TMA members listen to speakers during the TMA Fall Conference General Session.

From left, TMA President Carlos J. Cardenas, MD; Kirk Cole, Texas Department of State Health Services interim assistant deputy commissioner; and David Teuscher, MD, director of U.S. Department of Health and Human Services Region VI, discussed state and federal responses to Hurricane Harvey.

• If the patient were in your of- MO aY_VN K ZRc]SMKV ObKW LO \O-

quired to treat him or her? Or can elements of telemedicine, such as photo or video images, replace that physical exam?

• Through telemedicine, can a pa- tient convey and provide all of the information you need to treat and diagnose their condition?

• Would the treatment and diagnosis you provide through telemedicine be reK]YXKLVO KXN T_]^S KLVO SX KX in-person setting?

View the panel’s slide deck on the

TMA website at Telemedicine. During a discussion of the 2017

Texas Legislature, Beaumont anes- thesiologist Ray Callas, MD, former chair of TMA’s Council on Legisla- tion, moderated a panel of three of the state’s physician-legislators: Rep. Tom Oliverson, MD (R-Cypress); Rep. 4 . =ROP OVN .9 < 1K^O]`SVVO % KXN Sen.

Charles Schwertner, MD (R-

Georgetown). Dr. Callas recapped several of med-

icine’s biggest legislative victories this year. Along with the landmark tele- medicine legislation, he highlighted the banning of several forms of dis- crimination against physicians based YX WKSX^OXKXMO YP MO\^S MK^SYX% Z\Y- tecting doctors’ ability to bill for their services while expanding balance- billing mediation; and the defeat of

16 TEXAS MEDICINE November 2017

every bill that sought to expand scope of practice for nonphysicians. Dr. Callas asked the three lawmak- ers to name the 2017 legislature’s most important accomplishments, their biggest disappointments of the ses- sion, and what physicians should do before the start of the next session in January 2019. Senator Schwertner said address-

ing problems with Child Protective Services (CPS) was “a bipartisan ef- fort, but I can tell you it was the hard- est legislative endeavor I’ve ever un- dertaken.” Despite the challenge of differing opinions on how to improve the CPS system, Senator Schwertner was proud of the work that resulted in ]SQXS MKX^ P_XNSXQ PY\ -:= KXN ZYVSMc reforms. Representative Oliverson said

he’s proud of the legislature adopt- ing an emphasis on greater behavioral health, including the passage of bills such as House Bill 10 to improve ac- cess to mental health services. HB 10 establishes a state mental health par- S^c aY\UQ\Y_Z KXN MVK\S O] LOXO ^ terms and coverage for mental health and substance abuse. <OZ\O]OX^K^S`O =ROP OVN \OPO\- enced his efforts to “keep the bad stuff away” when it came to detrimental legislation, which drew applause from the room. “It is good when we pass good leg- islation. Sometimes, there will be a better impact when we kill something

that’s just going to be bad for doctors and bad for the patients,” he said. Among the biggest disappoint- ments of the session, all three legisla- tors cited the increased attempts of nonphysicians to expand their scope of practice into a physician’s domain. Representative Oliverson said he was particularly troubled by relatively new rhetoric from nonphysician practitioners that physicians are “ex- torting money” from them by making them enter into expensive collabora- tive agreements. Refuting that argument, he said, is “something that as the House of Medi- cine, we need to prophylactically look SX^Y KXN b ^RK^ Z\YLVOW LOPY\O S^ QO^] bON PY\ _] SX K aKc aO NYXt^ VSUO v

Health and Human Services Commission

restructures again MORE CHANGES ARE afoot at the Tex- as Health and Human Services Com- mission. The agency announced in August that it will consolidate several programs while adding four members to its leadership team. TMA staff is assessing how the changes might af- fect the provision of quality Medicaid, mental health, and public health ser- vices in the state. The changes are the second phase


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