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A BILL TO BE ENTITLED
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AN ACT
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relating to the use of telemonitoring in the medical assistance |
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program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.001, Government Code, is amended by |
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adding Subdivision (7) to read as follows: |
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(7) "Telemonitoring" means the use of |
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telecommunications and information technology to provide access to |
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health assessment, intervention, consultation, supervision, and |
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information across distance. Telemonitoring includes the use of |
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technologies such as telephones, facsimile machines, e-mail |
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systems, text messaging systems, and remote patient monitoring |
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devices to collect and transmit patient data for monitoring and |
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interpretation. |
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SECTION 2. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Sections 531.02176, 531.02177, and 531.02178 to |
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read as follows: |
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Sec. 531.02176. MEDICAID TELEMONITORING PILOT PROGRAMS FOR |
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DIABETES. (a) The commission shall determine whether the Medicaid |
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Enhanced Care program's diabetes self-management training |
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telemonitoring pilot program was cost neutral. |
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(b) In determining whether the pilot program described by |
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Subsection (a) was cost neutral, the commission shall, at a |
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minimum, compare: |
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(1) the health care costs of program participants who |
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received telemonitoring services with the health care costs of a |
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group of Medicaid recipients who did not receive telemonitoring |
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services; |
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(2) the health care services used by program |
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participants who received telemonitoring services with the health |
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care services used by a group of Medicaid recipients who did not |
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receive telemonitoring services; |
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(3) for program participants who received |
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telemonitoring services, the amount spent on health care services |
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before, during, and after the receipt of telemonitoring services; |
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and |
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(4) for program participants who received |
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telemonitoring services, the health care services used before, |
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during, and after the receipt of telemonitoring services. |
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(c) If the commission determines that the pilot program |
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described by Subsection (a) was cost neutral, the executive |
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commissioner shall adopt rules for providing telemonitoring |
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services through the Medicaid Texas Health Management Program for |
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select diabetes patients in a manner comparable to that program. |
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(d) If the commission determines that the pilot program |
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described by Subsection (a) was not cost neutral, the commission |
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shall develop and implement within the Medicaid Texas Health |
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Management Program for select diabetes patients a new diabetes |
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telemonitoring pilot program based on evidence-based best |
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practices, provided that the commission determines implementing |
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the new diabetes telemonitoring pilot program would be cost |
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neutral. |
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(e) In determining whether implementing a new diabetes |
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telemonitoring pilot program under Subsection (d) would be cost |
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neutral, the commission shall consider appropriate factors, |
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including the following: |
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(1) the target population, participant eligibility |
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criteria, and the number of participants to whom telemonitoring |
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services would be provided; |
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(2) the type of telemonitoring technology to be used; |
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(3) the estimated cost of the telemonitoring services |
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to be provided; |
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(4) the estimated cost differential to the state based |
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on changes in participants' use of emergency department services, |
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outpatient services, pharmaceutical and ancillary services, and |
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inpatient services other than inpatient labor and delivery |
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services; and |
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(5) other indirect costs that may result from the |
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provision of telemonitoring services. |
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Sec. 531.02177. MEDICAID TELEMONITORING PILOT PROGRAM FOR |
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CERTAIN CONDITIONS. (a) The commission shall develop and |
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implement a pilot program within the Medicaid Texas Health |
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Management Program to evaluate the cost neutrality of providing |
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telemonitoring services to persons who are diagnosed with health |
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conditions other than diabetes, if the commission determines |
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implementing the pilot program would be cost neutral. |
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(b) In determining whether implementing a pilot program |
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under Subsection (a) would be cost neutral, the commission shall |
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consider appropriate factors, including the following: |
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(1) the types of health conditions that could be |
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assessed through the program by reviewing existing research and |
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other evidence on the effectiveness of providing telemonitoring |
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services to persons with those conditions; |
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(2) the target population, participant eligibility |
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criteria, and the number of participants to whom telemonitoring |
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services would be provided; |
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(3) the type of telemonitoring technology to be used; |
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(4) the estimated cost of the telemonitoring services |
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to be provided; |
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(5) the estimated cost differential to the state based |
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on changes in participants' use of emergency department services, |
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outpatient services, pharmaceutical and ancillary services, and |
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inpatient services other than inpatient labor and delivery |
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services; and |
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(6) other indirect costs that may result from the |
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provision of telemonitoring services. |
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Sec. 531.02178. DISSEMINATION OF INFORMATION ABOUT |
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EFFECTIVE TELEMONITORING STRATEGIES. The commission shall |
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annually: |
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(1) identify telemonitoring strategies implemented |
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within the Medicaid program that have demonstrated cost neutrality |
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or resulted in improved performance on key health measures; and |
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(2) disseminate information about the identified |
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strategies to encourage the adoption of effective telemonitoring |
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strategies. |
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SECTION 3. (a) Not later than January 1, 2012, the |
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executive commissioner of the Health and Human Services Commission |
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shall adopt the rules required by Section 531.02176(c), Government |
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Code, as added by this Act, if the commission determines that the |
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Medicaid Enhanced Care program's diabetes self-management training |
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telemonitoring pilot program was cost neutral. |
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(b) Not later than September 1, 2012, the Health and Human |
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Services Commission shall determine whether implementing a new |
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diabetes telemonitoring pilot program would be cost neutral if |
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required by Section 531.02176(d), Government Code, as added by this |
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Act, and report that determination to the governor and the |
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Legislative Budget Board. |
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SECTION 4. Not later than September 1, 2012, the Health and |
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Human Services Commission shall determine whether implementing a |
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telemonitoring pilot program for health conditions other than |
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diabetes would be cost neutral as required by Section 531.02177(a), |
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Government Code, as added by this Act, and report that |
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determination to the governor and the Legislative Budget Board. |
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SECTION 5. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 6. This Act takes effect September 1, 2011. |