House Democrats’ Six Day Filibuster
Prevents Passage of CSSB 2397

Attempt to Amend Senate Bills blocked

Capitol Update
Thursday, May 28, 2009
Austin, Texas

Our efforts to revise the Texas Medical Practice Act in the 2009 Texas Legislature have been blocked.  The struggle in this legislative session was one in a series of battles in our war to require transparency of the actions of the Texas Medical Board, ensure legal due process for physicians subject to complaints and to protect patients’ and physicians’ rights.  Although CSSB 2397, which contained many provisions from CSHB 3816, was set on the Major State Calendar in the Texas House, it did not come up for a vote prior to the Tuesday midnight deadline. 

Last Thursday, May 21st, the Democrats decided to prevent any action on the Voter ID bill which was also on the Major State Calendar.  The tactics they used were to extensively debate hundreds of bills for six days on the Local and Consent Calendar until the Tuesday midnight deadline.  Because of this, no bills on the Major State Calendar or General Calendar, of which there were hundreds and hundreds, were ever brought up for a House vote and effectively died this session.  CSSB 2397 was one of those bills.

When the House Democrats started to filibuster, known as chubbing, we realized that we needed to amend some provisions from CSHB 3816 onto bills that were already in the Senate.  HB 732, by Rep. Hartnett, was the most likely vehicle.  Rep. Hartnett agreed to have Sen. Dan Patrick co-sponsor this in the Senate.  Before he could do this the bill was intercepted and the chair of the Senate Health and Human Services Committee, Sen. Jane Nelson, passed the bill to Sen. Joan Huffman.  I met with Sen. Huffman personally and requested that she place the following amendments on her bill:

Section One: Seven (7) year Statute of Limitation on complaints.
Section Two: Elimination of confidentiality of complainant with exceptions for patients, employees or subordinates.
Section Three: Elimination of anonymous complaints; requires insurance companies to notify a physician if files a complaint against him
Section Four: Allows physicians 45 days to respond to the TMB after receiving a complaint; members of the TMB expert witness panel must be actively practicing medicine.

Despite appeals made by Lt. Governor Dewhurst, Rep. Hartnett and numerous co-authors of HB 3816 in the House, Senator Huffman declined to allow us to offer any amendments.

The TMA, their in-house governmental affairs team and army of hired-gun lobbyists worked against us every step of the way.  They are a formidable enemy.  The health insurance companies also opposed our efforts behind the scenes.  One health insurance lobbyist told one of our insiders that “we use confidential complaints to go after doctors.”  There appears to be an unholy alliance between the TMA, Texas Medical Board (TMB) and health insurance companies.

We then turned our attention to another bill, HB 2845, sponsored by Rep. Riddle and co-sponsored by Sen. Robert Nichols in the Senate.  Lt. Governor Dewhurst was a great ally in our efforts and set up a meeting with Senator Nichols, me and the Association of American Physicians and Surgeons’ (AAPS) lobbyists, Allen Blakemore and Stephen Raines, which occurred Monday night at 9:45pm. At that meeting Senator Nichols reviewed our amendments for thirty minutes. Sen. Nichols said he supported the amendments but said he would have to find out if they were germane to the bill itself.

At 5: 30 pm on Tuesday, May 26th, we had a meeting with Lt. Gov. Dewhurst, Sen. Nichols and Karina Davis, Senate Parliamentarian in the Lt. Governor’s office. We were told that our amendments to SB 2845, co-sponsored by Sen. Nichols, were not germane. This means that we could not amend our language onto HB 2845.

Lt. Governor Dewhurst promised to order an interim hearing of the Texas Medical Board chaired by Senator Nichols. Sen. Nichols was in full agreement with this proposal and animated when he agreed. We will be working with Lt. Gov. Dewhurst and Senator Nichols to set up an interim hearing. Lt. Gov. Dewhurst also promised to bring media attention to the need for substantial reforms at the TMB.  

The members of the 2009 Texas Legislature knew that we were here. We exposed the injustices of the TMB to the legislators. Strong relationships with numerous legislators were also developed.

