By Gray                                                H.B. No. 518
         76R375 KLA-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the use of telemedicine in the state Medicaid program.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
 1-5     is amended by adding Section 32.0242 to read as follows:
 1-6           Sec. 32.0242.  TELEMEDICAL CONSULTATIONS IN CERTAIN MEDICAID
 1-7     PROGRAMS.  (a)  In this section:
 1-8                 (1)  "EPSDT Program"  means the Early and Periodic
 1-9     Screening, Diagnosis, and Treatment Program.
1-10                 (2)  "Telemedical consultation" means a medical  or
1-11     dental consultation for purposes of patient diagnosis,  treatment,
1-12     or transfer of medical or dental data that requires the use of
1-13     advanced telecommunications technology, including:
1-14                       (A)  compressed digital interactive video, audio,
1-15     or data transmission;
1-16                       (B)  clinical data transmission via computer
1-17     imaging for teleradiology or telepathology; and
1-18                       (C)  other technology that facilitates access to
1-19     a health care service, medical specialty expertise, or dental care
1-20     service provided by the EPSDT Program.
1-21           (b)  The department, in its rules governing the EPSDT
1-22     Program, shall require a telemedical consultation for the provision
1-23     of an EPSDT Program service to a child who receives medical
1-24     assistance under this chapter if an in-person consultation with a
 2-1     health care provider is not reasonably available where the child
 2-2     resides or works.  The department may not require a telemedical
 2-3     consultation for the provision of an EPSDT Program service to a
 2-4     child who receives medical assistance under this chapter if an
 2-5     in-person consultation with a health care provider is reasonably
 2-6     available where the child resides or works.
 2-7           (c)  The department, in its rules governing the EPSDT
 2-8     Program, shall require a health care facility that receives
 2-9     reimbursement for an EPSDT Program service provided through a
2-10     telemedical consultation to establish quality of care protocols and
2-11     patient confidentiality guidelines to ensure that the telemedical
2-12     consultation meets acceptable standards of patient care and legal
2-13     requirements.
2-14           (d)  The Texas State Board of Medical Examiners and the State
2-15     Board of Dental Examiners, in consultation with the department, may
2-16     adopt rules as necessary to:
2-17                 (1)  ensure that appropriate care is provided to a
2-18     child who receives an EPSDT Program service through a telemedical
2-19     consultation; and
2-20                 (2)  prevent abuse and fraud resulting from the use of
2-21     a telemedical consultation in the EPSDT Program, including rules
2-22     relating to the filing of a claim for reimbursement and the
2-23     maintaining of records related to a telemedical consultation.
2-24           SECTION 2.  This Act takes effect September 1, 1999.
2-25           SECTION 3.  Not later than January 1, 2000, the Texas
2-26     Department of Health shall adopt the rules required by Section
2-27     32.0242, Human Resources Code, as added by this Act.
 3-1           SECTION 4.  If before implementing any provision of this Act,
 3-2     a state agency determines that a waiver or authorization from a
 3-3     federal agency is necessary for implementation of that provision,
 3-4     the agency affected by the provision shall request the waiver or
 3-5     authorization and may delay implementing that provision until the
 3-6     waiver or authorization is granted.
 3-7           SECTION 5.  The importance of this legislation and the
 3-8     crowded condition of the calendars in both houses create an
 3-9     emergency and an imperative public necessity that the
3-10     constitutional rule requiring bills to be read on three several
3-11     days in each house be suspended, and this rule is hereby suspended.