1-1 By: Duncan, Madla S.B. No. 1483
1-2 (In the Senate - Filed March 9, 2001; March 13, 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 7, Nays 0; April 11, 2001,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 1483 By: Gallegos
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to certain services provided through telemedicine.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Subchapter B, Chapter 531, Government Code, is
1-13 amended by adding Sections 531.02171 and 531.02172 to read as
1-14 follows:
1-15 Sec. 531.02171. TELEMEDICINE MEDICAL SERVICES AND TELEHEALTH
1-16 SERVICES PILOT PROGRAMS. (a) In this section:
1-17 (1) "Health professional" means:
1-18 (A) a physician;
1-19 (B) an individual who is licensed or certified
1-20 in this state to perform health care services and who is authorized
1-21 to assist a physician in providing telemedicine medical services
1-22 that are delegated and supervised by the physician; or
1-23 (C) a licensed or certified health professional
1-24 acting within the scope of the license or certification who does
1-25 not perform a telemedicine medical service.
1-26 (2) "Physician" means a person licensed to practice
1-27 medicine in this state under Subtitle B, Title 3, Occupations Code.
1-28 (3) "Telehealth service" has the meaning assigned by
1-29 Section 57.042, Utilities Code.
1-30 (4) "Telemedicine medical service" has the meaning
1-31 assigned by Section 57.042, Utilities Code.
1-32 (b) The commission shall establish pilot programs in
1-33 designated areas of this state under which the commission, in
1-34 administering government-funded health programs, may reimburse a
1-35 health care professional participating in the pilot program for
1-36 telemedicine medical services or telehealth services authorized
1-37 under the licensing law applicable to the health care professional.
1-38 Each pilot program established before January 1, 2003, must provide
1-39 services in areas of this state that are not more than 150 miles
1-40 from the border between this state and the United Mexican States.
1-41 (c) In developing and operating a pilot program under this
1-42 section, the commission shall:
1-43 (1) solicit and obtain support for the program from
1-44 local officials and the medical community;
1-45 (2) focus on enhancing health outcomes in the area
1-46 served by the pilot program through increased access to medical or
1-47 health care services, including:
1-48 (A) health screenings;
1-49 (B) prenatal care;
1-50 (C) medical or surgical follow-up visits;
1-51 (D) periodic consultation with specialists
1-52 regarding chronic disorders;
1-53 (E) triage and pretransfer arrangements; and
1-54 (F) transmission of diagnostic images or data;
1-55 (3) establish quantifiable measures and expected
1-56 health outcomes for each authorized telemedicine medical service or
1-57 telehealth service;
1-58 (4) consider condition-specific applications of
1-59 telemedicine medical services or telehealth services, including
1-60 applications for:
1-61 (A) pregnancy;
1-62 (B) diabetes;
1-63 (C) heart disease; and
1-64 (D) cancer; and
2-1 (5) demonstrate that the provision of services
2-2 authorized as telemedicine medical services or telehealth services
2-3 will not adversely affect the delivery of traditional medical
2-4 services or other health care services within the area served by
2-5 the pilot program.
2-6 Sec. 531.02172. TELEMEDICINE ADVISORY COMMITTEE. (a) The
2-7 commissioner shall establish an advisory committee to assist the
2-8 commission in:
2-9 (1) evaluating policies for telemedical consultations
2-10 under Section 531.0217;
2-11 (2) evaluating policies for telemedicine medical
2-12 service or telehealth service pilot programs established under
2-13 Section 531.02171;
2-14 (3) ensuring the efficient and consistent development
2-15 and use of telecommunication technology for telemedical
2-16 consultations and telemedicine medical services or telehealth
2-17 services reimbursed under government-funded health programs;
2-18 (4) monitoring the type of programs receiving
2-19 reimbursement under Sections 531.0217 and 531.02171; and
2-20 (5) coordinating the activities of state agencies
2-21 concerned with the use of telemedical consultations and
2-22 telemedicine medical services or telehealth services.
2-23 (b) The advisory committee must include:
2-24 (1) representatives of health and human services
2-25 agencies and other state agencies concerned with the use of
2-26 telemedical consultations in the Medicaid program and the state
2-27 child health plan program, including representatives of:
2-28 (A) the commission;
2-29 (B) the Texas Department of Health;
2-30 (C) the Center for Rural Health Initiatives;
2-31 (D) the Telecommunications Infrastructure Fund
2-32 Board;
2-33 (E) the Texas Department of Insurance;
2-34 (F) the Texas State Board of Medical Examiners;
2-35 (G) the Board of Nurse Examiners; and
2-36 (H) the Texas State Board of Pharmacy;
2-37 (2) representatives of health science centers in this
2-38 state;
2-39 (3) experts on telemedicine, telemedical consultation,
2-40 and telemedicine medical services; and
2-41 (4) representatives of consumers of health services
2-42 provided through telemedical consultations and telemedicine medical
2-43 services.
