Texas 2021 - 87th Regular

Texas Senate Bill SB412 Compare Versions

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

Old	New	Differences
1	1	By: Buckingham S.B. No. 412
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to telemedicine, telehealth, and technology-related
7	7	health care services.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 531.0216, Government Code, is amended by
10	10	amending Subsection (i) and adding Subsections (k) and (l) to read
11	11	as follows:
12	12	(i) The executive commissioner by rule shall ensure that a
13	13	federally qualified health center as defined by 42 U.S.C. Section
14	14	1396d(l)(2)(B) or a rural health clinic as defined by 42 U.S.C.
15	15	Section 1396d(l)(1) may be reimbursed for the originating site
16	16	facility fee or the distant site practitioner fee or both, as
17	17	appropriate, for a covered telemedicine medical service or
18	18	telehealth service delivered by a health care provider to a
19	19	Medicaid recipient. The commission is required to implement this
20	20	subsection only if the legislature appropriates money specifically
21	21	for that purpose. If the legislature does not appropriate money
22	22	specifically for that purpose, the commission may, but is not
23	23	required to, implement this subsection using other money available
24	24	to the commission for that purpose.
25	25	(k) No later than January 1, 2022, the commission shall
26	26	implement reimbursement for telemedicine medical services and
27	27	telehealth services in the following programs, services and
28	28	benefits:
29	29	(1) Children with Special Health Care Needs program,
30	30	(2) Early Childhood Intervention,
31	31	(3) School and Health Related Services,
32	32	(4) physical therapy, occupational therapy and speech
33	33	therapy,
34	34	(5) targeted case management,
35	35	(6) nutritional counseling services,
36	36	(7) Texas Health Steps checkups,
37	37	(8) Medicaid 1915(c)waiver programs, including the
38	38	Community Living and Support Services waiver, and
39	39	(9) any other program, benefit, or service under the
40	40	commission's jurisdiction that the commissioner determines to be
41	41	cost effective and clinically effective.
42	42	(l) The commission shall implement audio-only benefits for
43	43	behavioral health services, and may implement audio-only benefits
44	44	in any program under the commission's jurisdiction, in accordance
45	45	with federal and state law and shall consider other factors,
46	46	including whether reimbursement is cost-effective and whether the
47	47	provision of the service is clinically effective, in making the
48	48	determination.
49	49	SECTION 2. Section 531.02164, Government Code, is amended
50	50	by adding Subsection (f) to read as follows:
51	51	(f) In complying with state and federal requirements to
52	52	provide access to medically necessary services under the Medicaid
53	53	managed care program, a Medicaid managed care organization may
54	54	reimburse providers for home telemonitoring services not
55	55	specifically defined in this section and shall consider other
56	56	factors, including whether reimbursement is cost-effective and
57	57	whether the provision of the service is clinically effective, in
58	58	making the determination.
59	59	SECTION 3. Section 533, Government Code, is amended by
60	60	adding Section 533.00252 to read as follows:
61	61	533.00252 DELIVERY OF TELECOMMUNICATION SERVICES. (a) The
62	62	commission shall implement policies and procedures to improve
63	63	access to care through telemedicine, telehealth, tele-monitoring,
64	64	and other telecommunication or information technology solutions.
65	65	(b) To the extent authorized by federal law, the commission
66	66	shall establish policies and procedures that allow managed care
67	67	organizations to conduct assessment and service coordination
68	68	activities for members receiving home and community-based services
69	69	through telecommunication or information technology in the
70	70	following circumstances:
71	71	(1) when the managed care organization determines it
72	72	appropriate;
73	73	(2) the member requests activities occur through
74	74	telecommunication or information technology;
75	75	(3) when in-person activities are not feasible due to
76	76	a natural disaster, pandemic, public health emergency; or
77	77	(4) in other circumstances identified by the
78	78	commission.
79	79	(c) If assessment or service coordination activities are
80	80	conducted through telecommunication or information technology, the
81	81	managed care organization must:
82	82	(1) monitor health care services provided to the
83	83	member for fraud, waste, and abuse; and
84	84	(2) determine the need for additional social services
85	85	and supports.
86	86	(d) Except as provided by Subsection (b)(3), a managed care
87	87	organization must conduct the following activities for members
88	88	receiving home and community-based services:
89	89	(1) at least one in-person visit for the population
90	90	that requires face to face visits as determined by HHSC; or
91	91	(2) additional in-person visits as determined
92	92	necessary by the managed care organization.
93	93	(e) To the extent authorized by federal law, the commission
94	94	must allow managed care members receiving assessments or service
95	95	coordination through telecommunication or information technology
96	96	to provide verbal authorizations in lieu of written signatures on
97	97	all required forms.
98	98	SECTION 4. Section 533.0061 (b), Government Code, is
99	99	amended by adding Subsection (b)(3) to read as follows:
100	100	(b) To the extent it is feasible, the provider access
101	101	standards established under this section must:
102	102	(1) distinguish between access to providers in urban
103	103	and rural settings; and
104	104	(2) consider the number and geographic distribution of
105	105	Medicaid-enrolled providers in a particular service delivery area,
106	106	and
107	107	(3) consider and include the availability of
108	108	telemedicine and telehealth services within the provider network
109	109	of a managed care organization.
110	110	SECTION 5. Chapter 533, Government Code, is amended by
111	111	adding Subsection 533.088(c)to read as follows:
112	112	Sec. 533.008. MARKETING GUIDELINES. (a) The commission
113	113	shall establish marketing guidelines for managed care
114	114	organizations that contract with the commission to provide health
115	115	care services to recipients, including guidelines that prohibit:
116	116	(1) door-to-door marketing to recipients by managed
117	117	care organizations or agents of those organizations;
118	118	(2) the use of marketing materials with inaccurate or
119	119	misleading information;
120	120	(3) misrepresentations to recipients or providers;
121	121	(4) offering recipients material or financial
122	122	incentives to choose a managed care plan other than nominal gifts or
123	123	free health screenings approved by the commission that the managed
124	124	care organization offers to all recipients regardless of whether
125	125	the recipients enroll in the managed care plan;
126	126	(5) the use of marketing agents who are paid solely by
127	127	commission; and
128	128	(6) face-to-face marketing at public assistance
129	129	offices by managed care organizations or agents of those
130	130	organizations.
131	131	(b) This section does not prohibit:
132	132	(1) the distribution of approved marketing materials
133	133	at public assistance offices; or
134	134	(2) the provision of information directly to
135	135	recipients under marketing guidelines established by the
136	136	commission.
137	137	(c) The executive commissioner shall adopt and publish
138	138	guidance that allows managed care plans that contract with the
139	139	commission to communicate with their enrolled recipients via text
140	140	message in accordance with this section. Such guidance shall
141	141	include the development and implementation of standardized consent
142	142	language to be used by managed care plans in obtaining patient
143	143	consent to receive text messages. The guidance must be published no
144	144	later than January 1, 2022.
145	145	SECTION 6. If before implementing any provision of this Act
146	146	a state agency determines that a waiver or authorization from a
147	147	federal agency is necessary for implementation of that provision,
148	148	the agency affected by the provision shall request the waiver or
149	149	authorization and may delay implementing that provision until the
150	150	waiver or authorization is granted.
151	151	SECTION 7. This Act takes effect September 1, 2021.