84R9759 SCL-F
By: Smithee H.B. No. 2172
A BILL TO BE ENTITLED
AN ACT
relating to coverage of telehealth services or telemedicine medical
services under health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1455.001, Insurance Code, is amended by
amending Subdivision (3) and adding Subdivision (4) to read as
follows:
(3) "Telehealth service" or [and] "telemedicine
medical service" means a health care service or medical service,
respectively, 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 [have the
meanings assigned by Section 57.042, Utilities Code].
(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.
SECTION 2. Section 1455.004, Insurance Code, is amended by
adding Subsections (c), (d), (e), and (f) to read as follows:
(c) A health benefit plan may not cover a telemedicine
medical service unless the telemedicine provider:
(1) is licensed in this state;
(2) has established a physician-patient relationship
with the recipient of the service;
(3) is able to verify the identity of the patient;
(4) has discussed the risks and benefits of
telemedicine medical services with the patient;
(5) 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;
(6) provides only services that are medically
indicated;
(7) adopts protocols to prevent fraud and abuse;
(8) does not violate state or federal laws relating to
patient privacy;
(9) maintains medical records for all telemedicine
medical services;
(10) 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
(11) practices according to the appropriate standard
of care for the patient's condition.
(d) For the purposes of Subsection (c), a telemedicine
provider may establish a physician-patient relationship in an
initial encounter using telemedicine medical services.
(e) For the purposes of Subsection (c), a telemedicine
provider must 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 are provided.
(f) For the purposes of Subsection (c), a telemedicine
provider shall ensure that the confidentiality of the patient's
medical information is maintained as required by Chapter 159,
Occupations Code, or other applicable law.
SECTION 3. The change in law made by this Act applies only
to a health benefit plan delivered, issued for delivery, or renewed
on or after January 1, 2016. A health benefit plan delivered,
issued for delivery, or renewed before January 1, 2016, is governed
by the law in effect immediately before the effective date of this
Act, and that law is continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2015.