84R9759 SCL-F
  By: Smithee H.B. No. 2172
  relating to coverage of telehealth services or telemedicine medical
  services under health benefit plans.
         SECTION 1.  Section 1455.001, Insurance Code, is amended by
  amending Subdivision (3) and adding Subdivision (4) to read as
               (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
               (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.