By: Moncrief S.B. No. 64 2001S0001/2 A BILL TO BE ENTITLED AN ACT 1-1 relating to the use of telemedicine in the state Medicaid program. 1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-3 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, 1-4 is amended by adding Section 32.0247 to read as follows: 1-5 Sec. 32.0247. USE OF TELEMEDICINE MEDICAL SERVICES IN 1-6 CERTAIN MEDICAID PROGRAMS. (a) In this section: 1-7 (1) "EPSDT program" means the early and periodic 1-8 screening, diagnosis, and treatment program. 1-9 (2) "Telemedicine medical service" means a health care 1-10 service initiated by a licensed physician or, under the appropriate 1-11 delegation and supervision of a licensed physician, an advanced 1-12 practice nurse or physician assistant who provides a health care 1-13 service for purposes of patient assessment, diagnosis, or 1-14 treatment, or the transfer of medical data, that requires the use 1-15 of advanced telecommunications technology, including: 1-16 (A) compressed digital interactive video, audio, 1-17 or data transmission; 1-18 (B) clinical data transmission via computer 1-19 imaging by way of still image capture; or 1-20 (C) other technology that facilitates access to 1-21 a health care service or medical specialty expertise provided by 1-22 the EPSDT program. 1-23 (b) The Texas Department of Health, in its rules governing 1-24 the EPSDT program, shall require a telemedicine medical service for 1-25 the provision of an EPSDT program service to a child who receives 2-1 medical assistance under this chapter if an in-person service with 2-2 a health care provider is not reasonably available where the child 2-3 resides or works. The Texas Department of Health may not require a 2-4 telemedicine medical service for the provision of an EPSDT program 2-5 service to a child who receives medical assistance under this 2-6 chapter if the service can be reasonably provided in person. 2-7 (c) The Texas Department of Health, in its rules governing 2-8 the EPSDT program, shall require a health care facility that 2-9 receives reimbursement for an EPSDT program service provided 2-10 through a telemedicine medical service to establish quality of 2-11 care protocols and patient confidentiality guidelines to ensure 2-12 that the telemedicine medical service meets acceptable standards of 2-13 patient care and legal requirements. 2-14 (d) The Texas State Board of Medical Examiners, in 2-15 consultation with the Texas Department of Health, may adopt rules 2-16 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 telemedicine 2-19 medical service; and 2-20 (2) prevent abuse and fraud resulting from the use of 2-21 a telemedicine medical service in the EPSDT program, including 2-22 rules relating to the filing of a claim for reimbursement and the 2-23 maintaining of records related to a telemedicine medical service. 2-24 (e) The provisions of this section do not provide any 2-25 authority to replace, substitute, or circumvent the requirements 2-26 for a rural health clinic or for physician delegation of 3-1 prescriptive authority to an advanced practice nurse or physician 3-2 assistant. 3-3 SECTION 2. This Act takes effect immediately if it receives 3-4 a vote of two-thirds of all the members elected to each house, as 3-5 provided by Section 39, Article III, Texas Constitution. If this 3-6 Act does not receive the vote necessary for immediate effect, this 3-7 Act takes effect September 1, 2001. 3-8 SECTION 3. Not later than January 1, 2002, the Texas 3-9 Department of Health shall adopt the rules required by Section 3-10 32.0247, Human Resources Code, as added by this Act. 3-11 SECTION 4. If, before implementing any provision of this 3-12 Act, a state agency determines that a waiver or authorization from 3-13 a federal agency is necessary for implementation of that provision, 3-14 the agency affected by the provision shall request the waiver or 3-15 authorization and may delay implementing that provision until the 3-16 waiver or authorization is granted.