Bill Text: TX SB412 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to telemedicine, telehealth, and technology-related health care services.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Introduced - Dead) 2021-04-08 - Co-author authorized [SB412 Detail]
Download: Texas-2021-SB412-Introduced.html
By: Buckingham | S.B. No. 412 | |
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relating to telemedicine, telehealth, and technology-related | ||
health care services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 531.0216, Government Code, is amended by | ||
amending Subsection (i) and adding Subsections (k) and (l) to read | ||
as follows: | ||
(i) The executive commissioner by rule shall ensure that a | ||
federally qualified health center as defined by 42 U.S.C. Section | ||
1396d(l)(2)(B) or a rural health clinic as defined by 42 U.S.C. | ||
Section 1396d(l)(1) may be reimbursed for the originating site | ||
facility fee or the distant site practitioner fee or both, as | ||
appropriate, for a covered telemedicine medical service or | ||
telehealth service delivered by a health care provider to a | ||
Medicaid recipient. The commission is required to implement this | ||
subsection only if the legislature appropriates money specifically | ||
for that purpose. If the legislature does not appropriate money | ||
specifically for that purpose, the commission may, but is not | ||
required to, implement this subsection using other money available | ||
to the commission for that purpose. | ||
(k) No later than January 1, 2022, the commission shall | ||
implement reimbursement for telemedicine medical services and | ||
telehealth services in the following programs, services and | ||
benefits: | ||
(1) Children with Special Health Care Needs program, | ||
(2) Early Childhood Intervention, | ||
(3) School and Health Related Services, | ||
(4) physical therapy, occupational therapy and speech | ||
therapy, | ||
(5) targeted case management, | ||
(6) nutritional counseling services, | ||
(7) Texas Health Steps checkups, | ||
(8) Medicaid 1915(c)waiver programs, including the | ||
Community Living and Support Services waiver, and | ||
(9) any other program, benefit, or service under the | ||
commission's jurisdiction that the commissioner determines to be | ||
cost effective and clinically effective. | ||
(l) The commission shall implement audio-only benefits for | ||
behavioral health services, and may implement audio-only benefits | ||
in any program under the commission's jurisdiction, in accordance | ||
with federal and state law and shall consider other factors, | ||
including whether reimbursement is cost-effective and whether the | ||
provision of the service is clinically effective, in making the | ||
determination. | ||
SECTION 2. Section 531.02164, Government Code, is amended | ||
by adding Subsection (f) to read as follows: | ||
(f) In complying with state and federal requirements to | ||
provide access to medically necessary services under the Medicaid | ||
managed care program, a Medicaid managed care organization may | ||
reimburse providers for home telemonitoring services not | ||
specifically defined in this section and shall consider other | ||
factors, including whether reimbursement is cost-effective and | ||
whether the provision of the service is clinically effective, in | ||
making the determination. | ||
SECTION 3. Section 533, Government Code, is amended by | ||
adding Section 533.00252 to read as follows: | ||
533.00252 DELIVERY OF TELECOMMUNICATION SERVICES. (a) The | ||
commission shall implement policies and procedures to improve | ||
access to care through telemedicine, telehealth, tele-monitoring, | ||
and other telecommunication or information technology solutions. | ||
(b) To the extent authorized by federal law, the commission | ||
shall establish policies and procedures that allow managed care | ||
organizations to conduct assessment and service coordination | ||
activities for members receiving home and community-based services | ||
through telecommunication or information technology in the | ||
following circumstances: | ||
(1) when the managed care organization determines it | ||
appropriate; | ||
(2) the member requests activities occur through | ||
telecommunication or information technology; | ||
(3) when in-person activities are not feasible due to | ||
a natural disaster, pandemic, public health emergency; or | ||
(4) in other circumstances identified by the | ||
commission. | ||
(c) If assessment or service coordination activities are | ||
conducted through telecommunication or information technology, the | ||
managed care organization must: | ||
(1) monitor health care services provided to the | ||
member for fraud, waste, and abuse; and | ||
(2) determine the need for additional social services | ||
and supports. | ||
(d) Except as provided by Subsection (b)(3), a managed care | ||
organization must conduct the following activities for members | ||
receiving home and community-based services: | ||
(1) at least one in-person visit for the population | ||
that requires face to face visits as determined by HHSC; or | ||
(2) additional in-person visits as determined | ||
necessary by the managed care organization. | ||
(e) To the extent authorized by federal law, the commission | ||
must allow managed care members receiving assessments or service | ||
coordination through telecommunication or information technology | ||
to provide verbal authorizations in lieu of written signatures on | ||
all required forms. | ||
SECTION 4. Section 533.0061 (b), Government Code, is | ||
amended by adding Subsection (b)(3) to read as follows: | ||
(b) To the extent it is feasible, the provider access | ||
standards established under this section must: | ||
(1) distinguish between access to providers in urban | ||
and rural settings; |
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(2) consider the number and geographic distribution of | ||
Medicaid-enrolled providers in a particular service delivery area, | ||
and | ||
(3) consider and include the availability of | ||
telemedicine and telehealth services within the provider network | ||
of a managed care organization. | ||
SECTION 5. Chapter 533, Government Code, is amended by | ||
adding Subsection 533.088(c)to read as follows: | ||
Sec. 533.008. MARKETING GUIDELINES. (a) The commission | ||
shall establish marketing guidelines for managed care | ||
organizations that contract with the commission to provide health | ||
care services to recipients, including guidelines that prohibit: | ||
(1) door-to-door marketing to recipients by managed | ||
care organizations or agents of those organizations; | ||
(2) the use of marketing materials with inaccurate or | ||
misleading information; | ||
(3) misrepresentations to recipients or providers; | ||
(4) offering recipients material or financial | ||
incentives to choose a managed care plan other than nominal gifts or | ||
free health screenings approved by the commission that the managed | ||
care organization offers to all recipients regardless of whether | ||
the recipients enroll in the managed care plan; | ||
(5) the use of marketing agents who are paid solely by | ||
commission; and | ||
(6) face-to-face marketing at public assistance | ||
offices by managed care organizations or agents of those | ||
organizations. | ||
(b) This section does not prohibit: | ||
(1) the distribution of approved marketing materials | ||
at public assistance offices; or | ||
(2) the provision of information directly to | ||
recipients under marketing guidelines established by the | ||
commission. | ||
(c) The executive commissioner shall adopt and publish | ||
guidance that allows managed care plans that contract with the | ||
commission to communicate with their enrolled recipients via text | ||
message in accordance with this section. Such guidance shall | ||
include the development and implementation of standardized consent | ||
language to be used by managed care plans in obtaining patient | ||
consent to receive text messages. The guidance must be published no | ||
later than January 1, 2022. | ||
SECTION 6. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 7. This Act takes effect September 1, 2021. |