Bill Text: TX HB1738 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to telehealth and home telemonitoring services, including the provision of those services under Medicaid.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Introduced - Dead) 2019-03-20 - Left pending in committee [HB1738 Detail]
Download: Texas-2019-HB1738-Introduced.html
86R6128 MM-D | ||
By: Guillen | H.B. No. 1738 |
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relating to telehealth and home telemonitoring services, including | ||
the provision of those services under Medicaid. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 531.02164, Government Code, is amended | ||
by adding Subsections (c-1), (c-2), and (f) to read as follows: | ||
(c-1) Notwithstanding Subsection (c)(1), the program | ||
required under this section may also provide that home | ||
telemonitoring services are available to a pediatric patient with | ||
chronic or complex medical needs who: | ||
(1) is being concurrently treated by at least three | ||
medical specialists; | ||
(2) is diagnosed with end-stage solid organ disease; | ||
(3) has received an organ transplant; or | ||
(4) is diagnosed with severe asthma. | ||
(c-2) For purposes of the program established under this | ||
section, the executive commissioner shall: | ||
(1) establish an enhanced Medicaid reimbursement rate | ||
for home telemonitoring services related to management of a | ||
person's medication that is at least $6 per day more than the rate | ||
in effect on January 1, 2019; | ||
(2) establish billing codes and a fee schedule for | ||
Medicaid reimbursement for home telemonitoring services provided | ||
by a federally-qualified health center, as defined by 42 U.S.C. | ||
Section 1396d(l)(2)(B), that are separate from other billing codes | ||
and fee schedules established for reimbursement for services | ||
provided by a federally-qualified health center; | ||
(3) develop a process to prevent fraud and verify the | ||
success of a data transmission that includes validation of the data | ||
transmission by the service provider's data carrier; and | ||
(4) allow for reimbursement for home telemonitoring | ||
services provided for a period of at least 120 days per episode. | ||
(f) Each provider of home telemonitoring services under the | ||
program established under this section shall provide to the | ||
commission data regarding the services provided for analytical | ||
purposes. | ||
SECTION 2. Subchapter B, Chapter 531, Government Code, is | ||
amended by adding Section 531.02177 to read as follows: | ||
Sec. 531.02177. STUDY CONCERNING HOME TELEMONITORING AND | ||
TELEHEALTH SERVICES FRAUD, WASTE, AND ABUSE. (a) Subject to the | ||
availability of funds, the commission shall conduct a study to | ||
identify patterns or instances of fraud, waste, or abuse committed | ||
by providers of Medicaid home telemonitoring services and | ||
telehealth services. | ||
(b) Not later than September 1, 2020, the commission shall | ||
submit to the governor, the lieutenant governor, the speaker of the | ||
house of representatives, and each legislative standing committee | ||
with primary jurisdiction over Medicaid the results of the study | ||
conducted under this section and recommendations for legislative or | ||
other action. | ||
(c) Based on the findings of the commission, the executive | ||
commissioner may adopt rules necessary to prevent or reduce fraud, | ||
waste, and abuse by providers of Medicaid home telemonitoring | ||
services and telehealth services. | ||
(d) This section expires September 1, 2021. | ||
SECTION 3. Section 111.001(3), Occupations Code, is amended | ||
to read as follows: | ||
(3) "Telehealth service" means a health service, other | ||
than a telemedicine medical service, delivered by a health | ||
professional licensed, certified, or otherwise entitled to | ||
practice in this state and acting within the scope of the health | ||
professional's license, certification, or entitlement to a patient | ||
at a different physical location than the health professional using | ||
telecommunications or information technology. The term includes: | ||
(A) peer services provided by a certified mental | ||
health peer specialist or a certified substance use recovery | ||
specialist; | ||
(B) substance use counseling services; and | ||
(C) targeted case management services. | ||
SECTION 4. The following sections of the Government Code | ||
are repealed: | ||
(1) Section 531.02164(d); and | ||
(2) Section 531.02176. | ||
SECTION 5. As soon as practicable after the effective date | ||
of this Act, the executive commissioner of the Health and Human | ||
Services Commission shall adopt rules necessary to implement the | ||
changes in law made by this Act. | ||
SECTION 6. 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 7. This Act takes effect September 1, 2019. |