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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of telemedicine medical services by a |
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physician. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The legislature finds that there are |
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circumstances in which telemedicine medical services may be |
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provided to patients in this state in a manner that is highly |
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convenient and cost-effective for the patient and that safeguards |
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the patient's need for competent and effective medical care. A |
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governmental entity in this state may not construe or implement the |
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changes in law made by this Act to discourage or inhibit broad |
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access by patients in this state to highly convenient and |
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cost-effective telemedicine medical services. |
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SECTION 2. Section 111.001, Occupations Code, is amended to |
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read as follows: |
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Sec. 111.001. DEFINITIONS. In this chapter: |
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(1) 'Health professional' and 'physician' have the |
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meanings assigned by Section 1455.001, Insurance Code. |
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(2) "Telecommunications technology" means technology |
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used for communication or for the transfer of information or data. |
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The term includes: |
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(A) wired or wireless telephone services; |
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(B) interactive video, audio, or data |
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transmission; and |
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(C) data transmission using computer imaging. |
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(3) "Telehealth service" means a health service, other |
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than a telemedicine medical service, that is delivered by a health |
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professional and that requires the use of telecommunications |
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technology. |
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(4) "Telemedicine medical service" means a health care |
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service provided to a patient in this state through the use of |
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telecommunications technology in real time by a physician, or by a |
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health professional acting under physician delegation and |
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supervision, to: |
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(A) evaluate, diagnose, consult with, or treat a |
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patient; or |
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(B) transfer medical data ['Telehealth service'
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and 'telemedicine medical service' have the meanings assigned by
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Section 57.042, Utilities Code]. |
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SECTION 3. Section 111.004, Occupations Code, is amended to |
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read as follows: |
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Sec. 111.004. RULES. The Texas Medical [State] Board [of
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Medical Examiners], in consultation with the commissioner of |
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insurance, as appropriate, may adopt rules necessary to: |
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(1) ensure that patients using telemedicine medical |
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services receive appropriate, quality care; |
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(2) prevent abuse and fraud in the use of telemedicine |
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medical services, including rules relating to the filing of claims |
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and records required to be maintained in connection with |
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telemedicine medical services; |
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(3) ensure adequate supervision of health |
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professionals who are not physicians and who provide telemedicine |
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medical services; and |
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(4) establish the maximum number of health |
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professionals who are not physicians that a physician may supervise |
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through a telemedicine medical service[; and
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[(5)
require a face-to-face consultation between a
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patient and a physician providing a telemedicine medical service
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within a certain number of days following an initial telemedicine
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medical service only if the physician has never seen the patient]. |
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SECTION 4. Chapter 111, Occupations Code, is amended by |
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adding Section 111.006 to read as follows: |
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Sec. 111.006. PROVISION OF TELEMEDICINE MEDICAL SERVICES |
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UNDER CERTAIN CIRCUMSTANCES. (a) This section does not apply to |
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the provision of telemedicine medical services under circumstances |
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in which: |
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(1) the physician providing the services conducts a |
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face-to-face visit with the patient before providing the services; |
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(2) the patient receiving the services undergoes an |
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in-person evaluation by another physician who refers the patient to |
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the physician providing the services for additional care and |
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documents the referral in the patient's medical record; or |
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(3) the services are provided at an established |
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medical site, as defined by Texas Medical Board rules, where a |
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patient seeks medical care and where there is a patient site |
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presenter and sufficient technology and medical equipment to allow |
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for an adequate physical evaluation. |
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(b) Before a physician may provide telemedicine medical |
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services to a patient, the physician must establish a |
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physician-patient relationship with the patient. A physician may |
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establish a physician-patient relationship with a patient by an |
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initial encounter through the use of telecommunications |
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technology. |
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(c) A physician shall provide telemedicine medical services |
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according to a written protocol adopted by the physician or the |
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organization in which the physician is practicing. A protocol must |
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include: |
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(1) a description of the circumstances under which the |
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provision of telemedicine medical services is medically |
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appropriate, including a description of the circumstances under |
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which the physician-patient relationship may be established and |
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services may be provided through the use of a telephone; |
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(2) an indication of the types of medically indicated |
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services that may be provided under the circumstances described in |
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Subdivision (1); |
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(3) procedures to prevent fraud and abuse in the |
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provision of telemedicine medical services; |
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(4) policies for the maintenance of adequate medical |
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records of the telemedicine medical services provided; and |
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(5) guidelines for advising a patient to see a |
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physician or other appropriate health professional in person and |
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within a reasonable time if the patient's symptoms do not improve. |
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(d) A physician may not prescribe a Schedule II, III, IV, or |
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V controlled substance, as specified under Chapter 481, Health and |
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Safety Code, in the course of providing telemedicine medical |
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services. |
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(e) A physician providing telemedicine medical services |
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shall exercise the physician's discretion to: |
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(1) ensure that the physician is providing the |
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services using the same standard of care applicable to the |
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provision of medical services in a traditional clinical setting; |
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and |
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(2) determine when a face-to-face examination of a |
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patient is necessary to comply with the applicable standard of care |
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for the services. |
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(f) The Texas Medical Board may not require that |
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telemedicine medical services be provided only in conjunction with: |
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(1) a face-to-face visit with or in-person evaluation |
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of the patient before, while, or after the patient receives |
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telemedicine medical services; or |
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(2) an examination of the patient at an established |
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medical site as described in Subsection (a)(3) before, while, or |
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after the patient receives telemedicine medical services. |
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SECTION 5. This Act takes effect September 1, 2015. |