1-1     By:  Ellis                                            S.B. No. 1041
 1-2           (In the Senate - Filed March 1, 2001; March 5, 2001, read
 1-3     first time and referred to Committee on Health and Human Services;
 1-4     April 11, 2001, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 6, Nays 0; April 11, 2001,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 1041                By:  Moncrief
 1-8                            A BILL TO BE ENTITLED
 1-9                                   AN ACT
1-10     relating to services provided through telemedicine  for children
1-11     with special health care needs.
1-12           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13           SECTION 1.  Chapter 35, Health and Safety Code, is amended by
1-14     adding Section 35.0041 to read as follows:
1-15           Sec. 35.0041.  PARTICIPATION AND REIMBURSEMENT OF
1-16     TELEMEDICINE SERVICE PROVIDERS.  (a)  In this section,
1-17     "telemedicine" means the use of interactive audio, video, or other
1-18     electronic media to deliver health care services.  The term
1-19     includes the use of electronic media for diagnosis, consultation,
1-20     treatment, and transfer of medical data.  The term does not include
1-21     services performed by using a telephone or facsimile machine.
1-22           (b)  The department by rule shall develop and implement
1-23     policies permitting reimbursement of a provider for services under
1-24     the program performed using telemedicine.
1-25           (c)  The policies must provide for reimbursement of:
1-26                 (1)  providers using telemedicine in a cost-effective
1-27     manner that ensures the availability to a child with special health
1-28     care needs of services appropriately performed using telemedicine
1-29     that are comparable to the same types of services available to that
1-30     child without use of telemedicine;
1-31                 (2)  a provider for a service performed using
1-32     telemedicine at an amount equal to the amount paid to a provider
1-33     for performing the same service without using telemedicine; and
1-34                 (3)  multiple providers of different services who
1-35     participate in a single telemedicine session for a child with
1-36     special health care needs, if the department determines that
1-37     reimbursing each provider for the session is cost-effective in
1-38     comparison to the costs that would be involved in obtaining the
1-39     services from providers without the use of telemedicine, including
1-40     the costs of transportation and lodging and other direct costs.
1-41           (d)  In developing and implementing the policies required by
1-42     this section, the department shall consult with:
1-43                 (1)  The University of Texas Medical Branch at
1-44     Galveston;
1-45                 (2)  Texas Tech University Health Sciences Center;
1-46                 (3)  the Health and Human Services Commission,
1-47     including the state Medicaid office;
1-48                 (4)  providers of telemedicine hub sites in this state;
1-49                 (5)  providers of services to children with special
1-50     health care needs; and
1-51                 (6)  representatives of consumer or disability groups
1-52     affected by changes to services for children with special health
1-53     care needs.
1-54           (e)  This section applies to services for which coverage is
1-55     provided under the health benefits plan established under Section
1-56     35.0031.
1-57           SECTION 2.  Subchapter D, Chapter 62, Health and Safety Code,
1-58     is amended by adding Section 62.157 to read as follows:
1-59           Sec. 62.157.  TELEMEDICINE FOR CHILDREN WITH SPECIAL HEALTH
1-60     CARE NEEDS.  (a)  In providing covered benefits to a child with
1-61     special health care needs, a health plan provider must permit
1-62     benefits to be provided through telemedicine in accordance with
1-63     policies developed by the commission.
1-64           (b)  The policies must provide for:
 2-1                 (1)  the availability of covered benefits appropriately
 2-2     provided through telemedicine that are comparable to the same types
 2-3     of covered benefits provided without the use of telemedicine; and
 2-4                 (2)  the availability of covered benefits for different
 2-5     services performed by multiple health care providers during a
 2-6     single telemedicine session, if the commission determines that
 2-7     delivery of the covered benefits in that manner is cost-effective
 2-8     in comparison to the costs that would be involved in obtaining the
 2-9     services from providers without the use of telemedicine, including
2-10     the costs of transportation and lodging and other direct costs.
2-11           (c)  In developing the policies required by Subsection (a),
2-12     the commission shall consult with:
2-13                 (1)  The University of Texas Medical Branch at
2-14     Galveston;
2-15                 (2)  Texas Tech University Health Sciences Center;
2-16                 (3)  the Texas Department of Health;
2-17                 (4)  providers of telemedicine hub sites in this state;
2-18                 (5)  providers of services to children with special
2-19     health care needs; and
2-20                 (6)  representatives of consumer or disability groups
2-21     affected by changes to services for children with special health
2-22     care needs.
2-23           (d)  In this section, "telemedicine" has the meaning assigned
2-24     by Section 35.0041.
2-25           SECTION 3.  Subchapter B, Chapter 531, Government Code, is
2-26     amended by adding Section 531.02161 to read as follows:
2-27           Sec. 531.02161.  MEDICAID SERVICES PROVIDED THROUGH
2-28     TELEMEDICINE TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS.  (a)  In
2-29     this section:
2-30                 (1)  "Child with special health care needs" has the
2-31     meaning assigned by Section 35.0022, Health and Safety Code.
2-32                 (2)  "Telemedicine" has the meaning assigned by Section
2-33     35.0041, Health and Safety Code.
2-34           (b)  The commission by rule shall establish policies that
2-35     permit reimbursement under the state Medicaid program for services
2-36     provided through telemedicine to children with special health care
2-37     needs.
2-38           (c)  The policies required under this section must:
2-39                 (1)  be designed to:
2-40                       (A)  prevent unnecessary travel and encourage
2-41     efficient use of telemedicine for children with special health care
2-42     needs in all suitable circumstances; and
2-43                       (B)  ensure in a cost-effective manner the
2-44     availability to a child with special health care needs of services
2-45     appropriately performed using telemedicine that are comparable to
2-46     the same types of services available to that child without the use
2-47     of telemedicine; and
2-48                 (2)  provide for reimbursement of multiple providers of
2-49     different services who participate in a single telemedicine session
2-50     for a child with special health care needs, if the commission
2-51     determines that reimbursing each provider for the session is
2-52     cost-effective in comparison to the costs that would be involved in
2-53     obtaining the services from providers without the use of
2-54     telemedicine, including the costs of transportation and lodging and
2-55     other direct costs.
2-56           SECTION 4.  The Health and Human Services Commission and the
2-57     Texas Department of Health shall develop and implement policies
2-58     required by this Act not later than December 31, 2001.
2-59           SECTION 5.  If before implementing any provision of this Act
2-60     a state agency determines that a waiver or authorization from a
2-61     federal agency is necessary for implementation of that provision,
2-62     the agency affected by the provision shall request the waiver or
2-63     authorization and may delay implementing that provision until the
2-64     waiver or authorization is granted.
2-65           SECTION 6.  This Act takes effect September 1, 2001.
2-66                                  * * * * *