We must continue to press the battle to its successful conclusion!

Confident of our ultimate success, I remain, as always,

Sincerely yours,

Steven F. Hotze, M.D.
President
Texans for Patients’ and Physician’s Rights
20214 Braidwood, Suite 215
Katy, Texas 77450
281.698.8679 - Stacey Bandfield, Director of Public Relations
stacey.bandfield@hotzehwc.com 
www.txppr.org

Keep Pressure on Senator Huffman

Austin, Texas
Monday, May 25, 2009

Right now our best chance to obtain any changes at the Texas Medical Board rests in the hands of Sen. Joan Huffman of Houston. Hopefully, over the weekend, she has reconsidered her unwillingness to help on this matter.

Please call and send e-mails to Senator Joan Huffman’s office and ask her to allow HB 732, which she is co-sponsoring in the Senate, to be amended with some key provisions from CSHB 3816.  . We want to amend some provisions from HB 3816 onto HB 732. These amendments would provide transparency of the TMB’s actions, ensure legal due process and protect patients’ and physicians’ rights. Rep. Hartnett, author of HB 732, agrees to have his bill amended in the Senate. Lt. Gov. Dewhurst wants this bill amended as well. Sen. Huffman holds the key to revising the Texas Medical Practice Act.                         

Amending HB 732 is our best opportunity for success!

Sen. Joan Huffman - (o) 512.463.0117

Emails

Sen. Huffman: joan.huffman@senate.state.tx.us
Legislative Director: jonathan.stinson@senate.state.tx.us
Legislative Aide, Health Policy: Kyle.kamrath@senate.state.tx.us

We have a great opportunity in the Senate to ensure more legal due process in the way the Texas Medical Board handles physicians subject to complaints, by amending HB 732, by Hartnett. We have an amendment ready which would incorporate four (4) provisions of CSHB 3816, which passed the House Public Health Committee by a 10-1 vote,  but died when time ran out in the House two weeks ago.

Section One: Seven (7) year Statute of Limitation on complaints.

Section Two: Elimination of confidentiality of complainant with exceptions for patients, employees or subordinates.

Section Three: Elimination of anonymous complaints; requires insurance companies to notify a physician if files a complaint against him

Section Four: Allows physicians 45 days to respond to the TMB after receiving a complaint; members of the TMB expert witness panel must be actively practicing medicine.

Please find attached the Synopsis of Senate Amendment to HB 732 and HB 732 Senate Amendment.  

I have recommended for Sen. Huffman’s consideration that she reevaluate the issue at hand. The provisions that we are suggesting as amendments above allow a semblance of legal due process to be incorporated into the complaint system at the Texas Medical Board.

As a former criminal judge Sen. Huffman surely realizes the significance of the 6th Amendment of the Constitution. In it we find the underlying principles which have been incorporated in Anglo and American civil and criminal jurisprudence for hundreds of years, 1) the right to know your accuser, 2) the right to know the accusations against you, 3) the right to know the identity of witnesses against you, and 4) the right to have witnesses testify in your behalf. The Texas Medical Board does not allow any of these basic legal due processes. These rights should be provided and it seems that Sen. Huffman, as a former State District Criminal Judge, would be the first to endorse this policy.

Sen. Huffman was known as a judge who did not tolerate injustice. I am confident that she will do the right thing in this situation and allow us to amend HB 732.

Your contacting of Rep. McCall has paid off! CSSB 2397 has been placed on the House Major State Calendar for Tuesday. It is the vehicle in the House which contains key provisions from CSHB 3816. Due to the Democrats slowing down the process to prevent having to vote on the Voter ID bill, it is uncertain whether the House will get a chance to vote on this bill prior to this Tuesday night deadline.

We must continue to press the battle!  Please contact your state representative and senator and encourage them to support CSSB 2397.

