Texas 2015 - 84th Regular

Texas House Bill HB3444 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R10560 EES-F
2	2	By: Laubenberg H.B. No. 3444
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the provision of telemedicine medical services by a
8	8	physician.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The legislature finds that there are
11	11	circumstances in which telemedicine medical services may be
12	12	provided to patients in this state in a manner that is highly
13	13	convenient and cost-effective for the patient and that safeguards
14	14	the patient's need for competent and effective medical care. A
15	15	governmental entity in this state may not construe or implement the
16	16	changes in law made by this Act to discourage or inhibit broad
17	17	access by patients in this state to highly convenient and
18	18	cost-effective telemedicine medical services.
19	19	SECTION 2. Section 111.001, Occupations Code, is amended to
20	20	read as follows:
21	21	Sec. 111.001. DEFINITIONS. In this chapter:
22	22	(1) 'Health professional' and 'physician' have the
23	23	meanings assigned by Section 1455.001, Insurance Code.
24	24	(2) "Telecommunications technology" means technology
25	25	used for communication or for the transfer of information or data.
26	26	The term includes:
27	27	(A) wired or wireless telephone services;
28	28	(B) interactive video, audio, or data
29	29	transmission; and
30	30	(C) data transmission using computer imaging.
31	31	(3) "Telehealth service" means a health service, other
32	32	than a telemedicine medical service, that is delivered by a health
33	33	professional and that requires the use of telecommunications
34	34	technology.
35	35	(4) "Telemedicine medical service" means a health care
36	36	service provided to a patient in this state through the use of
37	37	telecommunications technology in real time by a physician, or by a
38	38	health professional acting under physician delegation and
39	39	supervision, to:
40	40	(A) evaluate, diagnose, consult with, or treat a
41	41	patient; or
42	42	(B) transfer medical data ['Telehealth service'
43	43	and 'telemedicine medical service' have the meanings assigned by
44	44	Section 57.042, Utilities Code].
45	45	SECTION 3. Section 111.004, Occupations Code, is amended to
46	46	read as follows:
47	47	Sec. 111.004. RULES. The Texas Medical [State] Board [of
48	48	Medical Examiners], in consultation with the commissioner of
49	49	insurance, as appropriate, may adopt rules necessary to:
50	50	(1) ensure that patients using telemedicine medical
51	51	services receive appropriate, quality care;
52	52	(2) prevent abuse and fraud in the use of telemedicine
53	53	medical services, including rules relating to the filing of claims
54	54	and records required to be maintained in connection with
55	55	telemedicine medical services;
56	56	(3) ensure adequate supervision of health
57	57	professionals who are not physicians and who provide telemedicine
58	58	medical services; and
59	59	(4) establish the maximum number of health
60	60	professionals who are not physicians that a physician may supervise
61	61	through a telemedicine medical service[; and
62	62	[(5) require a face-to-face consultation between a
63	63	patient and a physician providing a telemedicine medical service
64	64	within a certain number of days following an initial telemedicine
65	65	medical service only if the physician has never seen the patient].
66	66	SECTION 4. Chapter 111, Occupations Code, is amended by
67	67	adding Section 111.006 to read as follows:
68	68	Sec. 111.006. PROVISION OF TELEMEDICINE MEDICAL SERVICES
69	69	UNDER CERTAIN CIRCUMSTANCES. (a) This section does not apply to
70	70	the provision of telemedicine medical services under circumstances
71	71	in which:
72	72	(1) the physician providing the services conducts a
73	73	face-to-face visit with the patient before providing the services;
74	74	(2) the patient receiving the services undergoes an
75	75	in-person evaluation by another physician who refers the patient to
76	76	the physician providing the services for additional care and
77	77	documents the referral in the patient's medical record; or
78	78	(3) the services are provided at an established
79	79	medical site, as defined by Texas Medical Board rules, where a
80	80	patient seeks medical care and where there is a patient site
81	81	presenter and sufficient technology and medical equipment to allow
82	82	for an adequate physical evaluation.
83	83	(b) Before a physician may provide telemedicine medical
84	84	services to a patient, the physician must establish a
85	85	physician-patient relationship with the patient. A physician may
86	86	establish a physician-patient relationship with a patient by an
87	87	initial encounter through the use of telecommunications
88	88	technology.
89	89	(c) A physician shall provide telemedicine medical services
90	90	according to a written protocol adopted by the physician or the
91	91	organization in which the physician is practicing. A protocol must
92	92	include:
93	93	(1) a description of the circumstances under which the
94	94	provision of telemedicine medical services is medically
95	95	appropriate, including a description of the circumstances under
96	96	which the physician-patient relationship may be established and
97	97	services may be provided through the use of a telephone;
98	98	(2) an indication of the types of medically indicated
99	99	services that may be provided under the circumstances described in
100	100	Subdivision (1);
101	101	(3) procedures to prevent fraud and abuse in the
102	102	provision of telemedicine medical services;
103	103	(4) policies for the maintenance of adequate medical
104	104	records of the telemedicine medical services provided; and
105	105	(5) guidelines for advising a patient to see a
106	106	physician or other appropriate health professional in person and
107	107	within a reasonable time if the patient's symptoms do not improve.
108	108	(d) A physician may not prescribe a Schedule II, III, IV, or
109	109	V controlled substance, as specified under Chapter 481, Health and
110	110	Safety Code, in the course of providing telemedicine medical
111	111	services.
112	112	(e) A physician providing telemedicine medical services
113	113	shall exercise the physician's discretion to:
114	114	(1) ensure that the physician is providing the
115	115	services using the same standard of care applicable to the
116	116	provision of medical services in a traditional clinical setting;
117	117	and
118	118	(2) determine when a face-to-face examination of a
119	119	patient is necessary to comply with the applicable standard of care
120	120	for the services.
121	121	(f) The Texas Medical Board may not require that
122	122	telemedicine medical services be provided only in conjunction with:
123	123	(1) a face-to-face visit with or in-person evaluation
124	124	of the patient before, while, or after the patient receives
125	125	telemedicine medical services; or
126	126	(2) an examination of the patient at an established
127	127	medical site as described in Subsection (a)(3) before, while, or
128	128	after the patient receives telemedicine medical services.
129	129	SECTION 5. This Act takes effect September 1, 2015.