills in the Texas House and Senate have been filed to expand health-care access and strengthen price transparency statewide.
State Rep. Drew Darby, R-San Angelo, filed HB 3794 in the House and state Sen. Mayes Middleton, R-Galveston, filed SB 1859 in the Senate.
“Texans deserve access to high-quality healthcare close to home, and this legislation will improve care while empowering both patients and providers,” Darby said. “By introducing stronger price transparency measures, we can ensure Texans have access to high-quality, affordable care. This legislation is a common-sense approach to healthcare that will lead to better outcomes for everyone.”
Under current law, a mandatory delegation framework exists that requires licensed Advanced Practice Registered Nurses (APRNs), including nurse practitioners, to find and enter into a contract with a physician in order to provide care to patients. The physician doesn’t need to be present to see the patient, consult with the APRN about care, or work in the same city or county where the care is being provided.
The bill amends state code to allow nurse practitioners to act as licensed independent practitioners. It defines vocational nursing, APNs, nursing and other terms and services. It also directs the Texas Board of Nursing to adopt rules to allow registered nurses to become APRNs, including licensing, educational and training requirements, according to the bill language.
APRNs are authorized to perform diagnostic tests, give diagnoses, provide treatment for health problems, prescribe therapeutic, nutrition, home health, hospice, physical and occupational therapy, and other services, prescribe medication, make referrals, serve as primary care providers, among other measures. Providers are also given the choice to opt in or out of the mandatory delegation framework.
The proposal also implements price transparency measures that directly impact state-funded programs like Medicaid, the Employees Retirement System and the Teacher Retirement System. It prohibits physicians from billing at a higher rate for APRN’s patient visits unless they personally see the patient and make a decision regarding their care during that visit. Lawmakers argue doing so will eliminate an “abusive billing practice” and drive down healthcare costs.
“This is a commonsense bill that increases access and lowers the cost of healthcare in Texas,” Middleton said. “Advanced Practice Registered Nurses have long filled a vital role in healthcare. This bill will not only remove costly and unnecessary government red tape, but the bill will also improve accessibility to care in low income and rural communities that need it the most. We need to expand access to quality healthcare to as many Texans as we can, and this bill accomplishes exactly that.”
As Texas continues to gain residents and leads the U.S. in population growth, it ranks last nationwide in healthcare access and affordability. The lawmakers point out that 87% of Texas’ 254 counties are “classified as primary care shortage areas;” 46.5% are designated as “maternity care deserts.”
Both result in Texans, especially those living in rural areas, not having access to adequate care, the lawmakers argue. Restrictive licensing laws for APRNs only make matters worse, they argue, because they prevent “qualified providers from practicing independently despite their training, certification, and experience.”
If the bills pass their respective chambers and are signed into law by Gov. Greg Abbott, the changes would bring Texas in line with 27 states that already eliminated similar restrictions.
More than 40 Texas-based organizations support the proposal, including the Texas Conservative Coalition Research Institute, Texas Organization of Rural and Community Hospitals, AARP Texas, Texas Association of Business, and others. The proposal has broad bipartisan support; both the state Republican and Democratic party platforms have endorsed it.
Last month, state Rep. Joanne Shofner, R-Nacogdoches, filed a similar bill, HB 2532.
The efforts follow a multi-year effort led by Abbott to expand the healthcare workforce. After signing executive orders to reduce the regulatory burden on the nursing profession and expand access to nursing services, he also created a task force to address healthcare workforce shortages in Texas.
“Texas has invested millions in job training grants to help prepare students for high-demand, good-paying jobs in our healthcare industry, but we must do more to address this workforce shortage. As Texas continues to grow, it is critical that we bolster our healthcare industry with a highly skilled workforce that will support the health of Texans and drive our booming economy to even greater heights,” he said when announcing the task force’s recommendations. Many of the recommendations are being incorporated into regulatory and legislative reforms this legislative session.
