Texas 2019 - 86th Regular

Texas House Bill HB1738 Compare Versions

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

Old	New	Differences
1	1	86R6128 MM-D
2	2	By: Guillen H.B. No. 1738
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to telehealth and home telemonitoring services, including
8	8	the provision of those services under Medicaid.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 531.02164, Government Code, is amended
11	11	by adding Subsections (c-1), (c-2), and (f) to read as follows:
12	12	(c-1) Notwithstanding Subsection (c)(1), the program
13	13	required under this section may also provide that home
14	14	telemonitoring services are available to a pediatric patient with
15	15	chronic or complex medical needs who:
16	16	(1) is being concurrently treated by at least three
17	17	medical specialists;
18	18	(2) is diagnosed with end-stage solid organ disease;
19	19	(3) has received an organ transplant; or
20	20	(4) is diagnosed with severe asthma.
21	21	(c-2) For purposes of the program established under this
22	22	section, the executive commissioner shall:
23	23	(1) establish an enhanced Medicaid reimbursement rate
24	24	for home telemonitoring services related to management of a
25	25	person's medication that is at least $6 per day more than the rate
26	26	in effect on January 1, 2019;
27	27	(2) establish billing codes and a fee schedule for
28	28	Medicaid reimbursement for home telemonitoring services provided
29	29	by a federally-qualified health center, as defined by 42 U.S.C.
30	30	Section 1396d(l)(2)(B), that are separate from other billing codes
31	31	and fee schedules established for reimbursement for services
32	32	provided by a federally-qualified health center;
33	33	(3) develop a process to prevent fraud and verify the
34	34	success of a data transmission that includes validation of the data
35	35	transmission by the service provider's data carrier; and
36	36	(4) allow for reimbursement for home telemonitoring
37	37	services provided for a period of at least 120 days per episode.
38	38	(f) Each provider of home telemonitoring services under the
39	39	program established under this section shall provide to the
40	40	commission data regarding the services provided for analytical
41	41	purposes.
42	42	SECTION 2. Subchapter B, Chapter 531, Government Code, is
43	43	amended by adding Section 531.02177 to read as follows:
44	44	Sec. 531.02177. STUDY CONCERNING HOME TELEMONITORING AND
45	45	TELEHEALTH SERVICES FRAUD, WASTE, AND ABUSE. (a) Subject to the
46	46	availability of funds, the commission shall conduct a study to
47	47	identify patterns or instances of fraud, waste, or abuse committed
48	48	by providers of Medicaid home telemonitoring services and
49	49	telehealth services.
50	50	(b) Not later than September 1, 2020, the commission shall
51	51	submit to the governor, the lieutenant governor, the speaker of the
52	52	house of representatives, and each legislative standing committee
53	53	with primary jurisdiction over Medicaid the results of the study
54	54	conducted under this section and recommendations for legislative or
55	55	other action.
56	56	(c) Based on the findings of the commission, the executive
57	57	commissioner may adopt rules necessary to prevent or reduce fraud,
58	58	waste, and abuse by providers of Medicaid home telemonitoring
59	59	services and telehealth services.
60	60	(d) This section expires September 1, 2021.
61	61	SECTION 3. Section 111.001(3), Occupations Code, is amended
62	62	to read as follows:
63	63	(3) "Telehealth service" means a health service, other
64	64	than a telemedicine medical service, delivered by a health
65	65	professional licensed, certified, or otherwise entitled to
66	66	practice in this state and acting within the scope of the health
67	67	professional's license, certification, or entitlement to a patient
68	68	at a different physical location than the health professional using
69	69	telecommunications or information technology. The term includes:
70	70	(A) peer services provided by a certified mental
71	71	health peer specialist or a certified substance use recovery
72	72	specialist;
73	73	(B) substance use counseling services; and
74	74	(C) targeted case management services.
75	75	SECTION 4. The following sections of the Government Code
76	76	are repealed:
77	77	(1) Section 531.02164(d); and
78	78	(2) Section 531.02176.
79	79	SECTION 5. As soon as practicable after the effective date
80	80	of this Act, the executive commissioner of the Health and Human
81	81	Services Commission shall adopt rules necessary to implement the
82	82	changes in law made by this Act.
83	83	SECTION 6. If before implementing any provision of this Act
84	84	a state agency determines that a waiver or authorization from a
85	85	federal agency is necessary for implementation of that provision,
86	86	the agency affected by the provision shall request the waiver or
87	87	authorization and may delay implementing that provision until the
88	88	waiver or authorization is granted.
89	89	SECTION 7. This Act takes effect September 1, 2019.