Bill Text: TX SB670 | 2019-2020 | 86th Legislature | Comm Sub

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to telemedicine and telehealth services.

Spectrum: Slight Partisan Bill (Republican 5-2)

Status: (Passed) 2019-06-14 - Effective on 9/1/19 [SB670 Detail]

Download: Texas-2019-SB670-Comm_Sub.html
  86R23578 MM-F
 
  By: Buckingham S.B. No. 670
 
  (Price, Guillen, Sheffield, Ashby,
 
  González of El Paso, et al.) 
 
 
 
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 531.001, Government Code, is amended by
  adding Subdivisions (4-c) and (4-d) to read as follows:
               (4-c)  "Medicaid managed care organization" means a
  managed care organization as defined by Section 533.001 that
  contracts with the commission under Chapter 533 to provide health
  care services to Medicaid recipients.
               (4-d)  "Platform" means the technology, system,
  software, application, modality, or other method through which a
  health professional remotely interfaces with a patient when
  providing a health care service or procedure as a telemedicine
  medical service or telehealth service.
         SECTION 2.  Section 531.0216, Government Code, is amended by
  amending Subsections (c) and (c-1) and adding Subsections (g), (h),
  (i), and (j) to read as follows:
         (c)  The commission shall encourage health care providers
  and health care facilities to provide [participate as] telemedicine
  medical services and [service providers or] telehealth services
  [service providers] in the health care delivery system. The
  commission may not require that a service be provided to a patient
  through telemedicine medical services or telehealth services [when
  the service can reasonably be provided by a physician through a
  face-to-face consultation with the patient in the community in
  which the patient resides or works. This subsection does not
  prohibit the authorization of the provision of any service to a
  patient through telemedicine medical services or telehealth
  services at the patient's request].
         (c-1)  The commission shall[:
               [(1)]  explore opportunities to increase STAR Health
  program providers' use of telemedicine medical services in
  medically underserved areas of this state[; and
               [(2)     encourage STAR Health program providers to use
  telemedicine medical services as appropriate].
         (g)  The commission shall ensure that a Medicaid managed care
  organization:
               (1)  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 Medicaid
  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;
               (2)  does not limit, deny, or reduce reimbursement for
  a covered health care service or procedure delivered by a health
  care provider with whom the managed care organization contracts to
  a Medicaid recipient as a telemedicine medical service or a
  telehealth service based on the health care provider's choice of
  platform for providing the health care service or procedure; and
               (3)  ensures that the use of telemedicine medical
  services or telehealth services promotes and supports
  patient-centered medical homes by allowing a Medicaid recipient to
  receive a telemedicine medical service or telehealth service from a
  provider other than the recipient's primary care physician or
  provider, except as provided by Section 531.0217(c-4), only if:
                     (A)  the telemedicine medical service or
  telehealth service is provided in accordance with the law and
  contract requirements applicable to the provision of the same
  health care service in an in-person setting, including requirements
  regarding care coordination; and
                     (B)  the provider of the telemedicine medical
  service or telehealth service gives notice to the Medicaid
  recipient's primary care physician or provider regarding the
  telemedicine medical service or telehealth service, including a
  summary of the service, exam findings, a list of prescribed or
  administered medications, and patient instructions, for the
  purpose of sharing medical information, provided that the recipient
  has a primary care physician or provider and the recipient or, if
  appropriate, the recipient's parent or legal guardian, consents to
  the notice.
         (h)  The commission shall develop, document, and implement a
  monitoring process to ensure that a Medicaid managed care
  organization ensures that the use of telemedicine medical services
  or telehealth services promotes and supports patient-centered
  medical homes and care coordination in accordance with Subsection
  (g)(3). The process must include monitoring of the rate at which a
  telemedicine medical service or telehealth service provider gives
  notice in accordance with Subsection (g)(3)(B).
         (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) 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.
         (j)  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
  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 3.  Sections 531.0217(c-4), (d), and (k), Government
  Code, are 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].
         (d)  The commission shall require reimbursement for a
  telemedicine medical service at the same rate as Medicaid
  reimburses for the same [a comparable] in-person medical service.
  A request for reimbursement may not be denied solely because an
  in-person medical service between a physician and a patient did not
  occur. The commission may not limit a physician's choice of
  platform for providing a telemedicine medical service or telehealth
  service by requiring that the physician use a particular platform
  to receive reimbursement for the service.
         (k)  This section does not affect any requirement relating
  to:
               (1)  [a federally qualified health center;
               [(2)]  a rural health clinic; or
               (2) [(3)]  physician delegation of the authority to
  carry out or sign prescription drug orders to an advanced practice
  nurse or physician assistant.
         SECTION 4.  The following provisions of the Government Code
  are repealed:
               (1)  Sections 531.0216(b) and (e);
               (2)  Section 531.02161;
               (3)  Sections 531.0217(c-1), (c-2), (c-3), and (f);
               (4)  Section 531.02173; and
               (5)  Section 531.02176.
         SECTION 5.  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 6.  This Act takes effect September 1, 2019.
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