87R4420 KFF-D
By: Raney H.B. No. 2612
A BILL TO BE ENTITLED
AN ACT
relating to the provision of Medicaid and child health plan program
services using telecommunications or information technology and to
reimbursement for those services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.0216(i), Government Code, is amended
to read as follows:
(i) The executive commissioner by rule shall ensure that a
rural health clinic as defined by 42 U.S.C. Section 1396d(l)(1) and
a federally qualified health center as defined by 42 U.S.C. Section
1396d(l)(2)(B) may be reimbursed for the originating site facility
fee or the distant site practitioner fee or both, as appropriate,
for a covered telemedicine medical service or telehealth service
delivered by a health care provider to a Medicaid recipient. [The
commission is required to implement this subsection only if the
legislature appropriates money specifically for that purpose. If
the legislature does not appropriate money specifically for that
purpose, the commission may, but is not required to, implement this
subsection using other money available to the commission for that
purpose.]
SECTION 2. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.02161 to read as follows:
Sec. 531.02161. OPTION TO RECEIVE SERVICES THROUGH
TELECOMMUNICATIONS AND INFORMATION TECHNOLOGY UNDER MEDICAID AND
CHILD HEALTH PLAN PROGRAM. (a) In this section, "case management
services" includes service coordination, service management, and
care coordination.
(b) To the extent permitted by federal law and to the extent
appropriate, the commission shall ensure that Medicaid recipients
and child health plan program enrollees, regardless of whether
receiving benefits through a managed care delivery model or another
delivery model, have the option to receive services as telemedicine
medical services, telehealth services, or otherwise using
telecommunications or information technology, including the
following services:
(1) evaluation services;
(2) case management services;
(3) behavioral health services;
(4) occupational, physical, and speech therapy
services;
(5) professional and specialized therapy services
provided under the community living assistance and support services
(CLASS) waiver program;
(6) assessment services, including nursing
assessments under the following Section 1915(c) waiver programs:
(A) the community living assistance and support
services (CLASS) waiver program;
(B) the deaf-blind with multiple disabilities
(DBMD) waiver program;
(C) the home and community-based services (HCS)
waiver program; and
(D) the Texas home living (TxHmL) waiver program;
and
(7) hospice services.
SECTION 3. Section 531.0217(d), Government Code, is
redesignated as Section 531.02176, Government Code, and amended to
read as follows:
Sec. 531.02176. REIMBURSEMENT PARITY FOR TELEMEDICINE
MEDICAL AND TELEHEALTH SERVICES. (a) [(d)] The commission shall
require reimbursement for a telemedicine medical service or
telehealth service at the same rate as Medicaid reimburses for the
same in-person [medical] service. A request for reimbursement may
not be denied solely because an in-person [medical] service between
a health care provider [physician] and a patient did not occur.
(b) The commission may not limit a provider's [physician's]
choice of platform for providing a telemedicine medical service or
telehealth service by requiring that the provider [physician] use a
particular platform to receive reimbursement for the service.
SECTION 4. Section 62.1571, Health and Safety Code, is
amended to read as follows:
Sec. 62.1571. TELEMEDICINE MEDICAL SERVICES AND TELEHEALTH
SERVICES. (a) In providing covered benefits to a child, a health
plan provider must permit benefits to be provided through
telemedicine medical services and telehealth services in
accordance with policies developed by the commission.
(b) The policies must provide for:
(1) the availability of covered benefits
appropriately provided through telemedicine medical services or
telehealth services that are comparable to the same types of
covered benefits provided without the use of telemedicine medical
services or telehealth services; and
(2) the availability of covered benefits for different
services performed by multiple health care providers during a
single session of telemedicine medical services or telehealth
services, if the executive commissioner determines that delivery of
the covered benefits in that manner is cost-effective in comparison
to the costs that would be involved in obtaining the services from
providers without the use of telemedicine medical services or
telehealth services, including the costs of transportation and
lodging and other direct costs.
(c) The commission shall require reimbursement for a
telemedicine medical service or telehealth service at the same rate
as the child health plan program reimburses for the same in-person
service. A request for reimbursement may not be denied solely
because an in-person service between a health care provider and a
patient did not occur. The commission may not limit a provider's
choice of platform for providing a telemedicine medical service or
telehealth service by requiring that the provider use a particular
platform to receive reimbursement for the service.
(d) In this section, "telehealth service" and "telemedicine
medical service" have [has] the meanings [meaning] assigned by
Section 531.001, Government Code.
SECTION 5. 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 6. This Act takes effect September 1, 2021.