By: Moncrief S.B. No. 66
2001S0002/2
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the creation and operation of a telemedicine pilot
1-2 program to provide certain workers' compensation medical benefits.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Chapter 408, Labor Code, is amended by adding
1-5 Subchapter M to read as follows:
1-6 SUBCHAPTER M. TELEMEDICINE MEDICAL SERVICES PILOT PROGRAM
1-7 Sec. 408.241. DEFINITIONS. In this subchapter:
1-8 (1) "Regional telemedicine medical center" means a
1-9 site operated by the commission that provides telemedicine medical
1-10 services under this subchapter.
1-11 (2) "Telemedicine medical services location" means a
1-12 doctor's office or another location that is equipped with
1-13 appropriate telecommunications facilities and a telemedicine
1-14 medical services infrastructure as necessary to perform
1-15 telemedicine medical services.
1-16 (3) "Telemedicine medical service" means a health care
1-17 service initiated by a licensed physician or, under the appropriate
1-18 delegation and supervision of a licensed physician, and advanced
1-19 practice nurse or physician assistant who provides a health care
1-20 service for purposes of patient assessment, diagnosis, or
1-21 treatment, or the transfer of medical data, that requires the use
1-22 of advanced telecommunications technology, including:
1-23 (A) compressed digital interactive video, audio,
1-24 or data transmission;
1-25 (B) clinical data transmission via computer
2-1 imaging by way of still image capture; or
2-2 (C) other technology that facilitates access to
2-3 a health care service or medical specialty expertise.
2-4 Sec. 408.242. PILOT PROGRAM: REGIONAL WORKERS' COMPENSATION
2-5 TELEMEDICINE MEDICAL SERVICES CENTER. (a) The commission, in
2-6 cooperation with the Texas State Board of Medical Examiners, shall
2-7 establish a pilot program in the use of telemedicine medical
2-8 services within the workers' compensation system to be provided
2-9 through regional telemedicine medical centers.
2-10 (b) The pilot program shall operate at a location, or
2-11 locations, determined by the commission and the Research and
2-12 Oversight Council on Workers' Compensation. After April 30, 2002,
2-13 the commission may expand the operating area covered by the pilot
2-14 program as the commission determines to be appropriate.
2-15 (c) The commission shall enter into memoranda of
2-16 understanding as necessary to implement this subchapter.
2-17 Sec. 408.243. USE OF TELEMEDICINE TO PROVIDE MEDICAL
2-18 SERVICES. (a) Each regional telemedicine medical center shall
2-19 make available a pool of specially trained doctors drawn from a
2-20 range of health care specialties, including specialists in spinal
2-21 injuries.
2-22 (b) To be eligible to serve as a designated doctor through
2-23 the pool created under this section, a doctor must demonstrate to
2-24 the satisfaction of the commission professional experience with the
2-25 impairment rating process used under this subtitle.
2-26 (c) The commission may arrange for telemedicine medical
3-1 services:
3-2 (1) with a designated doctor selected by the
3-3 commission if the parties to a claim are unable to agree on a
3-4 designated doctor under Section 408.122(c) or 408.125; or
3-5 (2) for the provision of a spinal surgery second
3-6 opinion under Section 408.026.
3-7 Sec. 408.244. TELEMEDICAL PROCEDURES. (a) If telemedicine
3-8 medical services are used, the commission shall provide for the
3-9 electronic transmission of the injured employee's medical records
3-10 to the doctor providing telemedicine medical services not later
3-11 than the 10th day before the date on which the telemedical
3-12 consultation is scheduled to occur.
3-13 (b) To use telemedicine medical services under this
3-14 subchapter, the injured employee shall go to the nearest
3-15 telemedicine medical services location that is connected to the
3-16 regional telemedicine medical center. The injured employee may be
3-17 accompanied by the employee's treating doctor. If the treating
3-18 doctor is not present, a health care practitioner who provides
3-19 health care services at that telemedicine medical services location
3-20 shall arrange a telephone conference call with the designated
3-21 doctor or doctor providing a second opinion regarding spinal
3-22 surgery.
3-23 (c) The doctor shall conduct a general examination in a
3-24 live, two-way teleconference. The doctor shall interview the
3-25 injured employee with the assistance of the treating doctor or the
3-26 health care practitioner and may review medical records and images
4-1 in the presence of the employee and the treating doctor or health
4-2 care practitioner.
4-3 (d) The telemedicine medical services location shall prepare
4-4 a data record with clinical notes of the telemedicine medical
4-5 examination for future reference and documentation of procedures.
4-6 Sec. 408.245. RESTRICTION OF PREEMPTION AUTHORITY. The
4-7 provisions of this subchapter do not provide any authority to
4-8 replace, substitute, or circumvent the requirements for a rural
4-9 health clinic or for physician delegation of prescriptive authority
4-10 to an advanced practice nurse or physician assistant.
4-11 SECTION 2. Section 408.026, Labor Code, is amended by adding
4-12 Subsection (c) to read as follows:
4-13 (c) A second opinion required under this section may be
4-14 performed through the use of telemedicine medical services as
4-15 provided by Subchapter M.
4-16 SECTION 3. Section 408.122, Labor Code, is amended by adding
4-17 Subsection (d) to read as follows:
4-18 (d) In selecting a designated doctor under Subsection (c) in
4-19 cases in which the parties are unable to agree on a designated
4-20 doctor, the commission may elect to use a telemedicine medical
4-21 examination with a designated doctor chosen under Section 408.243.
4-22 SECTION 4. The Texas Workers' Compensation Commission shall
4-23 analyze the results of the pilot program created under Subchapter
4-24 M, Chapter 408, Labor Code, as added by this Act, and shall report
4-25 those results to the 78th Legislature not later than February 1,
4-26 2003. The commission shall include in its report any
5-1 recommendations for further legislative action regarding the
5-2 provision of workers' compensation medical benefits through the use
5-3 of telemedicine.
5-4 SECTION 5. This Act takes effect immediately if it receives
5-5 a vote of two-thirds of all the members elected to each house, as
5-6 provided by Section 39, Article III, Texas Constitution. If this
5-7 Act does not receive the vote necessary for immediate effect, this
5-8 Act takes effect September 1, 2001.