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Featured, from left: Verónica Reyna, Executive Assistant/Office Manager, US Citrus, LLC; Congressman Vicente González, D-McAllen, who serves on the Financial Services Committee and the Foreign Affairs Committee in the U.S. House of Representatives in Washington, D.C.; and Lorena González, on Monday, May 27, 2019, promoting Persian lime produced by US Citrus, LLC, which is located in Hargill northeast of Edinburg. (https://uscitrus.com/products/persian-lime-tree)

Photograph By ISMAEL GARCÍA

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Congressman González to be keynote speaker on Monday, September 16, for Edinburg Chamber of Commerce’s Public Affairs Luncheon

By DAVID A. DÍAZ
Legislativemedia@aol.com

Congressman Vicente González, D-McAllen, is set to be the keynote speaker on Monday, September 16, 2019, for the Edinburg Chamber of Commerce’s Public Affairs Luncheon, which will be held at the Edinburg Conference Center at Renaissance, located at 118 Paseo Del Prado.

The event, for which tickets are available for purchase, will take place from 11:30 a.m. to 1 p.m. 

Tickets for the luncheon are available for $25 each. 

Members of the Edinburg Chamber of Commerce are able to purchase a reserved table of eight for $300, while nonmembers of the Edinburg Chamber of Commerce are able to purchase a reserved table of eight for $350 by calling 956/383-4974, emailing marketing@edinburg.com, or going online at http://www.edinburg.com.

Individual tickets also can be purchased at the event.

Following his remarks, González will take questions from audience members.

A lifetime resident of South Texas, González is married to Lorena Sáenz González, a former teacher and school administrator in Edinburg and McAllen. They reside in McAllen.

González is currently serving his second term in the U.S. Congress as the elected representative of the 15th District of Texas, which encompasses the growing suburban counties of Brooks, Duval, Guadalupe, Jim Hogg, Karnes, and Live Oak as well as portions of Hidalgo, and Wilson counties. 

The announcement of his scheduled appearance in Edinburg came soon after he announced details about the proposed Safe Highway program that would affect vehicle traffic between Mexico and South Texas.

On Tuesday, August 27, 2019, González sent letters to Mexican Ambassador to the United States Martha Bárcena and Secretary of Security and Civilian Protection Alfonso Durazo urging Mexico to create a timeline for the implementation of the Safe Highway program. 

He also asked for an assurance that Highway 40, which is part of the Safe Highway program, and a connection to U.S. – Mexico international bridges, is secured before a vote for the United States-Mexico-Canada Agreement (USMCA) is considered in Congress. 

The Safe Highway Program, which includes Highway 40 from Monterrey, Nuevo León to Reynosa, Tamaulipas to McAllen is one of six highways that will be part of the pilot program.

“For the United States and Mexico to continue reaping the benefits of North American trade, each country must fulfill its commitments to efficiency, security, and rule of law,” said González. “Proper implementation of the Safe Highway program will undoubtedly allow for the successful implementation of the United States-Mexico-Canada Agreement and encourage more cross-border commerce. I ask that the Mexican government make it a priority to secure Highway 40D all the way to each international bridge connecting Tamaulipas with South Texas.”

In late March 2019, González traveled to Mexico City to meet with Durazo. During the meeting, González expressed the importance of securing Highway 40 — a major artery for cargo and passenger vehicles traveling between Monterrey, Reynosa, and the United States — for both trade and tourism.

Currently, there are no protection guarantees for freight and passenger vehicles leading up to the international bridges that connect the U.S. and Mexico which include: Pharr International Bridge; Anzalduas International Bridge; Veterans International Bridge; Starr Camargo Bridge; Donna Rio Bravo International Bridge; Gateway International Bridge; and the Juarez-Lincoln International Bridge.

The security and safety of cross-border commerce and travelers from the United States to Mexico remain a top concern for González as he weighs his vote on the USMCA.

According to Wikipedia, USMCA is:

The Agreement between the United States of America, the United Mexican States, and Canada is a signed but not ratified free trade agreement between CanadaMexico, and the United States. It is referred to differently by each signatory—in the United States, it is called the United States–Mexico–Canada Agreement (USMCA); in Canada, it is officially known as the Canada–United States–Mexico Agreement (CUSMA) in English(though generally referred to as “USMCA” in English-language Canadian media) and the Accord Canada–États-Unis–Mexique (ACEUM) in French; and in Mexico, it is called the Tratado entre México, Estados Unidos y Canadá (T-MEC). The agreement is sometimes referred to as “New NAFTA” in reference to the previous trilateral agreement it is meant to supersede, the North American Free Trade Agreement (NAFTA).

