HBA-JRA, ALS C.S.H.B. 517 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 517 By: Gray Public Health 4/30/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Under current law, medicaid reimbursement is allowed for telemedical procedures performed in rural health care facilities. The purpose of this bill is to expand the availability of health care, particularly specialty health care, to citizens throughout the state. C.S.H.B. 517 requires health and human services agencies to provide Medicaid reimbursement for a telemedical consultation provided by a health professional who provides the consultation for a patient who resides in an area designated as a medically underserved area or a health professionals shortage area under certain circumstances. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority previously delegated to the Health and Human Services Commission is modified in SECTION 1 (Section 531.047, Government Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 531.047, Government Code, as added by Chapter 1251, Acts of the 75th Legislature, Regular Session, 1997, by amending Subsections (a), (b), (c), (d), and (e) and adding Subsection (h), as follows: Sec. 531.047. REIMBURSEMENT FOR CERTAIN MEDICAL CONSULTATIONS. (a) Redefines "rural county" to provide, as an additional qualification, that the county contains an area that was not designated as an urban area by the 1990 federal census and does not have within the boundaries of the county a licensed hospital with less than 100 beds. Redefines "rural health facility" to provide, as an additional qualification, that the health facility is a licensed hospital owned or operated by a municipality, county, hospital district, or hospital authority and provides inpatient or outpatient services, rather than a licensed, nonprofit hospital, or that the health facility is a health clinic affiliated with such a hospital or a federally-qualified health center. (b) Requires the Health and Human Services Commission (HHSC), by rule, to require each health and human services agency that administers a part of the Medicaid program to provide Medicaid reimbursement for a telemedical consultation provided by a health professional who provides the consultation for a patient who resides in an area designated as a medically underserved area or a health professionals shortage area if the medical examination of the patient is under the control of the consultant health professional, the consultation involves the participation of the health professional who obtains the consultation as appropriate to meet the medical needs of the patient and as necessary to provide information requested by the consultant health professional, and the results of the consultation are provided in a written report to the health professional who obtains the consultation. (c) Adds a consultation provided by a health professional described in Subsection (b) to a health professional who practices in an area designated as a medically underserved area or a health professionals shortage area to the consultations for which HHSC is required to ensure that reimbursement is provided. (d) Makes a conforming change. (e) Makes a conforming change. (h) Requires the commissioner of health and human services to establish an advisory committee to assist the commission in developing policies for telemedical consultations under this section. SECTION 2. Effective date: September 1, 1999. SECTION 3. Requires a state agency to request a waiver or authorization from a federal agency for implementation of a provision of this Act if the state agency determines that the waiver or authorization is necessary for implementation. SECTION 4. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute modifies the original in SECTION 1 (Section 531.047, Government Code) by amending Subsections (d) and (e), as well as (a), (b), and (c), and adding Subsection (h). In Subsection (a), the substitute redefines "rural county" and "rural health facility," rather than deleting those definitions, defining "health facility," and redefining "telemedical consultation." In Subsection (b), the substitute requires the Health and Human Services Commission, by rule, to require each health and human services agency that administers a part of the Medicaid program to provide Medicaid reimbursement for a telemedical consultation provided by a health professional who provides the consultation for a patient who resides in an area designated as a medically underserved area or a health professionals shortage area under certain circumstances. In Subsection (c), the substitute adds a consultation provided by a health professional described in Subsection (b) to a health professional who practices in an area designated as a medically underserved area or a health professionals shortage area, to the consultations for which HHSC is required to ensure that reimbursement is provided. In Subsections (d) and (e), the substitute makes conforming changes. In Subsection (h), the substitute requires the commissioner of health and human services to establish an advisory committee to assist the commission in developing policies for telemedical consultations under this section.