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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision and reimbursement of home telemonitoring |
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services under Medicaid. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.02164, Government Code, is amended |
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by amending Subsection (c) and adding Subsections (c-1) and (c-2) |
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to read as follows: |
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(c) The program established [required] under this section |
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must: |
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(1) provide that home telemonitoring services are |
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available only to a person [persons] who: |
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(A) is [are] diagnosed with one or more of the |
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following conditions: |
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(i) pregnancy; |
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(ii) diabetes; |
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(iii) heart disease; |
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(iv) cancer; |
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(v) chronic obstructive pulmonary disease; |
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(vi) hypertension; |
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(vii) congestive heart failure; |
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(viii) mental illness or serious emotional |
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disturbance; |
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(ix) asthma; |
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(x) myocardial infarction; or |
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(xi) stroke; and |
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(B) exhibits [exhibit] two or more of the |
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following risk factors: |
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(i) two or more hospitalizations in the |
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prior 12-month period; |
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(ii) frequent or recurrent emergency room |
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admissions; |
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(iii) a documented history of poor |
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adherence to ordered medication regimens; |
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(iv) a documented history of falls in the |
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prior six-month period; |
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(v) limited or absent informal support |
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systems; |
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(vi) living alone or being home alone for |
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extended periods of time; and |
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(vii) a documented history of care access |
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challenges; |
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(2) ensure that clinical information gathered by a |
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home and community support services agency or hospital while |
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providing home telemonitoring services is shared with the patient's |
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physician; [and] |
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(3) ensure that the program does not duplicate disease |
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management program services provided under Section 32.057, Human |
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Resources Code; and |
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(4) provide reimbursement for home telemonitoring |
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services in the event of an unsuccessful data transmission if the |
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provider of the services attempts to communicate with the patient |
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by telephone or in person to establish a successful data |
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transmission. |
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(c-1) Notwithstanding Subsection (c)(1), the program |
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established under this section may also provide that home |
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telemonitoring services are available to pediatric patients with |
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chronic or complex medical needs who: |
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(1) are being concurrently treated by at least three |
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medical specialists; |
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(2) are diagnosed with end-stage solid organ disease; |
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(3) have received an organ transplant; or |
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(4) are diagnosed with severe asthma. |
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(c-2) A provider that is reimbursed under Subsection (c)(4) |
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for home telemonitoring services provided to a patient may not also |
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be reimbursed for communicating with the patient by telephone or in |
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person to establish a successful data transmission as described by |
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Subsection (c)(4). |
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SECTION 2. Section 531.02176, Government Code, is repealed. |
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SECTION 3. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall adopt necessary rules to implement the |
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changes in law made by this Act. |
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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. |