IML C.S.H.B. 2017 75(R)BILL ANALYSIS

PUBLIC HEALTH
C.S.H.B. 2017
By: Maxey
4/18/97
Committee Report (Substituted)

BACKGROUND 

In 1989, Texas Tech University Health Science Center (TTUHSC) 
received a federal 
demonstration grant from the U.S. Department of Health and Human 
Services Office of Rural 
Health Policy.  With the funding from this grant, HealthNet, the 
state's largest telemedicine 
system, was created.  HealthNet connects TTUHSC's four West Texas 
campuses with rural 
health care facilities and prisons.  The system provides various 
medical services that include 
interactive video consultations, teleradiology, health care 
consultations from prisons, and 
continuing education.  

Currently, the telemedicine system is supported through funds 
from the medical school.  The 
consulting physicians are staff of the health science center, and 
do not receive any reimbursement 
from Medicaid, Medicare, or private payers.  The State 
Comptroller's, Texas Performance 
Review Report -  Disturbing the Peace:  The Challenge of Change, 
recommended that the State 
Medicaid Office establish procedures to reimburse providers who 
offer services by telemedicine.

PURPOSE

CSHB 2017 requires the Health and Human Services Commission 
(HHSC) to develop and 
implement a system to reimburse providers for services performed 
using telemedicine.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill expressly grants 
additional rulemaking authority to the 
Health and Human Services Commission in SECTION 1 (Section 
531.0215(a), Subchapter B, 
Government Code).

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter B, Chapter 531, Government Code, by 
adding the following:

Sec. 531.0215.  PARTICIPATION AND REIMBURSEMENT OF TELEMEDICINE 
SERVICE PROVIDERS UNDER MEDICAID.  Subsection (a) requires the 
HHSC to 
create rules to develop and implement a system to reimburse 
providers of services under 
the state Medicaid program for services performed using 
telemedicine.

Subsection (b) requires  the HHSC to review programs in other 
states, establish billing 
codes and fees, and provide for an approval process.

Subsection (c) requires the HHSC to encourage certain providers 
to participate in the 
telemedicine program.

Subsection (d) defines "telemedicine" as specified in Section 
3.606, Public Utility 
Regulatory Act of 1995 (Article 1446c-0, V.T.C.S.)

SECTION 2.  Requires Texas Tech University (TTU), with the 
cooperation of HHSC, to contact 
the Health Care Financing Administration as soon as practicable 
after the effective date of this 
Act, regarding approval of the federal waiver submitted before 
the effective date of this Act to 
allow TTU to receive reimbursement under the federal research and 
demonstration project for 
telemedicine services provided under the Medicare program.

 SECTION 3.  Emergency Clause.  This Act is effective upon passage.

COMPARISON OF ORIGINAL TO SUBSTITUTE

SECTION 1.  CSHB 2017 adds the words "PARTICIPATION AND" to the 
title of Section 
531.0215.  CSHB 2017 strikes Subsections (b)(4)-(5) of the 
original bill, requiring HHSC to (4) 
establish a state network of telemedicine service providers and 
(5) work to ensure that small rural 
hospitals benefit from telemedicine, and adds Subsection (c) as 
detailed above.  These changes 
were made to avoid fiscal implications.  CSHB 2017 incorporates 
Subsection (c) of the original 
bill, defining "telemedicine," into Subsection (d).