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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid telemedicine and telehealth services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.0216, Government Code, is amended by |
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amending Subsection (b) and adding Subsection (g) to read as |
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follows: |
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(b) In developing the system, the executive commissioner by |
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rule shall: |
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(1) review programs and pilot projects in other states |
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to determine the most effective method for reimbursement; |
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(2) establish billing codes and a fee schedule for |
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services; |
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(3) [consult with the Department of State Health
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Services to establish procedures to:
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[(A)
identify clinical evidence supporting
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delivery of health care services using a telecommunications system;
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and
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[(B)
annually review health care services,
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considering new clinical findings, to determine whether
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reimbursement for particular services should be denied or
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authorized;
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[(4)] establish a separate provider identifier for |
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telemedicine medical services providers, telehealth services |
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providers, and home telemonitoring services providers; and |
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(4) [(5)] establish a separate modifier for |
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telemedicine medical services, telehealth services, and home |
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telemonitoring services eligible for reimbursement. |
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(g) The commission shall ensure a managed care organization |
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that contracts with the commission under Chapter 533 to provide |
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health care services to Medicaid recipients does not deny |
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reimbursement for a covered health care service or procedure |
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delivered by a health care provider with whom the managed care |
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organization contracts to a recipient as a telemedicine medical |
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service or a telehealth service solely because the covered service |
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or procedure is not provided through an in-person consultation. |
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SECTION 2. Section 531.0217(c-4), Government Code, is |
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amended to read as follows: |
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(c-4) The commission shall ensure that Medicaid |
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reimbursement is provided to a physician for a telemedicine medical |
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service provided by the physician, even if the physician is not the |
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patient's primary care physician or provider, if: |
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(1) the physician is an authorized health care |
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provider under Medicaid; |
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(2) the patient is a child who receives the service in |
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a primary or secondary school-based setting; and |
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(3) the parent or legal guardian of the patient |
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provides consent before the service is provided[; and
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[(4)
a health professional is present with the patient
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during the treatment]. |
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SECTION 3. The following provisions of the Government Code |
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are repealed: |
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(1) Section 531.0216(e); |
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(2) Section 531.02161; |
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(3) Sections 531.0217(c-2) and (c-3); and |
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(4) Section 531.02173. |
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SECTION 4. 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 5. This Act takes effect September 1, 2019. |