You can locate your state representative or senator and his or her contact information at http://www.house.state.tx.us/resources/faq.htm#who_rep

Confident of our ultimate victory, I remain, as always,

Sincerely yours for liberty,

Steven F. Hotze, M.D.
President
Texans for Patients’ and Physician’s Rights
20214 Braidwood, Suite 215
Katy, Texas 77450
281.698.8679 - Stacey Bandfield, Director of Public Relations
stacey.bandfield@hotzehwc.com 
www.txppr.org

View the Testimony on the Senate Hearing
Tuesday May 05, 2009, Senate Health and Human Services Commitee on SB 2336
(Real Player Video)
Fast forward to 57:00 minutes for Introduction.
Fast forward to 103:00 minutes for the testimony of Dan Munton, M.D.
Fast forward to 110:30 minutes for the testimony of Andrew Schlafly, General Council, AAPS.
Fast forward to 118:30 minutes for the testimony of Steven F. Hotze, M.D.

CSSB 2397 in

Calendars Committee

May 21, 2009

CSSB 2397 is currently in Calendars. We are working with the House Calendars Committee, and expect Calendars to set it for a full vote before the Tuesday, May 26th, midnight deadline.

Please contact your state representatives to support CSSB 2397 when it comes up for a vote.  Several key provisions from CSHB 3816 have been included in this bill and it will be further amended on the House floor. 

You can locate your state representative and his or her contact information at http://www.house.state.tx.us/resources/faq.htm#who_rep

We will continue to update you on this crucial legislation.

Sincerely yours for liberty,

Steven F. Hotze, M.D.
President
Texans for Patients’ and Physician’s Rights
20214 Braidwood, Suite 215
Katy, Texas 77450
281.698.8679 - Stacey Bandfield, Director of Public Relations
stacey.bandfield@hotzehwc.com 
www.txppr.org

House Public Health Committee Hearing Today on SB 2397
Wednesday, May 20th, 2009

There will be a House Public Health Committee hearing today, Wednesday, May 20th  on SB 2397. Many of the provisions within CSHB 3816/SB 2336 will be incorporated into Senator Nelson’s bill, SB 2397. SB 2397 will be amended and become CSSB 2397.  It will contain the elimination of confidentiality of complaints where the identity is kept from the doctor except for patients, employees and subordinates who wish to remain confidential. It will also contain several other provisions, including:

• A seven-year statute of limitations on complaints to prevent the current practice of abusive complaints, some going back as far as 29 years.

• Elimination of confidential complaints (with narrow exceptions for patients, employees and subordinates) and provide the accused physician with a copy of the complaint.

• Anonymous complaints are eliminated.

• Abuse of the complaint process by insurance companies shall be grounds for imposing sanctions by the commissioner of the Texas Department of Insurance.

• Physicians may request the recording of the ISC disciplinary proceeding.

There will also be amendments offered for CSSB 2397 when it comes to the floor late this week, either Friday or Saturday.  We will keep you posted on the progress of this crucial legislation!

Sincerely yours,

Steven F. Hotze, M.D.
President
Texans for Patients’ and Physician’s Rights
20214 Braidwood, Suite 215
Katy, Texas 77450
281.698.8679 - Stacey Bandfield, Director of Public Relations
stacey.bandfield@hotzehwc.com 
www.txppr.org

Time Runs Out in 3rd Quarter Alternative Course of Action
to Pass Provisions of CSHB 3816

Austin, Texas
May 15, 2009

The Texas House ran out of time last night and did not get to hundreds and hundreds of bills before the 12 midnight deadline for passing House bills this session. This means that we will have to use alternative routes to get the provisions of CSHB 3816 enacted by the legislature. We are now in the fourth quarter of the game!

We have been developing several other ways to accomplish this for the past several weeks in the event that we ran out of time in the House. So we are on to Plan B. We must continue to press the battle!

Please know that I remain confident that we will pass significant revisions to the Texas Medical Practice Act in the 2009 Texas Legislature.

Please continue to call your State Representatives and Senators and tell them that you want them to vote for legislation which revises the Texas Medical Practice Act.

You can locate your state representative or senator and his or her contact information at http://www.house.state.tx.us/resources/faq.htm#who_rep.

