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A BILL TO BE ENTITLED
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AN ACT
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relating to telehealth and home telemonitoring services, including |
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the provision of those services under Medicaid. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.02164, Government Code, is amended |
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by adding Subsections (c-1), (c-2), and (f) to read as follows: |
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(c-1) Notwithstanding Subsection (c)(1), the program |
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required under this section may also provide that home |
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telemonitoring services are available to a pediatric patient with |
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chronic or complex medical needs who: |
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(1) is being concurrently treated by at least three |
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medical specialists; |
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(2) is diagnosed with end-stage solid organ disease; |
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(3) has received an organ transplant; or |
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(4) is diagnosed with severe asthma. |
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(c-2) For purposes of the program established under this |
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section, the executive commissioner shall: |
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(1) establish an enhanced Medicaid reimbursement rate |
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for home telemonitoring services related to management of a |
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person's medication that is at least $6 per day more than the rate |
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in effect on January 1, 2019; |
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(2) establish billing codes and a fee schedule for |
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Medicaid reimbursement for home telemonitoring services provided |
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by a federally-qualified health center, as defined by 42 U.S.C. |
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Section 1396d(l)(2)(B), that are separate from other billing codes |
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and fee schedules established for reimbursement for services |
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provided by a federally-qualified health center; |
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(3) develop a process to prevent fraud and verify the |
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success of a data transmission that includes validation of the data |
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transmission by the service provider's data carrier; and |
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(4) allow for reimbursement for home telemonitoring |
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services provided for a period of at least 120 days per episode. |
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(f) Each provider of home telemonitoring services under the |
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program established under this section shall provide to the |
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commission data regarding the services provided for analytical |
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purposes. |
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SECTION 2. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.02177 to read as follows: |
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Sec. 531.02177. STUDY CONCERNING HOME TELEMONITORING AND |
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TELEHEALTH SERVICES FRAUD, WASTE, AND ABUSE. (a) Subject to the |
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availability of funds, the commission shall conduct a study to |
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identify patterns or instances of fraud, waste, or abuse committed |
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by providers of Medicaid home telemonitoring services and |
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telehealth services. |
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(b) Not later than September 1, 2020, the commission shall |
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submit to the governor, the lieutenant governor, the speaker of the |
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house of representatives, and each legislative standing committee |
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with primary jurisdiction over Medicaid the results of the study |
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conducted under this section and recommendations for legislative or |
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other action. |
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(c) Based on the findings of the commission, the executive |
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commissioner may adopt rules necessary to prevent or reduce fraud, |
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waste, and abuse by providers of Medicaid home telemonitoring |
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services and telehealth services. |
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(d) This section expires September 1, 2021. |
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SECTION 3. Section 111.001(3), Occupations Code, is amended |
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to read as follows: |
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(3) "Telehealth service" means a health service, other |
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than a telemedicine medical service, delivered by a health |
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professional licensed, certified, or otherwise entitled to |
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practice in this state and acting within the scope of the health |
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professional's license, certification, or entitlement to a patient |
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at a different physical location than the health professional using |
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telecommunications or information technology. The term includes: |
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(A) peer services provided by a certified mental |
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health peer specialist or a certified substance use recovery |
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specialist; |
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(B) substance use counseling services; and |
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(C) targeted case management services. |
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SECTION 4. The following sections of the Government Code |
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are repealed: |
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(1) Section 531.02164(d); and |
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(2) Section 531.02176. |
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SECTION 5. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall adopt rules necessary to implement the |
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changes in law made by this Act. |
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SECTION 6. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 7. This Act takes effect September 1, 2019. |