86R887 MM-D
 
  By: Guerra H.B. No. 2062
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the provision and reimbursement of home telemonitoring
  services under Medicaid.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 531.02164, Government Code, is amended
  by amending Subsection (c) and adding Subsections (c-1) and (c-2)
  to read as follows:
         (c)  The program established [required] under this section
  must:
               (1)  provide that home telemonitoring services are
  available only to a person [persons] who:
                     (A)  is [are] diagnosed with one or more of the
  following conditions:
                           (i)  pregnancy;
                           (ii)  diabetes;
                           (iii)  heart disease;
                           (iv)  cancer;
                           (v)  chronic obstructive pulmonary disease;
                           (vi)  hypertension;
                           (vii)  congestive heart failure;
                           (viii)  mental illness or serious emotional
  disturbance;
                           (ix)  asthma;
                           (x)  myocardial infarction; or
                           (xi)  stroke; and
                     (B)  exhibits [exhibit] two or more of the
  following risk factors:
                           (i)  two or more hospitalizations in the
  prior 12-month period;
                           (ii)  frequent or recurrent emergency room
  admissions;
                           (iii)  a documented history of poor
  adherence to ordered medication regimens;
                           (iv)  a documented history of falls in the
  prior six-month period;
                           (v)  limited or absent informal support
  systems;
                           (vi)  living alone or being home alone for
  extended periods of time; and
                           (vii)  a documented history of care access
  challenges;
               (2)  ensure that clinical information gathered by a
  home and community support services agency or hospital while
  providing home telemonitoring services is shared with the patient's
  physician; [and]
               (3)  ensure that the program does not duplicate disease
  management program services provided under Section 32.057, Human
  Resources Code; and
               (4)  provide reimbursement for home telemonitoring
  services in the event of an unsuccessful data transmission if the
  provider of the services attempts to communicate with the patient
  by telephone or in person to establish a successful data
  transmission.
         (c-1)  Notwithstanding Subsection (c)(1), the program
  established under this section may also provide that home
  telemonitoring services are available to pediatric patients with
  chronic or complex medical needs who:
               (1)  are being concurrently treated by at least three
  medical specialists;
               (2)  are diagnosed with end-stage solid organ disease;
               (3)  have received an organ transplant; or
               (4)  are diagnosed with severe asthma.
         (c-2)  A provider that is reimbursed under Subsection (c)(4)
  for home telemonitoring services provided to a patient may not also
  be reimbursed for communicating with the patient by telephone or in
  person to establish a successful data transmission as described by
  Subsection (c)(4).
         SECTION 2.  Section 531.02176, Government Code, is repealed.
         SECTION 3.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall adopt necessary rules to implement the
  changes in law made by this Act.
         SECTION 4.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 5.  This Act takes effect September 1, 2019.