Texas 2021 - 87th Regular

Texas House Bill HB2612 Compare Versions

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

Old	New	Differences
1	1	87R4420 KFF-D
2	2	By: Raney H.B. No. 2612
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the provision of Medicaid and child health plan program
8	8	services using telecommunications or information technology and to
9	9	reimbursement for those services.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 531.0216(i), Government Code, is amended
12	12	to read as follows:
13	13	(i) The executive commissioner by rule shall ensure that a
14	14	rural health clinic as defined by 42 U.S.C. Section 1396d(l)(1) and
15	15	a federally qualified health center as defined by 42 U.S.C. Section
16	16	1396d(l)(2)(B) may be reimbursed for the originating site facility
17	17	fee or the distant site practitioner fee or both, as appropriate,
18	18	for a covered telemedicine medical service or telehealth service
19	19	delivered by a health care provider to a Medicaid recipient. [The
20	20	commission is required to implement this subsection only if the
21	21	legislature appropriates money specifically for that purpose. If
22	22	the legislature does not appropriate money specifically for that
23	23	purpose, the commission may, but is not required to, implement this
24	24	subsection using other money available to the commission for that
25	25	purpose.]
26	26	SECTION 2. Subchapter B, Chapter 531, Government Code, is
27	27	amended by adding Section 531.02161 to read as follows:
28	28	Sec. 531.02161. OPTION TO RECEIVE SERVICES THROUGH
29	29	TELECOMMUNICATIONS AND INFORMATION TECHNOLOGY UNDER MEDICAID AND
30	30	CHILD HEALTH PLAN PROGRAM. (a) In this section, "case management
31	31	services" includes service coordination, service management, and
32	32	care coordination.
33	33	(b) To the extent permitted by federal law and to the extent
34	34	appropriate, the commission shall ensure that Medicaid recipients
35	35	and child health plan program enrollees, regardless of whether
36	36	receiving benefits through a managed care delivery model or another
37	37	delivery model, have the option to receive services as telemedicine
38	38	medical services, telehealth services, or otherwise using
39	39	telecommunications or information technology, including the
40	40	following services:
41	41	(1) evaluation services;
42	42	(2) case management services;
43	43	(3) behavioral health services;
44	44	(4) occupational, physical, and speech therapy
45	45	services;
46	46	(5) professional and specialized therapy services
47	47	provided under the community living assistance and support services
48	48	(CLASS) waiver program;
49	49	(6) assessment services, including nursing
50	50	assessments under the following Section 1915(c) waiver programs:
51	51	(A) the community living assistance and support
52	52	services (CLASS) waiver program;
53	53	(B) the deaf-blind with multiple disabilities
54	54	(DBMD) waiver program;
55	55	(C) the home and community-based services (HCS)
56	56	waiver program; and
57	57	(D) the Texas home living (TxHmL) waiver program;
58	58	and
59	59	(7) hospice services.
60	60	SECTION 3. Section 531.0217(d), Government Code, is
61	61	redesignated as Section 531.02176, Government Code, and amended to
62	62	read as follows:
63	63	Sec. 531.02176. REIMBURSEMENT PARITY FOR TELEMEDICINE
64	64	MEDICAL AND TELEHEALTH SERVICES. (a) [(d)] The commission shall
65	65	require reimbursement for a telemedicine medical service or
66	66	telehealth service at the same rate as Medicaid reimburses for the
67	67	same in-person [medical] service. A request for reimbursement may
68	68	not be denied solely because an in-person [medical] service between
69	69	a health care provider [physician] and a patient did not occur.
70	70	(b) The commission may not limit a provider's [physician's]
71	71	choice of platform for providing a telemedicine medical service or
72	72	telehealth service by requiring that the provider [physician] use a
73	73	particular platform to receive reimbursement for the service.
74	74	SECTION 4. Section 62.1571, Health and Safety Code, is
75	75	amended to read as follows:
76	76	Sec. 62.1571. TELEMEDICINE MEDICAL SERVICES AND TELEHEALTH
77	77	SERVICES. (a) In providing covered benefits to a child, a health
78	78	plan provider must permit benefits to be provided through
79	79	telemedicine medical services and telehealth services in
80	80	accordance with policies developed by the commission.
81	81	(b) The policies must provide for:
82	82	(1) the availability of covered benefits
83	83	appropriately provided through telemedicine medical services or
84	84	telehealth services that are comparable to the same types of
85	85	covered benefits provided without the use of telemedicine medical
86	86	services or telehealth services; and
87	87	(2) the availability of covered benefits for different
88	88	services performed by multiple health care providers during a
89	89	single session of telemedicine medical services or telehealth
90	90	services, if the executive commissioner determines that delivery of
91	91	the covered benefits in that manner is cost-effective in comparison
92	92	to the costs that would be involved in obtaining the services from
93	93	providers without the use of telemedicine medical services or
94	94	telehealth services, including the costs of transportation and
95	95	lodging and other direct costs.
96	96	(c) The commission shall require reimbursement for a
97	97	telemedicine medical service or telehealth service at the same rate
98	98	as the child health plan program reimburses for the same in-person
99	99	service. A request for reimbursement may not be denied solely
100	100	because an in-person service between a health care provider and a
101	101	patient did not occur. The commission may not limit a provider's
102	102	choice of platform for providing a telemedicine medical service or
103	103	telehealth service by requiring that the provider use a particular
104	104	platform to receive reimbursement for the service.
105	105	(d) In this section, "telehealth service" and "telemedicine
106	106	medical service" have [has] the meanings [meaning] assigned by
107	107	Section 531.001, Government Code.
108	108	SECTION 5. If before implementing any provision of this Act
109	109	a state agency determines that a waiver or authorization from a
110	110	federal agency is necessary for implementation of that provision,
111	111	the agency affected by the provision shall request the waiver or
112	112	authorization and may delay implementing that provision until the
113	113	waiver or authorization is granted.
114	114	SECTION 6. This Act takes effect September 1, 2021.