ADVOCACY

Legislative Activity 2021

TexMEP worked closely with several legislative champions by filing 5 bills and 3 Appropriation Budget Riders in the 87th session. State Senator Charles Perry authored and passed SB1648 to further clarify SB1207 from the 86th session. Other legislative sponsors were Representatives Krause, Parker, Leach, Meyer and Chairman Oliverson. Cosponsors were Representative Cook, Minjarez, Moody, Noble, Rose, and Zwiener. Representative Tan Parker authored and introduce HB3677, HB3678, and HB3679 specifically for HME, DME & CRT.  Adrienne Trigg, TexMEP Legislative Committee Chair, worked collaboratively on authoring the 5 bills, registering and testifying on over a dozen hearings, and tracking 49 of the 319 Managed Care Organization Medicaid bills to advocate and support Texas providers.

Our largest win was passing SB1648 which was signed by the Governor to be effective 9/1/21. The bill will amend the Government Code to require the Health and Human Services Commission (HHSC) to allow a Medicaid recipient with complex medical needs who has an established relationship with a specialty provider to continue receiving care from the provider regardless of whether the recipient has primary health benefit plan coverage. For a recipient without primary health benefit coverage, a Medicaid managed care organization would be required to negotiate a single-case agreement with the specialty provider. The bill would also repeal the expiration date for certain provisions related to the interest list for the Medically Dependent Children Program (MDCP) waiver.

Out-of-network providers would be reimbursed using the methodology under 1 T.A.C. Ch. 353.4 until an agreement is made with the MCO for a single-case agreement. Additionally, the single-case agreement may be higher than the Medicaid fee-for-service rate, which could increase the cost of services.

Texas Power-Dependent Critical Durable Medical Equipment Workgroup

June 4, 2021

On June 4, 2021, TexMEP President, Victoria Peterson, was invited to attend and present at the Disaster preparedness DME Power Committee Meeting chaired by Ron Lucey, the Executive Director of the Texas Governor's Committee on People with Disabilities, regarding the DME industry, our place in the healthcare continuum, and what DME's do to help patients during natural disasters.   Along with Victoria in attendance, was Lauryn Estrella, TexMEP Executive Director, and Mark Gowen of Angel Medical/TexMEP Treasurer.  This meeting has led to FEMA inviting TexMEP to participate on the Texas Power-Dependent Critical Durable Medical Equipment Workgroup.

TexMEP Ice-Cream Capitol Meet-and-Greet

April 26, 2021

On April 26, 2021, TexMEP hosted an Ice-Cream Meet-and-Greet event at the Texas State Capitol Building. This event gave Texas providers the opportunity to meet with almost 200 legislators and staff to discuss the difficulties HME providers face and how these proposed legislative bills could help ease some of those hardships.  In attendance was Adrienne Trigg, TexMEP Legislative Committee Chair, along with Mark Gowen, TexMEP Treasurer, Laurie Bachorek, and other Texas providers who joined in support and discussions.

Though ultimately the sought-after specific language did not pass for HME/DME/CRT this session, with the lowest number of bills passing in the past 20 years, we continue working on creating positive relationships with state legislators and work in Texas’ special sessions to appropriate federal relief money.

MCO Sole-Source Contract Work Continues | TexMEP Wrangles Issues

June13, 2018

The Texas Medical Equipment Providers state association, better known as TexMEP, traveled to the state capitol at Austin in May 2018 for a hearing on Medicaid managed care patient and provider satisfaction, network adequacy and the future delivery of service through a managed care model.

TexMEP President Barbara Leech said she considers Texas fortunate to... click here to view full article

Contesting Sole Source Contracting and Reimbursement Cuts by Medicaid Managed Care Plans

February 3, 2018

Over the past 10 years, DME suppliers have focused their attention on the Medicare and Medicaid fee-for-service (“FFS”) programs. On the Medicare side, suppliers have had to deal with competitive bidding, aggressive auditors, reduced reimbursement, and stringent documentation requirements. On the Medicaid side, suppliers have focused on decreases in reimbursement and an increase in audits and investigations.  Now, there is another challenge…click here to view full article

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