By: Buckingham  S.B. No. 670
         (In the Senate - Filed February 6, 2019; March 1, 2019, read
  first time and referred to Committee on Health & Human Services;
  March 21, 2019, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; March 21, 2019,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 670 By:  Perry
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to Medicaid telemedicine and telehealth services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 531.0216, Government Code, is amended by
  amending Subsection (b) and adding Subsection (g) 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)  [consult with the Department of State Health
  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)]  establish a separate provider identifier for
  telemedicine medical services providers, telehealth services
  providers, and home telemonitoring services providers; and
               (4) [(5)]  establish a separate modifier for
  telemedicine medical services, telehealth services, and home
  telemonitoring services eligible for reimbursement.
         (g)  The commission shall ensure a managed care organization
  that contracts with the commission under Chapter 533 to provide
  health care services to Medicaid recipients does not deny
  reimbursement for a covered health care service or procedure
  delivered by a health care provider with whom the managed care
  organization contracts to a recipient as a telemedicine medical
  service or a telehealth service solely because the covered service
  or procedure is not provided through an in-person consultation.  In
  complying with state and federal requirements to provide access to
  medically necessary services under the Medicaid managed care
  program, a managed care organization determining whether
  reimbursement for a telemedicine medical service or telehealth
  service is appropriate shall continue to consider other factors,
  including whether reimbursement is cost-effective and whether the
  provision of the service is clinically effective.
         SECTION 2.  Section 531.0217(c-4), Government Code, is
  amended to read as follows:
         (c-4)  The commission shall ensure that Medicaid
  reimbursement is provided to a physician for a telemedicine medical
  service provided by the physician, even if the physician is not the
  patient's primary care physician or provider, if:
               (1)  the physician is an authorized health care
  provider under Medicaid;
               (2)  the patient is a child who receives the service in
  a primary or secondary school-based setting; and
               (3)  the parent or legal guardian of the patient
  provides consent before the service is provided[; and
               [(4)     a health professional is present with the patient
  during the treatment].
         SECTION 3.  The following provisions of the Government Code
  are repealed:
               (1)  Section 531.0216(e);
               (2)  Section 531.02161;
               (3)  Sections 531.0217(c-2) and (c-3); and
               (4)  Section 531.02173.
         SECTION 4.  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 5.  This Act takes effect September 1, 2019.
 
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