83R8147 SLB-D
By: Laubenberg H.B. No. 1470
A BILL TO BE ENTITLED
AN ACT
relating to the practice of telemedicine.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 111, Occupations Code, is amended to
read as follows:
CHAPTER 111. TELEMEDICINE MEDICAL SERVICES [AND TELEHEALTH]
Sec. 111.001. DEFINITIONS. In this chapter:
(1) "Advanced telecommunications technology" means
technology used for the transfer of data, not including telephone
or facsimile technology. The term includes:
(A) compressed digital interactive video, audio,
or data transmission;
(B) data transmission using computer imaging;
and
(C) other technology that facilitates access to
data.
(2) "Board" means the Texas Medical Board.
(3) "Telemedicine medical service" means a health care
service that is provided through the use of advanced
telecommunications technology for the purpose of:
(A) patient assessment, diagnosis, consultation,
or treatment; or
(B) the transfer of medical data.
(4) "Telemedicine provider" means:
(A) a physician who provides telemedicine
medical services; or
(B) a physician assistant or advanced practice
nurse who:
(i) provides telemedicine medical
services; and
(ii) is supervised by and has delegated
authority from a physician licensed in this state ['Health
professional' and 'physician' have the meanings assigned by Section
1455.001, Insurance Code.
[(2) 'Telehealth service' and 'telemedicine medical
service' have the meanings assigned by Section 57.042, Utilities
Code].
Sec. 111.002. INFORMED CONSENT. A telemedicine provider
must [treating physician or health professional who provides or
facilitates the use of telemedicine medical services or telehealth
services shall] ensure that the informed consent of the patient, or
another appropriate individual authorized to make health care
treatment decisions for the patient, is obtained before
telemedicine medical services [or telehealth services] are
provided.
Sec. 111.003. CONFIDENTIALITY. A telemedicine provider
[treating physician or health professional who provides or
facilitates the use of telemedicine medical services or telehealth
services] shall ensure that the confidentiality of the patient's
medical information is maintained as required by Chapter 159 or
other applicable law.
Sec. 111.004. RULES. The board [Texas State Board of
Medical Examiners], in consultation with the commissioner of
insurance, as appropriate, may adopt rules necessary to implement
this chapter. The board may not adopt a rule to limit the provision
of telemedicine medical services by a telemedicine provider who
meets the requirements of this chapter and other applicable law[:
[(1) ensure that patients using telemedicine medical
services receive appropriate, quality care;
[(2) prevent abuse and fraud in the use of
telemedicine medical services, including rules relating to the
filing of claims and records required to be maintained in
connection with telemedicine medical services;
[(3) ensure adequate supervision of health
professionals who are not physicians and who provide telemedicine
medical services;
[(4) establish the maximum number of health
professionals who are not physicians that a physician may supervise
through a telemedicine medical service; and
[(5) require a face-to-face consultation between a
patient and a physician providing a telemedicine medical service
within a certain number of days following an initial telemedicine
medical service only if the physician has never seen the patient].
Sec. 111.005. PROVISION OF TELEMEDICINE MEDICAL SERVICES.
(a) A telemedicine provider may provide telemedicine medical
services in this state only if the provider:
(1) is licensed in this state;
(2) has established a physician-patient relationship
with the recipient of the services;
(3) advises the patient to see a physician or other
health care professional in person within a reasonable time if the
patient's symptoms do not improve;
(4) provides only services that are medically
indicated;
(5) adopts protocols to prevent fraud and abuse;
(6) does not violate state or federal laws relating to
patient privacy;
(7) maintains medical records for all telemedicine
medical services;
(8) does not treat chronic pain with a controlled
substance listed on Schedule II, III, IV, or V under Chapter 481,
Health and Safety Code, at a site other than a site normally used
for the provision of medical care; and
(9) practices the same standard of care as in a
traditional clinical setting.
(b) For the purposes of Subsection (a)(2), a telemedicine
provider must establish a physician-patient relationship with a
patient in person and in an office setting before providing
telemedicine medical services to the patient.
SECTION 2. The Texas Medical Board shall adopt rules to
implement Chapter 111, Occupations Code, as amended by this Act,
not later than December 1, 2013.
SECTION 3. (a) Except as provided by Subsection (b) of this
section, this Act takes effect December 1, 2013.
(b) Section 2 of this Act takes effect September 1, 2013.