The Agreement is the result of a 2017–2018 renegotiation of NAFTA by its member states, which informally agreed to the terms on September 30, 2018, and formally on October 1. The USMCA was signed by U.S. President Donald Trump, Mexican President Enrique Peña Nieto, and Canadian Prime Minister Justin Trudeau on November 30, 2018 as a side event of the 2018 G20 Summit in Buenos Aires. Each country’s legislature still must ratify the agreement.

Compared to NAFTA, USMCA increases environmental and labor regulations and incentivizes more domestic production of cars and trucks. The agreement also provides updated intellectual property protections, Currency close, gives the United States more access to Canada’s dairy market, imposes a quota for Canadian and Mexican automotive production, and increases the duty-free limit for Canadians who buy U.S. goods online from $20 to $150.

(https://en.wikipedia.org/wiki/United_States–Mexico–Canada_Agreement)

González serves on the House Committee on Financial Services on the Subcommittees on Investor Protection, Entrepreneurship and Capital Markets; Housing, Community Development and Insurance; and Diversity and Inclusion. In his second term, he was appointed to the House Foreign Affairs Committee in the 116th Congress to promote stability, safety, success, security around the world.

He has advocated for revamping American foreign policy in Central America and a fresh start for U.S. – Mexico bilateral relations. He serves on the Subcommittees on Western Hemisphere, Civilian Security, and Trade; and Europe, Eurasia, Energy, and the Environment.

González earned his GED in 1985 before attending Del Mar College where he received an Associate’s Degree in Banking and Finance in 1990. He worked his way through college at Embry Riddle University where many of his classmates were active-duty military personnel. He earned a Bachelor’s Degree in Business Aviation in 1992 and later earned a Juris Doctorate degree from Texas Wesleyan University School of Law (now Texas A&M School of Law) in 1996. 

While attending law school, González worked as an intern in the office of former Congressman Solomon P. Ortiz. 

In 1997, he opened his law practice, V. González & Associates.

“PATIENT HEALTH CARE PROTECTION LAW”, APPROVED BY LEGISLATURE, TO HELP PATIENTS AVOID SURPRISE BILLS, SAYS SEN. JOSÉ MENÉNDEZ, D-SAN ANTONIO

The “Patient Health Care Protection Law” (Senate Bill 1742), which became law on Sunday, September 1, 2019, will work on behalf of both healthcare consumers and providers by requiring a health plan’s network directory to clearly identify which medical providers are in-network at network facilities as well as key reforms to prior authorization protocols, ensuring patients are getting value out of the premiums they pay to health insurance companies, says Sen. José Menéndez, D-San Antonio.

Menéndez was the author of SB 1742, which was unanimously approved by the Texas Legislature.

Sen. Dawn Buckingham, R-Lakeway, Sen. Charles Schwertner, R-Georgetown, and Sen. Judith Zaffirini, D-Laredo, were coauthors of SB 1742, while Rep. Julie Johnson, D-Carollton, was the sponsor.

An author is a legislator who files a bill and guides it through the legislative process (also called the primary author). The senate allows multiple primary authors for each bill or resolution. The house of representatives allows only one primary author, the house member whose signature appears on the original measure and on the copies filed with the chief clerk. Both chambers also have coauthors, and the house of representatives has joint authors.

A sponsor is the legislator who guides a bill through the legislative process after the bill has passed the originating chamber. The sponsor is a member of the opposite chamber of the one in which the bill was filed.

(https://tlc.texas.gov/docs/legref/Glossary.pdf)

“We are very proud of this legislation because it enhances patient access to timely and appropriate care, which minimizes potential treatment disruptions, and allows physicians to keep patients in-network for elective care. It is a needed resource since it makes it easier for patients to check their health plan through lawfully required online directories,” said Menéndez. “At the end of the day, it is about making sure Texans are receiving the value and quality they deserve when purchasing health insurance and seeking the care they need with more information and greater transparency.”

Health plan provider directories have not typically displayed this information in a uniform or user-friendly manner. SB 1742 now requires a health plan’s network directory to clearly identify which radiologists, anesthesiologists, pathologists, emergency physicians, neonatologists, and assistant surgeons are fully covered by the insurance.”

SB 1742 also incorporated additional key amendments that were negotiated to provide new protections and prevent prior authorization requirements by insurers from negatively impacting the health insurance market. The added amendments require greater transparency with prior authorizations and mandates that utilization reviews be conducted by a Texas-licensed physician in the same or similar specialty as the physician requesting the service or procedure to ensure the highest quality of patient care while preventing non-medical interference with patient care. 

