| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to coverage of telehealth services or telemedicine medical |
|
|
services under health benefit plans. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 1455.001, Insurance Code, is amended by |
|
|
amending Subdivision (3) and adding Subdivision (4) to read as |
|
|
follows: |
|
|
(3) "Telehealth service" or [and] "telemedicine |
|
|
medical service" means a health care service or medical service, |
|
|
respectively, that is provided through the use of advanced |
|
|
telecommunications technology for the purpose of: |
|
|
(A) patient assessment, diagnosis, consultation, |
|
|
or treatment; or |
|
|
(B) the transfer of medical data [have the
|
|
|
meanings assigned by Section 57.042, Utilities Code]. |
|
|
(4) "Telemedicine provider" means: |
|
|
(A) a physician who provides telemedicine |
|
|
medical services; or |
|
|
(B) a physician assistant or advanced practice |
|
|
nurse who: |
|
|
(i) provides telemedicine medical |
|
|
services; and |
|
|
(ii) is supervised by and has delegated |
|
|
authority from a physician licensed in this state. |
|
|
SECTION 2. Section 1455.004, Insurance Code, is amended by |
|
|
adding Subsections (c), (d), (e), and (f) to read as follows: |
|
|
(c) A health benefit plan may not cover a telemedicine |
|
|
medical service unless the telemedicine provider: |
|
|
(1) is licensed in this state; |
|
|
(2) has established a physician-patient relationship |
|
|
with the recipient of the service; |
|
|
(3) is able to verify the identity of the patient; |
|
|
(4) has discussed the risks and benefits of |
|
|
telemedicine medical services with the patient; |
|
|
(5) advises the patient to see a physician or other |
|
|
health care professional in person within a reasonable time if the |
|
|
patient's symptoms do not improve; |
|
|
(6) provides only services that are medically |
|
|
indicated; |
|
|
(7) adopts protocols to prevent fraud and abuse; |
|
|
(8) does not violate state or federal laws relating to |
|
|
patient privacy; |
|
|
(9) maintains medical records for all telemedicine |
|
|
medical services; |
|
|
(10) does not treat chronic pain with a controlled |
|
|
substance listed on Schedule II, III, IV, or V under Chapter 481, |
|
|
Health and Safety Code, at a site other than a site normally used |
|
|
for the provision of medical care; and |
|
|
(11) practices according to the appropriate standard |
|
|
of care for the patient's condition. |
|
|
(d) For the purposes of Subsection (c), a telemedicine |
|
|
provider may establish a physician-patient relationship in an |
|
|
initial encounter using telemedicine medical services. |
|
|
(e) For the purposes of Subsection (c), a telemedicine |
|
|
provider must ensure that the informed consent of the patient, or |
|
|
another appropriate individual authorized to make health care |
|
|
treatment decisions for the patient, is obtained before |
|
|
telemedicine medical services are provided. |
|
|
(f) For the purposes of Subsection (c), a telemedicine |
|
|
provider shall ensure that the confidentiality of the patient's |
|
|
medical information is maintained as required by Chapter 159, |
|
|
Occupations Code, or other applicable law. |
|
|
SECTION 3. The change in law made by this Act applies only |
|
|
to a health benefit plan delivered, issued for delivery, or renewed |
|
|
on or after January 1, 2016. A health benefit plan delivered, |
|
|
issued for delivery, or renewed before January 1, 2016, is governed |
|
|
by the law in effect immediately before the effective date of this |
|
|
Act, and that law is continued in effect for that purpose. |
|
|
SECTION 4. This Act takes effect September 1, 2015. |