1-1 AN ACT 1-2 relating to certain services provided through telemedicine. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Subchapter B, Chapter 531, Government Code, is 1-5 amended by adding Sections 531.02171 and 531.02172 to read as 1-6 follows: 1-7 Sec. 531.02171. TELEMEDICINE PILOT PROGRAMS. (a) In this 1-8 section: 1-9 (1) "Health professional" means: 1-10 (A) a physician; 1-11 (B) an individual who is licensed or certified 1-12 in this state to perform health care services and who is authorized 1-13 to assist a physician in providing telemedicine medical services 1-14 that are delegated and supervised by the physician; or 1-15 (C) a licensed or certified health professional 1-16 acting within the scope of the license or certification who does 1-17 not perform a telemedicine medical service. 1-18 (2) "Physician" means a person licensed to practice 1-19 medicine in this state under Subtitle B, Title 3, Occupations Code. 1-20 (3) "Telehealth service" means a health service, other 1-21 than a telemedicine medical service, delivered by a licensed or 1-22 certified health professional acting within the scope of the health 1-23 professional's license or certification who does not perform a 1-24 telemedicine medical service that requires the use of advanced 2-1 telecommunications technology, other than by telephone or 2-2 facsimile, including: 2-3 (A) compressed digital interactive video, audio, 2-4 or data transmission; 2-5 (B) clinical data transmission using computer 2-6 imaging by way of still-image capture and store and forward; and 2-7 (C) other technology that facilitates access to 2-8 health care services or medical specialty expertise. 2-9 (4) "Telemedicine medical service" means a health care 2-10 service initiated by a physician or provided by a health 2-11 professional acting under physician delegation and supervision, for 2-12 purposes of patient assessment by a health professional, diagnosis 2-13 or consultation by a physician, treatment, or the transfer of 2-14 medical data, that requires the use of advanced telecommunications 2-15 technology, other than by telephone or facsimile, including: 2-16 (A) compressed digital interactive video, audio, 2-17 or data transmission; 2-18 (B) clinical data transmission using computer 2-19 imaging by way of still-image capture and store and forward; and 2-20 (C) other technology that facilitates access to 2-21 health care services or medical specialty expertise. 2-22 (b) The commission shall establish pilot programs in 2-23 designated areas of this state under which the commission, in 2-24 administering government-funded health programs, may reimburse a 2-25 health professional participating in the pilot program for 2-26 telemedicine medical services or telehealth services authorized 2-27 under the licensing law applicable to the health professional. 3-1 Each pilot program established before January 1, 2003, must provide 3-2 services in areas of this state that are not more than 150 miles 3-3 from the border between this state and the United Mexican States. 3-4 (c) In developing and operating a pilot program under this 3-5 section, the commission shall: 3-6 (1) solicit and obtain support for the program from 3-7 local officials and the medical community; 3-8 (2) focus on enhancing health outcomes in the area 3-9 served by the pilot program through increased access to medical 3-10 services, including: 3-11 (A) health screenings; 3-12 (B) prenatal care; 3-13 (C) medical or surgical follow-up visits; 3-14 (D) periodic consultation with specialists 3-15 regarding chronic disorders; 3-16 (E) triage and pretransfer arrangements; and 3-17 (F) transmission of diagnostic images or data; 3-18 (3) establish quantifiable measures and expected 3-19 health outcomes for each authorized telemedicine medical service or 3-20 telehealth service; 3-21 (4) consider condition-specific applications of 3-22 telemedicine medical services or telehealth services, including 3-23 applications for: 3-24 (A) pregnancy; 3-25 (B) diabetes; 3-26 (C) heart disease; and 3-27 (D) cancer; and 4-1 (5) demonstrate that the provision of services 4-2 authorized as telemedicine medical services or telehealth services 4-3 will not adversely affect the provision of traditional medical 4-4 services within the area served by the pilot program. 4-5 (d) Notwithstanding an eligibility requirement prescribed by 4-6 other law or rule, the commission may establish requirements for a 4-7 person to participate in a pilot project under this section. 4-8 (e) Participation in the pilot project does not entitle a 4-9 participant to other services under a government-funded health 4-10 program. 4-11 (f) The commission may limit the number of participants of a 4-12 pilot project under this section. 