By Ellis S.B. No. 1041
77R5086 KKA-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to services provided through telemedicine for children
1-3 with special health care needs.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 35, Health and Safety Code, is amended by
1-6 adding Section 35.0041 to read as follows:
1-7 Sec. 35.0041. PARTICIPATION AND REIMBURSEMENT OF
1-8 TELEMEDICINE SERVICE PROVIDERS. (a) In this section,
1-9 "telemedicine" means the use of interactive audio, video, or other
1-10 electronic media to deliver health care services. The term
1-11 includes the use of electronic media for diagnosis, consultation,
1-12 treatment, and transfer of medical data. The term does not include
1-13 services performed by using a telephone or facsimile machine.
1-14 (b) The department by rule shall develop and implement
1-15 policies permitting reimbursement of a provider for services under
1-16 the program performed using telemedicine.
1-17 (c) The policies must provide for reimbursement of:
1-18 (1) providers using telemedicine in a cost-effective
1-19 manner that ensures the availability to a child with special health
1-20 care needs of services appropriately performed using telemedicine
1-21 that are comparable to the same types of services available to that
1-22 child without use of telemedicine;
1-23 (2) a provider for a service performed using
1-24 telemedicine at an amount equal to the amount paid to a provider
2-1 for performing the same service without using telemedicine; and
2-2 (3) multiple providers of different services who
2-3 participate in a single telemedicine session for a child with
2-4 special health care needs, if the department determines that
2-5 reimbursing each provider for the session is cost-effective in
2-6 comparison to the costs that would be involved in obtaining the
2-7 services from providers without use of telemedicine, including the
2-8 costs of transportation and lodging and other direct costs.
2-9 (d) In developing and implementing the policies required by
2-10 this section, the department shall consult with:
2-11 (1) The University of Texas Medical Branch at
2-12 Galveston;
2-13 (2) the Health and Human Services Commission,
2-14 including the state Medicaid office;
2-15 (3) providers of telemedicine hub sites in this state;
2-16 and
2-17 (4) providers of services to children with special
2-18 health care needs.
2-19 (e) This section applies to services for which coverage is
2-20 provided under the health benefits plan established under Section
2-21 35.0031.
2-22 SECTION 2. Subchapter D, Chapter 62, Health and Safety Code,
2-23 is amended by adding Section 62.157 to read as follows:
2-24 Sec. 62.157. TELEMEDICINE FOR CHILDREN WITH SPECIAL HEALTH
2-25 CARE NEEDS. (a) In providing covered benefits to a child with
2-26 special health care needs, a health plan provider must permit
2-27 benefits to be provided through telemedicine in accordance with
3-1 policies developed by the commission.
3-2 (b) The policies must provide for:
3-3 (1) the availability of covered benefits appropriately
3-4 provided through telemedicine that are comparable to the same types
3-5 of covered benefits provided without the use of telemedicine; and
3-6 (2) the availability of covered benefits for different
3-7 services performed by multiple health care providers during a
3-8 single telemedicine session, if the commission determines that
3-9 delivery of the covered benefits in that manner is cost-effective
3-10 in comparison to the costs that would be involved in obtaining the
3-11 services from providers without the use of telemedicine, including
3-12 the costs of transportation and lodging and other direct costs.
3-13 (c) In developing the policies required by Subsection (a),
3-14 the commission shall consult with:
3-15 (1) The University of Texas Medical Branch at
3-16 Galveston;
3-17 (2) the Texas Department of Health;
3-18 (3) providers of telemedicine hub sites in this state;
3-19 and
3-20 (4) providers of services to children with special
3-21 health care needs.
3-22 (d) In this section, "telemedicine" has the meaning assigned
3-23 by Section 35.0041.
3-24 SECTION 3. Subchapter B, Chapter 531, Government Code, is
3-25 amended by adding Section 531.02161 to read as follows:
3-26 Sec. 531.02161. MEDICAID SERVICES PROVIDED THROUGH
3-27 TELEMEDICINE TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS. (a) In
4-1 this section:
4-2 (1) "Child with special health care needs" has the
4-3 meaning assigned by Section 35.0022, Health and Safety Code.
4-4 (2) "Telemedicine" has the meaning assigned by Section
4-5 35.0041, Health and Safety Code.
4-6 (b) The commission by rule shall establish policies that
4-7 permit reimbursement under the state Medicaid program for services
4-8 provided through telemedicine to children with special health care
4-9 needs.
4-10 (c) The policies required under this section must:
4-11 (1) be designed to:
4-12 (A) prevent unnecessary travel and encourage
4-13 efficient use of telemedicine for children with special health care
4-14 needs in all suitable circumstances; and
4-15 (B) ensure in a cost-effective manner the
4-16 availability to a child with special health care needs of services
4-17 appropriately performed using telemedicine that are comparable to
4-18 the same types of services available to that child without use of
4-19 telemedicine; and
4-20 (2) provide for reimbursement of multiple providers of
4-21 different services who participate in a single telemedicine session
4-22 for a child with special health care needs, if the commission
4-23 determines that reimbursing each provider for the session is
4-24 cost-effective in comparison to the costs that would be involved in
4-25 obtaining the services from providers without use of telemedicine,
4-26 including the costs of transportation and lodging and other direct
4-27 costs.
5-1 SECTION 4. The Health and Human Services Commission and the
5-2 Texas Department of Health shall develop and implement policies
5-3 required by this Act not later than December 31, 2001.
5-4 SECTION 5. If before implementing any provision of this Act a
5-5 state agency determines that a waiver or authorization from a
5-6 federal agency is necessary for implementation of that provision,
5-7 the agency affected by the provision shall request the waiver or
5-8 authorization and may delay implementing that provision until the
5-9 waiver or authorization is granted.
5-10 SECTION 6. This Act takes effect September 1, 2001.