84R6180 EES-F
By: Coleman H.B. No. 2250
A BILL TO BE ENTITLED
AN ACT
relating to the delivery of telemedicine medical services and
telehealth services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 111.001, Occupations Code, is amended by
amending Subdivision (2) and adding Subdivisions (3) and (4) to
read as follows:
(2) "Residence" means a place where a person resides
and includes a home, a nursing home, a convalescent home, or a
residential unit ['Telehealth service' and 'telemedicine medical
service' have the meanings assigned by Section 57.042, Utilities
Code].
(3) "Telehealth service" means a health service, other
than a telemedicine medical service, that is delivered by a
licensed or certified health professional acting within the scope
of the health professional's license or certification who does not
perform a telemedicine medical service and that requires the use of
advanced telecommunications technology, including:
(A) compressed digital interactive video, audio,
or data transmission;
(B) clinical data transmission using computer
imaging by way of still-image capture and store and forward; and
(C) other technology that facilitates access to
health care services or medical specialty expertise.
(4) "Telemedicine medical service" means a health care
service that is initiated by a physician or provided by a health
professional acting under physician delegation and supervision,
that is provided for purposes of patient assessment by a health
professional, diagnosis or consultation by a physician, or
treatment, or for the transfer of medical data, and that requires
the use of advanced telecommunications technology, including:
(A) compressed digital interactive video, audio,
or data transmission;
(B) clinical data transmission using computer
imaging by way of still-image capture and store and forward; and
(C) other technology that facilitates access to
health care services or medical specialty expertise.
SECTION 2. Section 111.002, Occupations Code, is amended to
read as follows:
Sec. 111.002. INFORMED CONSENT. (a) Except as provided by
Subsection (c), a [A] 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.
(b) A copy of an informed consent form signed by a patient in
accordance with Subsection (a) must be retained in the patient's
medical record and provided to the patient or the patient's legally
authorized representative on request.
(c) A treating physician or health professional who
provides or facilitates the use of telemedicine medical services or
telehealth services to provide emergency medical care, as that term
is defined in Section 773.003, Health and Safety Code, is not
required to obtain informed consent before telemedicine medical
services or telehealth services are provided if:
(1) the patient is unable to give the patient's
informed consent; and
(2) an individual authorized to make health care
treatment decisions for the patient is unavailable to give the
individual's informed consent.
SECTION 3. Chapter 111, Occupations Code, is amended by
adding Section 111.0021 to read as follows:
Sec. 111.0021. RIGHT TO REFUSE. (a) A patient may refuse
at any time to receive telemedicine medical services or telehealth
services.
(b) A patient's refusal to receive telemedicine medical
services or telehealth services may not affect the patient's:
(1) right to future care, diagnosis, or treatment; or
(2) receipt of benefits under the Medicaid program.
SECTION 4. Section 111.004, Occupations Code, is amended to
read as follows:
Sec. 111.004. RULES. The Texas [State Board of] Medical
Board [Examiners], in consultation with the commissioner of
insurance, as appropriate, may adopt rules necessary to:
(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; and
(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].
SECTION 5. Chapter 111, Occupations Code, is amended by
adding Section 111.005 to read as follows:
Sec. 111.005. PROVISION OF SERVICES. (a) A treating
physician who provides telemedicine medical services shall
determine whether the presence of a physician or health
professional is required at the site where the patient is receiving
the services.
(b) A treating physician who provides telemedicine medical
services or a treating health professional who provides telehealth
services shall determine if a patient's residence is an appropriate
site at which the patient may receive the services.
SECTION 6. Not later than January 1, 2016, the executive
commissioner of the Health and Human Services Commission and the
Texas Medical Board shall adopt any rules necessary to implement
the changes in law made by this Act.
SECTION 7. 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 8. This Act takes effect September 1, 2015.