82R3956 EES-D
By: Guillen H.B. No. 1605
A BILL TO BE ENTITLED
AN ACT
relating to the use of telemonitoring in the medical assistance
program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.001, Government Code, is amended by
adding Subdivision (7) to read as follows:
(7) "Telemonitoring" means the use of
telecommunications and information technology to provide access to
health assessment, intervention, consultation, supervision, and
information across distance. Telemonitoring includes the use of
technologies such as telephones, facsimile machines, e-mail
systems, text messaging systems, and remote patient monitoring
devices to collect and transmit patient data for monitoring and
interpretation.
SECTION 2. Subchapter B, Chapter 531, Government Code, is
amended by adding Sections 531.02176, 531.02177, and 531.02178 to
read as follows:
Sec. 531.02176. MEDICAID TELEMONITORING PILOT PROGRAMS FOR
DIABETES. (a) The commission shall determine whether the Medicaid
Enhanced Care program's diabetes self-management training
telemonitoring pilot program was cost neutral.
(b) In determining whether the pilot program described by
Subsection (a) was cost neutral, the commission shall, at a
minimum, compare:
(1) the health care costs of program participants who
received telemonitoring services with the health care costs of a
group of Medicaid recipients who did not receive telemonitoring
services;
(2) the health care services used by program
participants who received telemonitoring services with the health
care services used by a group of Medicaid recipients who did not
receive telemonitoring services;
(3) for program participants who received
telemonitoring services, the amount spent on health care services
before, during, and after the receipt of telemonitoring services;
and
(4) for program participants who received
telemonitoring services, the health care services used before,
during, and after the receipt of telemonitoring services.
(c) If the commission determines that the pilot program
described by Subsection (a) was cost neutral, the executive
commissioner shall adopt rules for providing telemonitoring
services through the Medicaid Texas Health Management Program for
select diabetes patients in a manner comparable to that program.
(d) If the commission determines that the pilot program
described by Subsection (a) was not cost neutral, the commission
shall develop and implement within the Medicaid Texas Health
Management Program for select diabetes patients a new diabetes
telemonitoring pilot program based on evidence-based best
practices, provided that the commission determines implementing
the new diabetes telemonitoring pilot program would be cost
neutral.
(e) In determining whether implementing a new diabetes
telemonitoring pilot program under Subsection (d) would be cost
neutral, the commission shall consider appropriate factors,
including the following:
(1) the target population, participant eligibility
criteria, and the number of participants to whom telemonitoring
services would be provided;
(2) the type of telemonitoring technology to be used;
(3) the estimated cost of the telemonitoring services
to be provided;
(4) the estimated cost differential to the state based
on changes in participants' use of emergency department services,
outpatient services, pharmaceutical and ancillary services, and
inpatient services other than inpatient labor and delivery
services; and
(5) other indirect costs that may result from the
provision of telemonitoring services.
Sec. 531.02177. MEDICAID TELEMONITORING PILOT PROGRAM FOR
CERTAIN CONDITIONS. (a) The commission shall develop and
implement a pilot program within the Medicaid Texas Health
Management Program to evaluate the cost neutrality of providing
telemonitoring services to persons who are diagnosed with health
conditions other than diabetes, if the commission determines
implementing the pilot program would be cost neutral.
(b) In determining whether implementing a pilot program
under Subsection (a) would be cost neutral, the commission shall
consider appropriate factors, including the following:
(1) the types of health conditions that could be
assessed through the program by reviewing existing research and
other evidence on the effectiveness of providing telemonitoring
services to persons with those conditions;
(2) the target population, participant eligibility
criteria, and the number of participants to whom telemonitoring
services would be provided;
(3) the type of telemonitoring technology to be used;
(4) the estimated cost of the telemonitoring services
to be provided;
(5) the estimated cost differential to the state based
on changes in participants' use of emergency department services,
outpatient services, pharmaceutical and ancillary services, and
inpatient services other than inpatient labor and delivery
services; and
(6) other indirect costs that may result from the
provision of telemonitoring services.
Sec. 531.02178. DISSEMINATION OF INFORMATION ABOUT
EFFECTIVE TELEMONITORING STRATEGIES. The commission shall
annually:
(1) identify telemonitoring strategies implemented
within the Medicaid program that have demonstrated cost neutrality
or resulted in improved performance on key health measures; and
(2) disseminate information about the identified
strategies to encourage the adoption of effective telemonitoring
strategies.
SECTION 3. (a) Not later than January 1, 2012, the
executive commissioner of the Health and Human Services Commission
shall adopt the rules required by Section 531.02176(c), Government
Code, as added by this Act, if the commission determines that the
Medicaid Enhanced Care program's diabetes self-management training
telemonitoring pilot program was cost neutral.
(b) Not later than September 1, 2012, the Health and Human
Services Commission shall determine whether implementing a new
diabetes telemonitoring pilot program would be cost neutral if
required by Section 531.02176(d), Government Code, as added by this
Act, and report that determination to the governor and the
Legislative Budget Board.
SECTION 4. Not later than September 1, 2012, the Health and
Human Services Commission shall determine whether implementing a
telemonitoring pilot program for health conditions other than
diabetes would be cost neutral as required by Section 531.02177(a),
Government Code, as added by this Act, and report that
determination to the governor and the Legislative Budget Board.
SECTION 5. 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 6. This Act takes effect September 1, 2011.