The provisions of CSHB 3816 revise the Texas Medical Practice Act to prevent competitors, insurance companies, drug companies and hospitals from filing anonymous complaints against physicians. It prohibits conflicts of interest to prevent board members from working for insurance or other companies who are adverse to patients and physicians.  It provides for transparency of the actions of the Texas Medical Board, ensures legal due process and protects patients’ and physicians’ rights from regulatory abuse.  

Visit the Texans for Patients and Physicians website, www.txppr.com, to read CSHB 3816.

Synopsis of the Provisions of C.S.H.B. 3816 which we are working to
pass in the 2009 Texas Legislature

1. Eliminates anonymous and confidential complaints and provides the accused physician with a copy of the complaint (with narrow exceptions). This means that competitors, insurance companies, drug companies and hospitals can not file complaints against physicians without revealing their identity to the doctor subject to the complaint.  
2. Abuse of the complaint process by insurance companies shall be grounds for imposing sanctions by the commissioner of the Texas Department of Insurance.
3. A reasonable time of 45 days to respond to complaints (currently the physician must respond in only 14 days, which is far too short for a defense).
4. Prohibition of conflicts of interests by TMB members.
5. Expert witnesses must be actively practicing medicine in the same or similar specialty as the accused physician, and the expert shall review the record with the patients’ and physicians’ identities redacted.
6. No more disregard by the TMB of expert testimony that exonerates physicians subject to complaints; such reports must be provided to the physicians.
7. Transparency by requiring disclosure of the list of names of persons who served on the ISC disciplinary panels during the prior year.
8. A seven-year statute of limitations on complaints to prevent the current practice of abusive complaints that go back as far as 29 years.
9. A physician may practice medicine in a manner currently taught by an accredited organization, and the Board may not direct a physician in how to practice medicine except to prevent actual harm or an imminent risk of harm.
10. Physicians may request the recording of the ISC disciplinary proceeding.
11. The Board must accept the findings of the administrative law judge or contest them in a legal proceeding, rather than ignoring them as the Board does now.
12. The Board shall not discipline a physician for allegedly non-therapeutic care unless it has a likelihood of harm to a patient.
13. Doctors, like attorneys, deserve a right to a jury trial before license revocation.

Confident that, with God’s help and a lot of hard work, we shall be victorious, I remain, as always,

Sincerely yours,

Steven F. Hotze, M.D.
President
Texans for Patients’ and Physician’s Rights
20214 Braidwood, Suite 215
Katy, Texas 77450
281.698.8679 - Stacey Bandfield, Director of Public Relations
stacey.bandfield@hotzehwc.com 
www.txppr.org

Please read the Austin American Statesman article about HB 3816, which appeared on the front page, above the fold, in Wednesday’s paper. The article follows this letter.  

Action List

1. Visit the Texans for Patients' and Physicians' Rights website, www.txppr.com, and read H.B. 3816 and its summary. Place this website on your desktop screen to keep up with the progress of the bill.

2. Contribute $1000, $2000, $5000, $10,000 or more to AAPS to pay for the lobbying expenses needed to secure passage of this bill. Make your check payable to AAPS and send it to my office address below.

3. Contact your State Representative both by phone and e-mail and ask him to cosponsor H.B. 3816. The contact information for your state representative can be found on line at
http://www.house.state.tx.us/resources/faq.htm#who_rep.

4. Contact the officers of your medical association, either TOMA or TMA, and ask them to support H.B. 3816.

5. Enlist the support of your staff and patients. Supply them with this information and have them contact their state representative to ask him to support and sponsor H.B. 3816.

6. Please contact Rep. Fred Brown's and Senator Dan Patrick's offices and tell them "Thank you!" for introducing this legislation to protect patients' and physicians' rights by revising the TMPA.

Rep. Fred Brown – (512) 463-0698

Senator Dan Patrick – (512) 463-0107

Allow me to recommend that you print out this correspondence and keep it on your desk. Ask your assistant to help you accomplish the action list.

Please forward this letter to your colleagues by e-mail and/or distribute printed copies to them.

Working together I am convinced that we shall be successful in passing H.B.3816, bring transparency to the activities of the TMB and protect patients' and physicians rights.

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