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.