Bill Text: TX HB2697 | 2017-2018 | 85th Legislature | Comm Sub
Bill Title: Relating to telemedicine and telehealth services.
Spectrum: Slight Partisan Bill (Republican 5-3)
Status: (Introduced - Dead) 2017-05-10 - Laid on the table subject to call [HB2697 Detail]
Download: Texas-2017-HB2697-Comm_Sub.html
85R22531 EES-F | |||
By: Price, Coleman, et al. | H.B. No. 2697 | ||
Substitute the following for H.B. No. 2697: | |||
By: Price | C.S.H.B. No. 2697 |
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relating to telemedicine and telehealth services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 111.001, Occupations Code, is amended by | ||
amending Subdivision (2) and adding Subdivisions (3) and (4) to | ||
read as follows: | ||
(2) "Store and forward technology" means technology | ||
that stores and transmits or grants access to a person's clinical | ||
information for review by a health professional at a different | ||
physical location than the person. | ||
(3) "Telehealth service" means a health service, other | ||
than a telemedicine medical service, delivered by a health | ||
professional licensed, certified, or otherwise entitled to | ||
practice in this state and acting within the scope of the health | ||
professional's license, certification, or entitlement to a patient | ||
at a different physical location than the health professional using | ||
telecommunications or information technology. | ||
(4) "Telemedicine [ |
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service" means a health care service delivered by a physician | ||
licensed in this state, or a health professional acting under the | ||
delegation and supervision of a physician licensed in this state, | ||
and acting within the scope of the physician's or health | ||
professional's license to a patient at a different physical | ||
location than the physician or health professional using | ||
telecommunications or information technology [ |
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SECTION 2. Section 111.004, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 111.004. RULES. The Texas [ |
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Board [ |
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insurance, as appropriate, may adopt rules necessary to: | ||
(1) ensure that patients using telemedicine medical | ||
services receive appropriate, quality care; | ||
(2) prevent abuse and fraud in the use of telemedicine | ||
medical services, including rules relating to the filing of claims | ||
and records required to be maintained in connection with | ||
telemedicine medical services; | ||
(3) ensure adequate supervision of health | ||
professionals who are not physicians and who provide telemedicine | ||
medical services; and | ||
(4) establish the maximum number of health | ||
professionals who are not physicians that a physician may supervise | ||
through a telemedicine medical service[ |
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SECTION 3. Chapter 111, Occupations Code, is amended by | ||
adding Sections 111.005 through 111.008 to read as follows: | ||
Sec. 111.005. PRACTITIONER-PATIENT RELATIONSHIP FOR | ||
TELEMEDICINE MEDICAL SERVICES. (a) For purposes of Section | ||
562.056, a valid practitioner-patient relationship is present | ||
between a practitioner providing a telemedicine medical service and | ||
a patient receiving the telemedicine medical service as long as the | ||
practitioner complies with the standard of care described in | ||
Section 111.007 and the practitioner: | ||
(1) has a preexisting practitioner-patient | ||
relationship with the patient established in accordance with rules | ||
adopted under Section 111.006; | ||
(2) communicates, regardless of the method of | ||
communication, with the patient pursuant to a call coverage | ||
agreement established in accordance with Texas Medical Board rules | ||
with a physician requesting coverage of medical care for the | ||
patient; or | ||
(3) provides the telemedicine medical services | ||
through the use of one of the following methods, as long as the | ||
practitioner complies with the follow-up requirements in | ||
Subsection (b), and the method allows the practitioner to have | ||
access to, and the practitioner uses, the relevant clinical | ||
information that would be required in accordance with the standard | ||
of care described in Section 111.007: | ||
(A) synchronous audiovisual interaction between | ||
the practitioner and the patient in another location; | ||
(B) asynchronous store and forward technology, | ||
including asynchronous store and forward technology in conjunction | ||
with synchronous audio interaction between the practitioner and the | ||
patient in another location, as long as the practitioner uses | ||