4-13 Sec. 531.02172. TELEMEDICINE ADVISORY COMMITTEE. (a) The 4-14 commissioner shall establish an advisory committee to assist the 4-15 commission in: 4-16 (1) evaluating policies for telemedical consultations 4-17 under Section 531.0217; 4-18 (2) evaluating policies for telemedicine medical 4-19 services or telehealth services pilot programs established under 4-20 Section 531.02171; 4-21 (3) ensuring the efficient and consistent development 4-22 and use of telecommunication technology for telemedical 4-23 consultations and telemedicine medical services or telehealth 4-24 services reimbursed under government-funded health programs; 4-25 (4) monitoring the type of programs receiving 4-26 reimbursement under Sections 531.0217 and 531.02171; and 4-27 (5) coordinating the activities of state agencies 5-1 concerned with the use of telemedical consultations and 5-2 telemedicine medical services or telehealth services. 5-3 (b) The advisory committee must include: 5-4 (1) representatives of health and human services 5-5 agencies and other state agencies concerned with the use of 5-6 telemedical consultations in the Medicaid program and the state 5-7 child health plan program, including representatives of: 5-8 (A) the commission; 5-9 (B) the Texas Department of Health; 5-10 (C) the Center for Rural Health Initiatives; 5-11 (D) the Telecommunications Infrastructure Fund 5-12 Board; 5-13 (E) the Texas Department of Insurance; 5-14 (F) the Texas State Board of Medical Examiners; 5-15 (G) the Board of Nurse Examiners; and 5-16 (H) the Texas State Board of Pharmacy; 5-17 (2) representatives of health science centers in this 5-18 state; 5-19 (3) experts on telemedicine, telemedical consultation, 5-20 and telemedicine medical services or telehealth services; and 5-21 (4) representatives of consumers of health services 5-22 provided through telemedical consultations and telemedicine medical 5-23 services or telehealth services. 5-24 (c) A member of the advisory committee serves at the will of 5-25 the commissioner. 5-26 SECTION 2. Subchapter C, Chapter 57, Utilities Code, is 5-27 amended by adding Section 57.0471 to read as follows: 6-1 Sec. 57.0471. GRANTS TO CERTAIN HEALTH CARE FACILITIES. (a) 6-2 A health care facility providing telemedicine medical services or 6-3 telehealth services and participating in a pilot program under 6-4 Section 531.02171, Government Code, is eligible to receive a grant 6-5 under Section 57.047. 6-6 (b) The health care facility is not eligible to receive 6-7 private network services under Section 58.253(a), except with 6-8 respect to a project that would have been eligible to be funded by 6-9 the telecommunications infrastructure fund under this subchapter as 6-10 it existed on January 1, 2001. 6-11 SECTION 3. Section 531.0217(h), Government Code, is 6-12 repealed. 6-13 SECTION 4. (a) Not later than December 31, 2001, the 6-14 commissioner of health and human services shall establish the 6-15 telemedical consultation advisory committee as required by Section 6-16 531.02172, Government Code, as added by this Act. 6-17 (b) Not later than September 1, 2003, the advisory committee 6-18 established under Section 531.02172, Government Code, as added by 6-19 this Act, shall prepare a report relating to the implementation of 6-20 the pilot programs established under Section 531.02171, Government 6-21 Code, as added by this Act, and shall provide the report to the 6-22 governor, lieutenant governor, speaker of the house of 6-23 representatives, and appropriate standing committees of the senate 6-24 and house of representatives. 6-25 SECTION 5. The advisory committee established under Section 6-26 531.0217(h), Government Code, is abolished on the effective date of 6-27 this Act. 7-1 SECTION 6. If before implementing any provision of this Act 7-2 the commissioner of health and human services determines that a 7-3 waiver or authorization from a federal agency is necessary for 7-4 implementation of that provision, the agency affected by the 7-5 provision shall request the waiver or authorization and may delay 7-6 implementing that provision until the waiver or authorization is 7-7 granted. 7-8 SECTION 7. This Act takes effect immediately if it receives 7-9 a vote of two-thirds of all the members elected to each house, as 7-10 provided by Section 39, Article III, Texas Constitution. If this 7-11 Act does not receive the vote necessary for immediate effect, this 7-12 Act takes effect September 1, 2001. _______________________________ _______________________________ President of the Senate Speaker of the House I certify that H.B. No. 2700 was passed by the House on April 18, 2001, by a non-record vote; and that the House concurred in Senate amendments to H.B. No. 2700 on May 25, 2001, by the following vote: Yeas 139, Nays 0, 2 present, not voting. _______________________________ Chief Clerk of the House I certify that H.B. No. 2700 was passed by the Senate, with amendments, on May 17, 2001, by the following vote: Yeas 30, Nays 0, 1 present, not voting. _______________________________ Secretary of the Senate APPROVED: __________________________ Date __________________________ Governor