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.