Furthermore, the new law creates an interim committee to evaluate the prior authorization processes and their effect on Texas patients getting the care they need when they need it. This will be a tool in making sure that we are not allowing barriers for care and treatment for Texans.

SB 1742 will help patients avoid surprise billing events by ensuring that physician and health provider directories clearly indicated which physicians were in-network for a patient in a user-friendly format. The bill would come with no cost to the state government.

“Senate Bill 1742 will shine a bright light into the shadowy world where insurance companies grant or deny prior approvals,” said David C. Fleeger, M.D., President, Texas Medical Association. “This will help physicians make sure that our patients get the medicines, tests, and treatments that they need.”

Patients and health care providers depend on directories provided by health plan issuers to make health care choices, making it critical that these directories are easy to navigate and contain accurate information for patients and providers. However, these directories often are unclear and outdated, which can lead patients to inadvertently receive care at an in- network facility by an out-of-network physician. This can lead to surprise billing events for patients who do not have access to clear and updated information from their health benefit plan issuer. 

SB 1742 will rectify this by creating uniform standards for health benefit plan issuers’ directories, which could help prevent patients from receiving out-of-network care at in-network facilities.

SB 1742 also will ensure that physicians who sought to bring in specialists to provide needed care for patients could consult in network. This would further increase transparency for both physicians and patients.

“AARP Texas has advocated for protections against surprise medical bills and considers up to date and easily accessible provider directories an important part of protecting consumers. Texans need to have accurate information when they are searching for health care providers,” said Blake Huston, Associate State Director, AARP Texas. “This new law will ensure that consumers aren’t saddled with unexpected, out-of-network costs as a result of incorrect information about their insurance coverage.”

Bill Analysis By House Research Organization

According to the bill analysis of SB 1742 by the House Research Organization, which is the nonpartisan research arm of the House of Representatives:

Insurance Code sec. 1451.504 requires health benefit plan issuers that offer coverage for health care services through preferred or exclusive providers or through a network of physicians and health care providers to develop and maintain a physician and health care provider directory. The directory must include the name, street address, and telephone number of each physician and health care provider through which a health benefit plan offers coverage and must indicate whether the physician or provider is accepting new patients.

Insurance Code sec. 1451.505 requires a health benefit plan issuer to clearly display the directory on a public website and to display a link to the website in the electronic summary of benefits and coverage of each health benefit plan the issuer issued.

Insurance Code sec. 1451.501(1) defines “health care provider” as a practitioner, institutional provider, or other person or entity that provides health care services and that is licensed or authorized to practice in Texas. This term includes a pharmacist, pharmacy, hospital, nursing home, or other medical or health-related service facility that provides care. This term does not include physicians.

Health and Safety Code sec. 324.001(7) defines “facility” as a licensed ambulatory surgical center, a licensed birthing center, a licensed hospital, or a freestanding emergency medical care facility.

SB 1742 expands the requirements for physician and health care provider directories maintained by health benefit plan issuers to include certain information for health care providers that were facilities.

The bill defines a “facility-based physician” as a radiologist, anesthesiologist, pathologist, emergency department physician, neonatologist, or assistant surgeon with clinical privileges granted by a facility and who provided services to the facility’s patients under those privileges.

SB 1742 requires that physician and health care provider directories include the specialty, if any, of each physician and health care provider included in the directory. Directories also would have to be electronically searchable by physician or health care provider name, specialty, if any, facility, and location.

Under the bill, for each health care provider that was a facility included in a directory, the directory would have to:

•  List separate headings under the facility name for radiologists, anesthesiologists, pathologists, emergency department physicians, neonatologists, and assistant surgeons;
• List under each heading each facility-based physician that practiced the specialty corresponding with the heading that is a preferred provider, exclusive provider, or network physician; and
• Clearly indicate each health plan that could provide coverage for the services provided by each facility or facility-based physician that is a preferred provider, exclusive provider, or network physician.

The directory also would include each facility in a listing of all facilities included in the directory indicating:

• The name of the facility;
• The municipality in which the facility was located or the county in which the facility was located if the facility was in an unincorporated area;
• The name, street address, and telephone number of any facility-based physician that is a preferred provider, exclusive provider, or network physician or of the physician group in which the facility- based physician practiced; and
• Each health benefit plan issued by the issuer that could provide coverage for the services provided by a facility or facility-based physician group.

The directory would have to list a facility-based physician individually and as part of a physician group, if applicable.

Health benefit plan issuers would be required to update their websites to conform with the provisions of the bill by January 1, 2020.

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DeAnna Garza and Cynthia Cabral contributed to this article. For more on this and other Texas legislative news stories which affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (TitansoftheTexasLegislature.com).

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