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2007 10.23 Transcript of Hearing of Texas House Appropriations Committee on TMB, Subcommittee Regulatory

2007 10.23 Transcript of Hearing of Texas House Appropriations Committee on TMB, Subcommittee Regulatory

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Published by: Shirley Pigott MD on Feb 10, 2010
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02/26/2010

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Texas Legislative Hearing, Subcommittee on Regulatory,in Oversight of the Texas Medical Board (TMB)October 23, 2007(Draft 12/14/07, all rights reserved to make any corrections against the audio)Chairman: (inaudible) Subcommittee on Regulatory will now come to orderand will the clerk please call the roll?Clerk: Brown?Brown: Here.Clerk: Menendez?Menendez: Here.Clerk: Taylor? Darby?Darby: Here.Clerk: Lucio?Lucio: Here.Chairman: There is a quorum. I’d like to introduce some of our special guests today.Chairman Don Davis, chair of the health and human servicessubcommittee of appropriation. It’s good to have you here. Chairman BillCallegari, Chairman of the regulatory, good to have you here. Corbin VanArsdale, good to have you. [Inaudible, audio issues.] Debbie Riddle(inaudible)Chairman: Let the record show that Representative Taylor is here. And we just got acall folks from one of the golf courses wondering where all of theirdoctors were today. [Laughter] There is an overflow room right acrossthe hall if any of you would like to sit out. Members, this subcommittee ismeeting today to discuss fiscal matters relating to the Texas MedicalBoard. Let me begin by thanking everyone for being here today. Thank you to the members of the Texas Medical Board and their staff for theirattendance. We appreciate your service to the citizens of this state. Thank you to the members of the public for your participation today.As chairman of this subcommittee I take my oversight role very seriously.And to ensure the prudent use of funds of state agencies it is necessary forus to stay informed of agency operations. This is the purpose of thishearing today members. Aside from contingency appropriations andappropriations in the system benefit fund, the Texas Medical Board
 
 2received the third largest general revenue fund increase in percentageterms, almost 19%, and the second largest increase in dollar terms, $2.1million of all regulatory agencies in the 2008-2009 budget.To meet our oversight duty and in light of the great demands for Despont,Texas, medical board resources in recent years, I wanted to hold thishearing today. We will cover the medical boards operations from thefiscal perspective. This allows for latitude, but I would like for everyoneto present questions and testimony with that in mind.This subcommittee, even the full appropriations committee is not acommittee that creates policy or amends laws related to the practice andregulation of medicine. However, as state representatives, we all representcitizens on every aspect of government. To the extent that we heartestimony regarding policy or statutory recommendations we will takethese into consideration, to also forward these recommendations onto themembers of the appropriate legislative committees and the sunsetcommission.Additionally, if you are a doctor and you have a legal proceeding currentlybefore the Texas Medical Board or some other state of adjudication,you’re welcome to discuss that matter with us but in our role as legislatorswe do not have the authority to resolve these matters and we will not beprone to do that today. With that said, we can begin our invited testimony.Members, are there any questions or comments you’d like to make beforewe get started? If not, chair calls the legislative budget board. Hi, Nora.Velasquez: Good Morning.Chairman: Mark Wallace appeared also.Velasquez: Good Morning Mr. Chairman, members of the committee. My name isNora [Velasquez], the legislative budget board. In response to thequestions that you requested for today’s hearing, our office has prepared abrief overview of the Texas Medical Board. Each of you should have apacket similar to this one in front of you.Page one of your packet.Chairman: Does everybody have their copy? Okay.Velasquez: I’ll turn your attention to page one of the packet which includes asummary of expenditures of the fiscal years 2002-09 as well as FDEinformation for each fiscal year. I would like to highlight a correction at
 
 3the bottom of that table for fiscal year ’08 and ’09. That number shouldread 142.5, not 140.In addition to that I would just like to point out that in fiscal year 2003 the78
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legislature passed Senate Bill 104 related to the regulation andenforcement of the practice of medicine. This bill also created a generalrevenue fund which surcharged on physician license registration. Theinitial implementation of this bill required and involved an annualregistration and the collection of the $80. Following future years startingin fiscal year 2005, there was a biannual registration fee. As you will seefrom the table up at the top you will see that the amount of revenuecollected started to decrease after fiscal year 2005.In addition to adding revenue available to help the agency, the bill alsocreated an expert physician panel and strengthened the agency’senforcement activity.As requested, on page two of the packet we’ve included performancemeasure highlights from extended 2002 through fiscal year 2009.At this time I’d like to direct your attention to page three of the packet andbegin with some of the agency’s fiscal year 2006 financial challenges.The medical board presented information regarding a budget shortfall infiscal year 2006. After further review the governor’s office provided theagency with an emergency in deficiency grant in the amount of $375,000.A table that begins at the bottom of page three details the agency’s totalrequest and how those funds were implemented.On page four in fiscal year 2007 the agency submitted a similar request toour agency for a supplemental appropriation for an anticipated shortfallthat fiscal year as well as additional funds to pay for the governor’s grantthat had been provided to them the previous year. To address the agency’sshortfall, the 80
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legislature passed House Bill 18 which appropriated theagency an additional $1.8 million. This money was to be used to pay forthe governor’s grant as well as for expenses in the areas of licensing,enforcement, and information technology. The table on page fourhighlights the agency’s total request and how those funds have beenimplemented.I’d like to move forward to page six of your packet. We have alsoincluded information on the average cost per complaint resolved fromfiscal years 2002-09 as well as expert witness information. The agencyhas reported that expert witness fees for [inaudible 7:22] cases are a majorsource of expense.

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