clinical information from: | ||
(i) clinically relevant photographic or | ||
video images, including diagnostic images; or | ||
(ii) the patient's relevant medical | ||
records, such as the relevant medical history, laboratory and | ||
pathology results, and prescriptive histories; or | ||
(C) another form of audiovisual | ||
telecommunication technology that allows the practitioner to | ||
comply with the standard of care described in Section 111.007. | ||
(b) A practitioner who provides telemedicine medical | ||
services to a patient as described in Subsection (a)(3) shall: | ||
(1) provide the patient with guidance on appropriate | ||
follow-up care; and | ||
(2) if the patient consents and the patient has a | ||
primary care physician, provide to the patient's primary care | ||
physician within 72 hours after the practitioner provides the | ||
services to the patient a medical record or other report containing | ||
an explanation of the treatment provided by the practitioner to the | ||
patient and the practitioner's evaluation, analysis, or diagnosis, | ||
as appropriate, of the patient's condition. | ||
(c) Notwithstanding any other provision of this section, a | ||
practitioner-patient relationship is not present if a practitioner | ||
prescribes an abortifacient or any other drug or device that | ||
terminates a pregnancy. | ||
Sec. 111.006. COORDINATION TO ADOPT RULES THAT DETERMINE | ||
VALID PRESCRIPTION. (a) The Texas Medical Board, the Texas Board | ||
of Nursing, the Texas Physician Assistant Board, and the Texas | ||
State Board of Pharmacy shall jointly adopt rules that establish | ||
the determination of a valid prescription in accordance with | ||
Section 111.005. Rules adopted under this section must allow for | ||
the establishment of a practitioner-patient relationship by a | ||
telemedicine medical service provided by a practitioner to a | ||
patient in a manner that complies with Section 111.005(a)(3). | ||
(b) The Texas Medical Board, the Texas Board of Nursing, the | ||
Texas Physician Assistant Board, and the Texas State Board of | ||
Pharmacy shall jointly develop and publish on each respective | ||
board's Internet website responses to frequently asked questions | ||
relating to the determination of a valid prescription issued in the | ||
course of the provision of telemedicine medical services. | ||
Sec. 111.007. STANDARD OF CARE FOR TELEMEDICINE MEDICAL | ||
SERVICES AND TELEHEALTH SERVICES. (a) A health professional | ||
providing a health care service or procedure as a telemedicine | ||
medical service or a telehealth service is subject to the standard | ||
of care that would apply to the provision of the same health care | ||
service or procedure in an in-person setting. | ||
(b) An agency with regulatory authority over a health | ||
professional may not adopt rules pertaining to telemedicine medical | ||
services or telehealth services that would impose a higher standard | ||
of care than the standard described in Subsection (a). | ||
Sec. 111.008. MENTAL HEALTH SERVICES EXCLUDED. This | ||
chapter does not apply to mental health services. | ||
SECTION 4. Section 562.056, Occupations Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) For purposes of this section, a valid | ||
practitioner-patient relationship is present between a | ||
practitioner providing telemedicine medical services and the | ||
patient receiving the telemedicine medical services if the | ||
practitioner has complied with the requirements for establishing | ||
such a relationship in accordance with Section 111.005. | ||
SECTION 5. Section 1455.001(3), Insurance Code, is amended | ||
to read as follows: | ||
(3) "Telehealth service" and "telemedicine medical | ||
service" have the meanings assigned by Section 111.001 [ |
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Occupations [ |
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SECTION 6. Section 1455.004, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES | ||
AND TELEHEALTH SERVICES. (a) A health benefit plan may not exclude | ||
from coverage a covered health care service or procedure delivered | ||
by a preferred or contracted health professional to a covered | ||
patient as a telemedicine medical service or a telehealth service | ||
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care service or procedure is not provided through an in-person [ |
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(b) A health benefit plan may require a deductible, a | ||
copayment, or coinsurance for a covered health care service or | ||
procedure delivered by a preferred or contracted health | ||
professional to a covered patient as a telemedicine medical service | ||
or a telehealth service. The amount of the deductible, copayment, | ||
