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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of mental health telemedicine medical |
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services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 111.001, Occupations Code, is amended to |
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read as follows: |
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Sec. 111.001. DEFINITIONS. In this chapter: |
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(1) "Behavioral emergency" means a situation that |
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involves an individual who is behaving in a violent or |
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self-destructive manner and in which: |
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(A) preventive, de-escalative, or verbal |
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techniques are determined to be ineffective; and |
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(B) immediate restraint or seclusion of the |
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individual is necessary to prevent: |
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(i) imminent probable death or substantial |
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bodily harm to the individual because the individual is attempting |
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to commit suicide or inflict serious bodily harm; or |
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(ii) imminent physical harm to others |
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because of the individual's actions. |
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(2) "Established medical site" means a location at |
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which a patient seeks medical care that has sufficient technology |
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and medical equipment to allow for an adequate physical evaluation |
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of the patient. |
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(3) "Face-to-face evaluation" means an evaluation of a |
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patient in which the treating physician or health professional and |
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the patient are at the same physical location or the patient is at |
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an established medical site. |
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(4) "Group or institutional setting" includes a |
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residential treatment facility, halfway house, jail, juvenile |
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detention center, prison, nursing home, group home, rehabilitation |
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center, and assisted living facility. |
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(5) "Health professional" means: |
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(A) a physician; |
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(B) an individual who is: |
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(i) licensed or certified in this state to |
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perform health care services, including a licensed clinical social |
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worker, a licensed professional counselor, and a marriage and |
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family therapist; and |
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(ii) authorized to assist a physician in |
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providing telemedicine medical services that are delegated and |
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supervised by the physician; or |
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(C) a licensed or certified health professional, |
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including a licensed clinical social worker, a licensed |
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professional counselor, and a marriage and family therapist, acting |
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within the scope of the license or certification who performs a |
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telehealth service and who does not perform a telemedicine medical |
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service. |
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(6) "In-person evaluation" means an evaluation of a |
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patient in which the treating physician or health professional and |
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the patient are at the same physical location. |
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(7) "Patient site presenter" means an individual at |
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the patient's physical location who introduces the patient to the |
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treating physician or health professional for examination, to whom |
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the treating physician or health professional may delegate tasks, |
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and who: |
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(A) is licensed or certified in this state to |
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perform health care services and acts only within the scope of the |
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individual's license or certification; or |
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(B) is credentialed to provide qualified mental |
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health professional community services, has demonstrated and |
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documented competency in the work to be performed, and: |
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(i) holds a bachelor's or more advanced |
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degree from an accredited institution of higher education with a |
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minimum number of hours that is equivalent to a major in psychology, |
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social work, medicine, nursing, rehabilitation, counseling, |
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sociology, human growth and development, physician assistant |
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studies, gerontology, special education, educational psychology, |
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early childhood education, or early childhood intervention; |
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(ii) is a registered nurse; or |
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(iii) completes an alternative |
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credentialing process identified by the Department of State Health |
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Services. |
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(8) "Physician" has ["Health professional" and
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"physician" have] the meaning [meanings] assigned by Section |
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1455.001, Insurance Code. |
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[(2)
"Telehealth service" and "telemedicine medical
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service" have the meanings assigned by Section 57.042, Utilities
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Code.] |
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SECTION 2. Section 111.004, Occupations Code, is amended to |
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read as follows: |
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Sec. 111.004. RULES. The Texas [State Board of] Medical |
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Board [Examiners], in consultation with the commissioner of |
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insurance, as appropriate, may adopt rules necessary to: |
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(1) ensure that patients using telemedicine medical |
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services receive appropriate, quality care; |
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(2) prevent abuse and fraud in the use of telemedicine |
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medical services, including rules relating to the filing of claims |
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and records required to be maintained in connection with |
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telemedicine medical services; |
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(3) ensure adequate supervision of health |
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professionals who are not physicians and who provide telemedicine |
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medical services; |
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(4) establish the maximum number of health |
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professionals who are not physicians that a physician may supervise |
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through a telemedicine medical service; and |
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(5) subject to Section 111.005, require a face-to-face |
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consultation between a patient and a physician providing a |
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telemedicine medical service within a certain number of days |
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following an initial telemedicine medical service only if the |
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physician has never seen the patient. |
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SECTION 3. Chapter 111, Occupations Code, is amended by |
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adding Section 111.005 to read as follows: |
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Sec. 111.005. PROVISION OF MENTAL HEALTH TELEMEDICINE |
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MEDICAL SERVICES. A treating physician or health professional |
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providing only mental health telemedicine medical services to a |
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patient: |
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(1) is not required to engage the services of a patient |
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site presenter, except in a behavioral emergency; |
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(2) shall consider the patient's private home or a |
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group or institutional setting where the patient resides as an |
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established medical site; and |
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(3) is not required to conduct a face-to-face or |
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in-person evaluation of the patient to diagnose the patient in the |
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establishment of a physician-patient relationship with the |
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patient, except in a behavioral emergency, provided the physician |
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or health professional otherwise meets the standard of care. |
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SECTION 4. This Act takes effect September 1, 2017. |