By: Nelson S.B. No. 93
Line and page numbers may not match official copy.
Bill not drafted by TLC or Senate E&E.
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to providing telemedicine services.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 106.025(a), Health and Safety Code, is
1-5 amended to read as follows:
1-6 (a) The center shall:
1-7 (1) educate the public and recommend appropriate
1-8 public policies regarding the continued viability of rural health
1-9 care delivery in this state;
1-10 (2) monitor and work with state and federal agencies
1-11 to assess the impact of proposed rules on rural areas;
1-12 (3) provide impact statements of proposed rules as
1-13 considered appropriate by the center;
1-14 (4) streamline regulations to assist in the
1-15 development of service diversification of health care facilities;
1-16 (5) target state and federal programs to rural areas;
1-17 (6) promote and develop community involvement and
1-18 community support in maintaining, rebuilding, or diversifying local
1-19 health services;
1-20 (7) promote and develop diverse and innovative health
1-21 care service models in rural areas;
1-22 (8) encourage the use of advanced communications
1-23 technology to:
2-1 (A) ensure that rural areas receive the maximum
2-2 benefits of telemedicine and distance learning by promoting a
2-3 transmission rate structure that accommodates rural needs and by
2-4 improving the telecommunications infrastructure in rural areas; and
2-5 (B) provide access to specialty expertise,
2-6 clinical consultation, and continuing education;
2-7 (9) assist rural health care providers, communities,
2-8 and individuals in applying for public and private grants and
2-9 programs;
2-10 (10) encourage the development of regional emergency
2-11 transportation networks;
2-12 (11) work with state agencies, universities, and
2-13 private interest groups to conduct and promote research on rural
2-14 health issues, maintain and collect a timely data base, and develop
2-15 and maintain a rural health resource library;
2-16 (12) solicit the assistance of other offices or
2-17 programs of rural health in this state that are university-based to
2-18 carry out the duties of this chapter;
2-19 (13) disseminate information and provide technical
2-20 assistance to communities, health care providers, and individual
2-21 consumers of health care services;
2-22 (14) develop plans to implement a fee-for-service
2-23 health care professional recruitment service and a medical supplies
2-24 group purchasing program within the center;
2-25 (15) develop and initiate, in conjunction with the
2-26 Texas State Board of Medical Examiners, the Board of Nurse
3-1 Examiners, the Texas Department of Health, the Bureau of State
3-2 Health Data and Policy Analysis, the Texas State Board of Physician
3-3 Assistant Examiners, or other appropriate agencies, a study of
3-4 rural health clinics to:
3-5 (A) determine the efficiency and effectiveness
3-6 of rural health clinics;
3-7 (B) review the health outcomes of rural patients
3-8 treated in rural health clinics and report those outcomes in the
3-9 center's biennial report to the legislature;
3-10 (C) identify and address efficiency barriers for
3-11 the professional clinical relationship of physicians, nurses, and
3-12 physician assistants;
3-13 (D) assess the success of attracting primary
3-14 care physicians and allied health professionals to rural areas; and
3-15 (E) assess the appropriateness of the current
3-16 clinic designation process;
3-17 (16) develop and initiate a quality assessment program
3-18 to evaluate the health outcomes of rural patients treated in rural
3-19 health clinics; [and]
3-20 (17) encourage the active participation by physicians
3-21 and other health care providers in the early and periodic
3-22 screening, diagnosis, and treatment program;
3-23 (18) develop a uniform definition for telemedicine
3-24 that provides for the use of advanced technology including still
3-25 image capture and real-time, two-way, interactive voice, video, and
3-26 data communications;
4-1 (19) ensure the appropriate development and use of
4-2 telecommunications and technology in health care settings; and
4-3 (20) coordinate with various agencies to assist in
4-4 evaluating telemedicine programs and policy.
4-5 SECTION 2. Chapter 106, Health and Safety Code, is amended
4-6 by adding Subchapter H to read as follows:
4-7 SUBCHAPTER H. RURAL HEALTH PROVIDERS
4-8 Sec. 106.251. DEFINITIONS. In this subchapter, "Rural
4-9 county" means a county that:
4-10 (A) has a population of 50,000 or less; or
4-11 (B) contains an area that was not designated as an
4-12 urban area by the United States Bureau of the Census and does not
4-13 have within the boundaries of the county a hospital that:
4-14 (i) is licensed under Chapter 241, Health and
4-15 Safety Code; and
4-16 (ii) has more than 100 beds.
