BILL ANALYSIS
Senate Research Center S.B. 1340
79R9619 CLG-D By: Madla
AUTHOR'S/SPONSOR'S STATEMENT OF INTENT
In general, the Health and Human Services Commission (HHSC) should be looking to see where telemedicine and telepsychiatry could be used to increase access to services while controlling costs and maintaining quality.
As proposed, S.B. 1340 requires HHSC to establish a separate identifier for telemedicine medical services eligible for reimbursement. The bill requires HHSC to establish guidelines to permit the remote site "presenter" to be clinically trained staff but not necessarily a medical doctor, advance practice nurse, physician assistant, or registered nurse. S.B. 1340 allows HHSC to provide reimbursement for telemedicine medical services. The bill also requires the Texas State Board of Medical Examiners to update its rules to be consistent with these changes regarding telemedicine.
Further, S.B. 1340 encourages HHSC to recognize the use of telepsychiatry for delivery of services to mental health communities. In order to increase the use of telepsychiatry, the Department of State Health Services will first initiate a pilot a program; HHSC will review the results and then develop guidelines for expansion.
Finally, S.B. 1340 requires HHSC to complete research of certain initiatives and provide an analysis that includes an estimate of potential fiscal impact and identification of any major risks related to providing telemedicine medical services.
RULEMAKING AUTHORITY
Rulemaking authority previously granted to the Health and Human Services Commission is transferred to the executive commissioner of the Health and Human Services Commission in SECTION 1 (Section 531.0216(b), Government Code) of this bill.
Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 2 (Section 531.02163, Government Code) and SECTION 5 of this bill.
Rulemaking authority previously granted to the Texas State Board of Medical Examiners is modified in SECTION 3 (Section 531.0217, Government Code) of this bill.
Rulemaking authority is expressly granted to the Texas State Board of Medical Examiners in SECTION 3 (Section 531.0217, Government Code) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 531.0216(b), Government Code, to require the executive commissioner of the Health and Human Services Commission (HHSC), rather than the HHSC, by rule, to consider certain issues in developing a system to reimburse providers of services under the state Medicaid program for services performed using telemedicine medical services, including establish a separate identifier for telemedicine medical services eligible for reimbursement. Replaces the reference to the "Texas Department of Health" with the "Department of State Health Services." Deletes existing requirement deadline of January 1, 2001. Makes nonsubstantive changes.
SECTION 2. Amends Subchapter B, Chapter 531, Government Code, by adding Section 531.02163, as follows:
Sec. 531.02163. TELEPRESENTERS. (a) Defines "health professional."
(b) Requires the executive commissioner, by rule, to establish and adopt minimum standards to permit the use of trained health professionals other than physicians in presenting patients who are Medicaid recipients for telemedicine medical services consultations to be conducted by physicians at distant sites. Authorizes the health professionals to initiate the consultation but requires them to act under physician delegation and supervision throughout the consultation.
(c) Authorizes HHSC, notwithstanding Section 531.0217 (Reimbursement for Certain Medical Consultations), to provide reimbursement under the state Medicaid program for a telemedicine medical service initiated by a trained health professional who complies with the minimum standards adopted under this section.
SECTION 3. Amends Section 531.0217, Government Code, by amending Subsection (i) and adding Subsection (i-1), as follows:
(i) Deletes existing text authorizing the Texas State Board of Medical Examiners, in consultation with HHSC, as appropriate, to adopt rules to establish supervisory requirements for a service delegated to and performed by an individual who is not a physician. Makes nonsubstantive changes.
(i-1) Requires the Texas State Board of Medical Examiners, in consultation with HHSC, as appropriate, to adopt rules to establish supervisory requirements for a service delegated to and performed by an individual who is not a physician, including a health professional who is authorized to be a telepresenter under Section 531.02163.
SECTION 4. Amends Section 531.02172(a), Government Code, to make a conforming change.
SECTION 5. (a) Defines "telepsychiatry."
(b) Requires the executive commissioner, by rule, to develop and requires the Department of State Health Services to implement a pilot program under which Medicaid recipients in need of mental health services are provided those services through telepsychiatry.
(c) Requires the executive commissioner to design the pilot program in a manner that achieves certain goals.
(d) Prohibits the executive commissioner from requiring mental health services to be provided through telepsychiatry under the pilot program if an in-person consultation with a psychiatrist is reasonably available where the recipient resides or works.
(e) Authorizes HHSC to reimburse a provider participating in the pilot program for services provided through telepsychiatry.
(f) Authorizes HHSC to apply for and receive a grant to fund the pilot program under the federal New Freedom Initiative on Mental Health plan or from the Office of the National Coordinator for Health Information Technology. Requires HHSC to seek the assistance of the Office of State-Federal Relations in identifying and applying for federal grants for the pilot program.
(g) Requires HHSC to submit a report including certain information to the legislature regarding the results of the pilot program not later than December 1, 2006.
(h) Provides that this section expires September 1, 2007.
SECTION 6. (a) Requires HHSC to conduct a study to investigate certain issues related to the system of telemedicine medical services under the state's Medicaid program.
(b) Requires HHSC to submit a report containing regarding the results of the study and certain information to the presiding officers of each house and senate standing committee having jurisdiction over the state Medicaid program.
(c) Provides that this section expires September 1, 2007.
SECTION 7. Requires the Texas State Board of Medical Examiners to adopt rules as required by Section 531.0217(i-1), Government Code, as added by this Act, as soon as practicable after the effective date of this Act. Requires the executive commissioner of the Health and Human Services Commission to adopt rules as required by Section 531.0263, Government Code, as added by this Act, as soon as practicable after the effective date of this Act.
SECTION 8. Authorizes delay of implementation of any provision of this Act until any necessary federal waivers or authorizations are obtained.
SECTION 9. Effective date: September 1, 2005.