By Gray H.B. No. 519 76R253 PB-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the creation and operation of a telemedicine pilot 1-3 program to provide certain workers' compensation medical benefits. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Chapter 408, Labor Code, is amended by adding 1-6 Subchapter M to read as follows: 1-7 SUBCHAPTER M. TELEMEDICINE PILOT PROGRAM 1-8 Sec. 408.241. DEFINITIONS. In this subchapter: 1-9 (1) "Regional telemedical center" means a site 1-10 operated by The University of Texas Medical Branch at Galveston 1-11 that provides telemedicine under this subchapter. 1-12 (2) "Telemedical location" means a doctor's office or 1-13 other location that is equipped with appropriate telecommunications 1-14 facilities and a telemedicine infrastructure as necessary to 1-15 perform telemedicine. 1-16 (3) "Telemedicine" means the use of interactive audio, 1-17 video, or other electronic media to deliver health care. The term 1-18 includes the use of electronic media for diagnosis, consultation, 1-19 treatment, transfer of medical data, and medical education. 1-20 Sec. 408.242. PILOT PROGRAM: REGIONAL WORKERS' COMPENSATION 1-21 TELEMEDICAL CENTER. (a) The commission, in cooperation with the 1-22 Texas State Board of Medical Examiners and the governing body of 1-23 the academic health center at The University of Texas Medical 1-24 Branch at Galveston, shall establish a pilot program in the use of 2-1 telemedicine within the workers' compensation system to be provided 2-2 through regional telemedical centers. 2-3 (b) The University of Texas Medical Branch at Galveston 2-4 shall operate the pilot program through existing telemedical 2-5 locations operated by that university on or before September 1, 2-6 1999. 2-7 (c) The pilot program shall operate initially in the 2-8 Houston-Galveston statistical metropolitan area. After April 30, 2-9 2000, the commission may expand the operating area covered by the 2-10 pilot program as the commission determines to be appropriate. 2-11 (d) The commission and the governing body of the academic 2-12 health center at The University of Texas Medical Branch at 2-13 Galveston shall enter into memoranda of understanding as necessary 2-14 to implement this subchapter. 2-15 Sec. 408.243. USE OF TELEMEDICINE TO PROVIDE MEDICAL 2-16 SERVICES. (a) Each regional telemedical center shall make 2-17 available a pool of specially trained doctors drawn from a range of 2-18 health care specialties, including specialists in spinal injuries. 2-19 (b) To be eligible to serve as a designated doctor through 2-20 the pool created under this section, a doctor must demonstrate to 2-21 the satisfaction of the commission professional experience with the 2-22 impairment rating process used under this subtitle. 2-23 (c) The commission may arrange for a telemedical 2-24 consultation: 2-25 (1) with a designated doctor selected by the 2-26 commission if the parties to a claim are unable to agree on a 2-27 designated doctor under Section 408.122(c) or 408.125; or 3-1 (2) for the provision of a spinal surgery second 3-2 opinion under Section 408.026. 3-3 Sec. 408.244. TELEMEDICAL PROCEDURES. (a) If telemedical 3-4 services are used, the commission shall provide for the electronic 3-5 transmission of the injured employee's medical records to the 3-6 doctor providing telemedical services not later than the 10th day 3-7 before the date on which the telemedical consultation is scheduled 3-8 to occur. 3-9 (b) To use telemedical services under this subchapter, the 3-10 injured employee shall go to the nearest telemedical location that 3-11 is connected to the regional telemedical center. The injured 3-12 employee may be accompanied by the employee's treating doctor. If 3-13 the treating doctor is not present, a health care practitioner who 3-14 provides health care services at that telemedical location shall 3-15 arrange a telephone conference call with the designated doctor or 3-16 doctor providing a second opinion regarding spinal surgery. 3-17 (c) The doctor shall conduct a general examination in a 3-18 live, two-way teleconference. The doctor shall interview the 3-19 injured employee with the assistance of the treating doctor or the 3-20 health care practitioner and may review medical records and images 3-21 in the presence of the employee and the treating doctor or health 3-22 care practitioner. 3-23 (d) The telemedical location shall prepare a videotape 3-24 recording of the telemedical examination for future reference and 3-25 documentation of procedures. 3-26 Sec. 408.245. EXPIRATION OF PILOT PROGRAM. This subchapter 3-27 expires December 31, 2002. 4-1 SECTION 2. Section 408.026, Labor Code, is amended by adding 4-2 Subsection (c) to read as follows: 4-3 (c) A second opinion required under this section may be 4-4 performed through the use of telemedicine as provided by Subchapter 4-5 M. This subsection expires December 31, 2002. 4-6 SECTION 3. Section 408.122, Labor Code, is amended by adding 4-7 Subsection (d) to read as follows: 4-8 (d) In selecting a designated doctor under Subsection (c) in 4-9 cases in which the parties are unable to agree on a designated 4-10 doctor, the commission may elect to use a telemedical consultation 4-11 with a designated doctor chosen under Section 408.243. This 4-12 subsection expires December 31, 2002. 4-13 SECTION 4. The Texas Workers' Compensation Commission shall 4-14 analyze the results of the pilot program created under Subchapter 4-15 M, Chapter 408, Labor Code, as added by this Act, and shall report 4-16 those results to the 78th Legislature not later than February 1, 4-17 2003. The commission shall include in its report any 4-18 recommendations for further legislative action regarding the 4-19 provision of workers' compensation medical benefits through the use 4-20 of telemedicine. 4-21 SECTION 5. The importance of this legislation and the 4-22 crowded condition of the calendars in both houses create an 4-23 emergency and an imperative public necessity that the 4-24 constitutional rule requiring bills to be read on three several 4-25 days in each house be suspended, and this rule is hereby suspended, 4-26 and that this Act take effect and be in force from and after its 4-27 passage, and it is so enacted.