2-44 (c) A member of the advisory committee serves at the will of
2-45 the commissioner.
2-46 SECTION 2. Section 57.042, Utilities Code, is amended by
2-47 amending Subdivision (11) and adding Subdivision (12) to read as
2-48 follows:
2-49 (11) "Telehealth service" means a health service,
2-50 other than a telemedicine medical service, delivered by a licensed
2-51 or certified health professional acting within the scope of the
2-52 health professional's license or certification who does not perform
2-53 a telemedicine medical service that requires the use of advanced
2-54 telecommunications technology, other than by telephone or
2-55 facsimile, including:
2-56 (A) compressed digital interactive video, audio,
2-57 or data transmission;
2-58 (B) clinical data transmission using computer
2-59 imaging by way of still-image capture and store and forward; and
2-60 (C) other technology that facilitates access to
2-61 health care services or medical specialty expertise.
2-62 (12) "Telemedicine medical service" means a health
2-63 care service initiated by a physician or provided by a health
2-64 professional acting under physician delegation and supervision, for
2-65 purposes of patient assessment by a health professional, diagnosis
2-66 or consultation by a physician, treatment, or the transfer of
2-67 medical data, that requires the use of advanced telecommunications
2-68 technology, other than by telephone or facimile, including:
2-69 (A) compressed digital interactive video, audio,
3-1 or data transmission;
3-2 (B) clinical data transmission using computer
3-3 imaging by way of still-image capture and store and forward; and
3-4 (C) other technology that facilitates access to
3-5 health care services or medical specialty expertise[:]
3-6 [(A) means medical services delivered by
3-7 telecommunications technologies to rural or underserved public
3-8 not-for-profit health care facilities or primary health care
3-9 facilities in collaboration with an academic health center and an
3-10 associated teaching hospital or tertiary center or with another
3-11 public not-for-profit health care facility; and]
3-12 [(B) includes consultive services, diagnostic
3-13 services, interactive video consultation, teleradiology,
3-14 telepathology, and distance education for working health care
3-15 professionals].
3-16 SECTION 3. Subsections (a) and (b), Section 57.047,
3-17 Utilities Code, are amended to read as follows:
3-18 (a) The board may award a grant to a project or proposal
3-19 that:
3-20 (1) provides equipment and infrastructure necessary
3-21 for:
3-22 (A) distance learning;
3-23 (B) an information sharing program of a library;
3-24 [or]
3-25 (C) telemedicine medical services; or
3-26 (D) telehealth services;
3-27 (2) develops and implements the initial or
3-28 prototypical delivery of a course or other distance learning
3-29 material;
3-30 (3) trains teachers, faculty, librarians, or
3-31 technicians in the use of distance learning or information sharing
3-32 materials and equipment;
3-33 (4) develops a curriculum or instructional material
3-34 specially suited for telecommunications delivery;
3-35 (5) provides electronic information; or
3-36 (6) establishes or carries out an information sharing
3-37 program.
3-38 (b) The board may award a loan to a project or proposal to
3-39 acquire equipment needed for distance learning and telemedicine
3-40 medical service projects.
3-41 SECTION 4. Subchapter C, Chapter 57, Utilities Code, is
3-42 amended by adding Section 57.0471 to read as follows:
3-43 Sec. 57.0471. GRANTS TO CERTAIN HEALTH CARE FACILITIES. A
3-44 physician, health care professional, or health care facility
3-45 providing telemedicine medical services or telehealth services and
3-46 participating in a pilot program under Section 531.02171,
3-47 Government Code, is eligible to receive a grant under Section
3-48 57.047.
3-49 SECTION 5. Subsection (h), Section 531.0217, Government
3-50 Code, is repealed.
3-51 SECTION 6. (a) Not later than December 31, 2001, the
3-52 commissioner of health and human services shall establish the
3-53 telemedicine advisory committee as required by Section 531.02172,
3-54 Government Code, as added by this Act.
3-55 (b) Not later than September 1, 2003, the telemedicine
3-56 advisory committee established under Section 531.02172, Government
3-57 Code, as added by this Act, shall prepare a report relating to the
3-58 implementation of the pilot programs established under Section
3-59 531.02171, Government Code, as added by this Act, and shall provide
3-60 the report to the governor, lieutenant governor, speaker of the
3-61 house of representatives, and appropriate standing committees of
3-62 the senate and house of representatives.
3-63 SECTION 7. The advisory committee established under
3-64 Subsection (h), Section 531.0217, Government Code, is abolished on
3-65 the effective date of this Act.
3-66 SECTION 8. This Act takes effect immediately if it receives
3-67 a vote of two-thirds of all the members elected to each house, as
3-68 provided by Section 39, Article III, Texas Constitution. If this
3-69 Act does not receive the vote necessary for immediate effect, this
4-1 Act takes effect September 1, 2001.
4-2 * * * * *