85R978 EES-D
By: Guerra H.B. No. 727
A BILL TO BE ENTITLED
AN ACT
relating to the use of home telemonitoring services under Medicaid.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.02164, Government Code, is amended
by amending Subsection (c) and adding Subsections (c-1) and (c-2)
to read as follows:
(c) The program required under this section must:
(1) provide that home telemonitoring services are
available only to a person [persons] who:
(A) is [are] diagnosed with one or more of the
following conditions:
(i) pregnancy;
(ii) diabetes;
(iii) heart disease;
(iv) cancer;
(v) chronic obstructive pulmonary disease;
(vi) hypertension;
(vii) congestive heart failure;
(viii) mental illness or serious emotional
disturbance;
(ix) asthma;
(x) myocardial infarction; [or]
(xi) stroke; or [and]
(xii) another condition for which the
commission makes an evidence-based determination that monitoring
through the use of home telemonitoring services is cost-effective
and feasible; and
(B) exhibits [exhibit] two or more of the
following risk factors:
(i) two or more hospitalizations in the
prior 12-month period;
(ii) frequent or recurrent emergency room
admissions;
(iii) a documented history of poor
adherence to ordered medication regimens;
(iv) a documented history of falls in the
prior six-month period;
(v) limited or absent informal support
systems;
(vi) living alone or being home alone for
extended periods of time; and
(vii) a documented history of care access
challenges;
(2) ensure that clinical information gathered by a
home and community support services agency or hospital while
providing home telemonitoring services is shared with the patient's
physician; [and]
(3) ensure that the program does not duplicate disease
management program services provided under Section 32.057, Human
Resources Code; and
(4) provide reimbursement for home telemonitoring
services in the event of an unsuccessful data transmission if the
provider of the services attempts to communicate with the patient
by telephone or in person to establish a successful data
transmission.
(c-1) Notwithstanding Subsection (c)(1), the program
required under this section must also provide that home
telemonitoring services are available to a pediatric patient with
chronic or complex medical needs who:
(1) is being concurrently treated by at least three
medical specialists;
(2) is medically dependent on technology;
(3) is diagnosed with end-stage solid organ disease;
or
(4) requires mechanical ventilation.
(c-2) A provider that is reimbursed under Subsection (c)(4)
for home telemonitoring services provided to a patient may not also
be reimbursed for communicating with the patient by telephone or in
person to establish a successful data transmission as described by
Subsection (c)(4).
SECTION 2. Section 531.02176, Government Code, is repealed.
SECTION 3. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt necessary rules to implement the
changes in law made by this Act.
SECTION 4. 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 5. This Act takes effect September 1, 2017.