4-17 Sec. 106.252. HEALTH CARE PROFESSIONAL RECRUITMENT PROGRAM.
4-18 To promote the public purpose of providing adequate health care in
4-19 rural counties, the center may use money appropriated to the center
4-20 to make a grant to a rural county to recruit and retain health care
4-21 professionals to work in the county.
4-22 SECTION 3. Section 57.042(11), Utilities Code, is amended to
4-23 read as follows:
4-24 (11) "Telemedicine":
4-25 (A) means medical services delivered by
4-26 telecommunications technologies to rural or underserved [public
5-1 not-for-profit health care facilities or primary] health care
5-2 facilities in collaboration with an academic health center and an
5-3 associated teaching hospital or tertiary center or with another
5-4 [public not-for-profit] health care facility; and
5-5 (B) includes consultive services, diagnostic services,
5-6 interactive video consultation, teleradiology, telepathology, and
5-7 distance education for working health care professionals.
5-8 SECTION 4. Section 531.0217, Government Code is amended by
5-9 amending Subsections (a) and (b) to read as follows:
5-10 (a) In this section:
5-11 (1) "Health professional" means an advanced nurse
5-12 practitioner, an allied health professional, a mental health
5-13 professional, a physician, or a physician assistant who is licensed
5-14 in this state.
5-15 (2) "Rural county" means a county that:
5-16 (A) has a population of 50,000 or less; or
5-17 (B) contains an area that was not designated as
5-18 an urban area by the United States Bureau of the Census according
5-19 to the 1990 federal census and does not have within the boundaries
5-20 of the county a hospital that:
5-21 (i) is licensed under Chapter 241, Health
5-22 and Safety Code; and
5-23 (ii) has more than 100 beds.
5-24 (3) "Rural health facility" means a health facility
5-25 that is located in a rural county and at least 30 miles from any
5-26 accredited medical school or any teaching hospital affiliated with
6-1 an accredited medical school [and that is:]
6-2 [(A) a licensed, nonprofit hospital;]
6-3 [(B) a health clinic that is affiliated with:]
6-4 [(i) an accredited medical school;]
6-5 [(ii) a teaching hospital that is
6-6 affiliated with an accredited medical school;]
6-7 [(iii) a hospital described by Paragraph
6-8 (C); or]
6-9 [(iv) a federally qualified health center,
6-10 as defined by 42 U.S.C. Section 1396d(l) (2) (B), as amended; or]
6-11 [(C) a hospital that:]
6-12 [(i) is licensed under Chapter 241, Health
6-13 and Safety Code;]
6-14 [(ii) is owned or operated by a
6-15 municipality, county, hospital district, or hospital authority; and]
6-16 [(iii) provides inpatient or outpatient
6-17 services].
6-18 (4) "Telemedical consultation" means a medical
6-19 consultation for purposes of patient diagnosis or treatment that
6-20 requires the use of advanced telecommunications technology,
6-21 including:
6-22 (A) compressed digital interactive video, audio,
6-23 or data transmission;
6-24 (B) clinical data transmission via computer
6-25 imaging for teleradiology or telepathology; and
6-26 (C) other technology that facilitates access in
7-1 rural counties to health care services or medical specialty
7-2 expertise.
7-3 (b) The commission by rule shall require each health and
7-4 human services agency that administers a part of the Medicaid
7-5 program to provide Medicaid reimbursement for a telemedical
7-6 consultation provided by a physician licensed in this state [who
7-7 practices in:]
7-8 [(1) a rural health facility;]
7-9 [(2) an accredited medical school; or]
7-10 [(3) a teaching hospital that is affiliated with an
7-11 accredited medical school].
7-12 SECTION 5. The Legislative Budget Board shall prepare a cost
7-13 analysis that projects the costs of including pharmacists,
7-14 occupational therapists, physical therapists, and mental health
7-15 providers in the list of health professionals eligible to receive
7-16 Medicaid reimbursement for telemedicine services.
7-17 SECTION 6. If before implementing any provision of this Act
7-18 a state agency determines that a waiver or authorization from a
7-19 federal agency is necessary for implementation of that provision,
7-20 the agency affected by the provision shall request the waiver or
7-21 authorization and may delay implementing that provision until the
7-22 waiver or authorization is granted.
7-23 SECTION 7. This Act takes effect September 1, 2001.