or coinsurance may not exceed the amount of the deductible, | ||
copayment, or coinsurance required for the covered health care [ |
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in-person [ |
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(c) Notwithstanding Subsection (a), a health benefit plan | ||
is not required to provide coverage for a telemedicine medical | ||
service or a telehealth service provided by only synchronous or | ||
asynchronous audio interaction, including: | ||
(1) an audio-only telephone consultation; | ||
(2) a text-only e-mail message; or | ||
(3) a facsimile transmission. | ||
SECTION 7. Chapter 1455, Insurance Code, is amended by | ||
adding Section 1455.006 to read as follows: | ||
Sec. 1455.006. TELEMEDICINE MEDICAL SERVICES AND | ||
TELEHEALTH SERVICES STATEMENT. (a) Each issuer of a health | ||
benefit plan shall adopt and display in a conspicuous manner on the | ||
health benefit plan issuer's Internet website the issuer's policies | ||
and payment practices for telemedicine medical services and | ||
telehealth services. | ||
(b) This section does not require an issuer of a health | ||
benefit plan to display negotiated contract payment rates for | ||
health professionals who contract with the issuer to provide | ||
telemedicine medical services or telehealth services. | ||
SECTION 8. Sections 531.001(7) and (8), Government Code, | ||
are amended to read as follows: | ||
(7) "Telehealth service" has the meaning assigned by | ||
Section 111.001, Occupations Code [ |
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(8) "Telemedicine medical service" has the meaning | ||
assigned by Section 111.001, Occupations Code [ |
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SECTION 9. Section 531.0216(b), Government Code, is amended | ||
to read as follows: | ||
(b) In developing the system, the executive commissioner by | ||
rule shall: | ||
(1) review programs and pilot projects in other states | ||
to determine the most effective method for reimbursement; | ||
(2) establish billing codes and a fee schedule for | ||
services; | ||
(3) [ |
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Services to establish procedures to: | ||
(A) identify clinical evidence supporting | ||
delivery of health care services using a telecommunications system; | ||
and | ||
(B) annually review health care services, | ||
considering new clinical findings, to determine whether | ||
reimbursement for particular services should be denied or | ||
authorized; | ||
(4) [ |
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for telemedicine medical services providers, telehealth services | ||
providers, and home telemonitoring services providers; and | ||
(5) [ |
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telemedicine medical services, telehealth services, and home | ||
telemonitoring services eligible for reimbursement. | ||
SECTION 10. Sections 531.0217(c-1) and (i), Government | ||
Code, are amended to read as follows: | ||
(c-1) Notwithstanding Subsection (b) or (c), the commission | ||
shall provide for reimbursement under Medicaid for an office visit | ||
provided through telemedicine by a physician who is assessing and | ||
evaluating the patient from a distant site if [ |
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which the patient is receiving the service is not likely, within a | ||
reasonable degree of medical certainty, to undergo material | ||
deterioration within the 30-day period following the date of the | ||
visit. | ||
(i) The Texas Medical Board, in consultation with the | ||
commission, as appropriate, may adopt rules as necessary to: | ||
(1) ensure that appropriate care, including quality of | ||
care, is provided to patients who receive telemedicine medical | ||
services; and | ||
(2) prevent abuse and fraud through the use of | ||
telemedicine medical services, including rules relating to filing | ||
of claims and records required to be maintained in connection with | ||
telemedicine[ |
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SECTION 11. Section 771.151(7), Health and Safety Code, is | ||
amended to read as follows: | ||
(7) "Telemedicine medical service" has the meaning | ||
assigned by Section 111.001, Occupations Code [ |
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SECTION 12. Sections 531.02163 and 531.0217(i-1), | ||
Government Code, are repealed. | ||
SECTION 13. (a) Except as provided by Subsection (b) of | ||
this section, this Act takes effect immediately if it receives a | ||
vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2017. | ||
(b) Sections 1455.001(3) and 1455.004, Insurance Code, as | ||
amended by this Act, and Section 1455.006, Insurance Code, as added | ||
by this Act, take effect January 1, 2018. |