By Gray                                                H.B. No. 517
         76R376 KLA-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to Medicaid reimbursement for certain medical
 1-3     consultations.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Sections 531.047(a), (b), and (c), Government
 1-6     Code, as added by Chapter 1251, Acts of the 75th Legislature,
 1-7     Regular Session, 1997, are amended to read as follows:
 1-8           (a)  In this section:
 1-9                 (1)  "Health professional" means an advanced nurse
1-10     practitioner, an allied health professional, a mental health
1-11     professional, a physician, or a physician assistant who is licensed
1-12     in this state.
1-13                 (2)  "Health ["Rural county" means a county with a
1-14     population of less than 50,000.]
1-15                 [(3)  "Rural health] facility" means [a health facility
1-16     that is located in a rural county and at least 30 miles from any
1-17     accredited medical school or any teaching hospital affiliated with
1-18     an accredited medical school and that is]:
1-19                       (A)  a licensed, nonprofit hospital; or
1-20                       (B)  a health clinic that is affiliated with:
1-21                             (i)  an accredited medical school; or
1-22                             (ii)  a teaching hospital that is
1-23     affiliated with an accredited medical school.
1-24                 (3) [(4)]  "Telemedical consultation" means a medical
 2-1     consultation for purposes of patient diagnosis or treatment that
 2-2     requires the use of advanced telecommunications technology,
 2-3     including:
 2-4                       (A)  compressed digital interactive video, audio,
 2-5     or data transmission;
 2-6                       (B)  clinical data transmission via computer
 2-7     imaging for teleradiology or telepathology; and
 2-8                       (C)  other technology that facilitates access [in
 2-9     rural counties] to health care services or medical specialty
2-10     expertise.
2-11           (b)  The commission by rule shall require each health and
2-12     human services agency that administers a part of the Medicaid
2-13     program to provide Medicaid reimbursement for a telemedical
2-14     consultation provided by a physician licensed in this state who
2-15     practices in:
2-16                 (1)  a [rural] health facility;
2-17                 (2)  an accredited medical school; or
2-18                 (3)  a teaching hospital that is affiliated with an
2-19     accredited medical school.
2-20           (c)  The commission shall ensure that reimbursement is
2-21     provided only for a consultation provided by a physician described
2-22     in Subsection (b) to a health professional [who practices in a
2-23     rural county].
2-24           SECTION 2.  This Act takes effect September 1, 1999.
2-25           SECTION 3.  If before implementing any provision of this Act
2-26     a state agency determines that a waiver or authorization from a
2-27     federal agency is necessary for implementation of that provision,
 3-1     the agency affected by the provision shall request the waiver or
 3-2     authorization and may delay implementing that provision until the
 3-3     waiver or authorization is granted.
 3-4           SECTION 4.  The importance of this legislation and the
 3-5     crowded condition of the calendars in both houses create an
 3-6     emergency and an imperative public necessity that the
 3-7     constitutional rule requiring bills to be read on three several
 3-8     days in each house be suspended, and this rule is hereby suspended.