Highlights of the Regular Session of the 83rd Texas Legislature (2013)

It was a tumultuous end to the regular session of the 83rd Texas Legislature, and with Gov. Rick Perry’s announcement of a special session, lawmakers were not done. Below is a brief look at the legislation passed and the measures that fell short during the 140 days of the regular session. Approximately 5,868 House and Senate bills were filed, and some 1,436 bills were passed and sent to Perry for his consideration.

During the final weekend of the session, Texas House and Senate leaders approved the state’s budget for the Fiscal Years (FYs) 2014-15 biennium. Agreement on the FYs 2014-15 General Appropriations Bill, Senate Bill 1 by Senator Tommy Williams, was closely linked to two other major pieces of legislation introduced by the chairman of the House Appropriations Committee, Representative Jim Pitts: House Bill 10, the principal bill used to authorize additional spending for the current FYs 2012-13 biennium, and House Bill 1025, appropriating final funding for FYs 2012-13 and providing a means for resolving the state’s water projects.

While Medicaid caseload and cost increases are not fully funded, the two-year, $197 billion all-funds budget represents a significant increase over the $173 billion all-funds amount appropriated by the previous Texas Legislature in 2011. The good news for hospitals is that the Legislature agreed to provide up to $300 million for the FYs 2014-15 Medicaid Disproportionate Share Hospital (DSH) program and that money for trauma and nursing education funding is provided at or above FYs 2012-13 amounts. Unfortunately, the state budget also includes savings from Medicaid cost containment initiatives, which will significantly impact hospitals.

Some of the key session successes include, but are not limited to, the following:

  • The $6.6 billion state-funded supplemental appropriations bill plugged most of the budget holes for the FYs 2012-13 biennium left by the 2011 Texas Legislature. Included in the appropriation was approximately $4.5 billion in state funds for the Texas Medicaid program, which addresses the $4.5 billion shortfall when legislators short-funded forecasted Medicaid claims during the 2011 legislative session.
  • $138 million in state funding for the FY 2013 Medicaid DSH program. After federal match, the appropriation will help to fund about $338 million in Medicaid DSH payments to non-state hospitals in the current year.
  • Another important Medicaid provision in the budget appropriated as much as $300 million in state General Revenues in FYs 2014 and 2015 to improve Medicaid hospital payments either as DSH or through rate adjustments.
  • $33.75 million was protected for the biennium to allow nursing schools to maintain the increased enrollment they have achieved with some schools possibly expanding their programs (an increase of $3.75 million over current biennium).
  • Relative restoration and prioritization in funds for Graduate Medical Education (GME):
    • Almost $9 million to increase the Health Related Institution GME formula;
    • Almost $13 million for the Family Practice Residency Program;
    • Almost $2 million to the Texas Higher Education Coordinating Board (THECB) to award planning grants to hospitals that have never had residency programs; and,
    • $12 million to the THECB for GME expansion.
  • No harmful “treat-until-transfer” requirement for end-of-life care situations.
  • No undermining of medical liability and tort reforms, including efforts to assail existing peer review and credentialing provisions.
  • No legislation passed imposing mandatory, arbitrary nurse-staff ratios.
  • No repeal of the Driver Responsibility Program, which is the major source of funding for trauma facilities and emergency medical service providers (trauma payments to hospitals will be approximately $57.5 million per year in FYs 2014 and 2015).
  • No changes to Texas’ charity care and community benefit statute.
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