85R169 EES-D
By: Taylor of Collin S.B. No. 1428
A BILL TO BE ENTITLED
AN ACT
relating to the provision of mental health telemedicine medical
services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 111.001, Occupations Code, is amended to
read as follows:
Sec. 111.001. DEFINITIONS. In this chapter:
(1) "Behavioral emergency" means a situation that
involves an individual who is behaving in a violent or
self-destructive manner and in which:
(A) preventive, de-escalative, or verbal
techniques are determined to be ineffective; and
(B) immediate restraint or seclusion of the
individual is necessary to prevent:
(i) imminent probable death or substantial
bodily harm to the individual because the individual is attempting
to commit suicide or inflict serious bodily harm; or
(ii) imminent physical harm to others
because of the individual's actions.
(2) "Established medical site" means a location at
which a patient seeks medical care that has sufficient technology
and medical equipment to allow for an adequate physical evaluation
of the patient.
(3) "Face-to-face evaluation" means an evaluation of a
patient in which the treating physician or health professional and
the patient are at the same physical location or the patient is at
an established medical site.
(4) "Group or institutional setting" includes a
residential treatment facility, halfway house, jail, juvenile
detention center, prison, nursing home, group home, rehabilitation
center, and assisted living facility.
(5) "Health professional" means:
(A) a physician;
(B) an individual who is:
(i) licensed or certified in this state to
perform health care services, including a licensed clinical social
worker, a licensed professional counselor, and a marriage and
family therapist; and
(ii) authorized to assist a physician in
providing telemedicine medical services that are delegated and
supervised by the physician; or
(C) a licensed or certified health professional,
including a licensed clinical social worker, a licensed
professional counselor, and a marriage and family therapist, acting
within the scope of the license or certification who performs a
telehealth service and who does not perform a telemedicine medical
service.
(6) "In-person evaluation" means an evaluation of a
patient in which the treating physician or health professional and
the patient are at the same physical location.
(7) "Patient site presenter" means an individual at
the patient's physical location who introduces the patient to the
treating physician or health professional for examination, to whom
the treating physician or health professional may delegate tasks,
and who:
(A) is licensed or certified in this state to
perform health care services and acts only within the scope of the
individual's license or certification; or
(B) is credentialed to provide qualified mental
health professional community services, has demonstrated and
documented competency in the work to be performed, and:
(i) holds a bachelor's or more advanced
degree from an accredited institution of higher education with a
minimum number of hours that is equivalent to a major in psychology,
social work, medicine, nursing, rehabilitation, counseling,
sociology, human growth and development, physician assistant
studies, gerontology, special education, educational psychology,
early childhood education, or early childhood intervention;
(ii) is a registered nurse; or
(iii) completes an alternative
credentialing process identified by the Department of State Health
Services.
(8) "Physician" has ["Health professional" and
"physician" have] the meaning [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.]
SECTION 2. 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;
(4) establish the maximum number of health
professionals who are not physicians that a physician may supervise
through a telemedicine medical service; and
(5) subject to Section 111.005, 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 3. Chapter 111, Occupations Code, is amended by
adding Section 111.005 to read as follows:
Sec. 111.005. PROVISION OF MENTAL HEALTH TELEMEDICINE
MEDICAL SERVICES. A treating physician or health professional
providing only mental health telemedicine medical services to a
patient:
(1) is not required to engage the services of a patient
site presenter, except in a behavioral emergency;
(2) shall consider the patient's private home or a
group or institutional setting where the patient resides as an
established medical site; and
(3) is not required to conduct a face-to-face or
in-person evaluation of the patient to diagnose the patient in the
establishment of a physician-patient relationship with the
patient, except in a behavioral emergency, provided the physician
or health professional otherwise meets the standard of care.
SECTION 4. This Act takes effect September 1, 2017.