84R6180 EES-F
 
  By: Coleman H.B. No. 2250
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the delivery of telemedicine medical services and
  telehealth services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 111.001, Occupations Code, is amended by
  amending Subdivision (2) and adding Subdivisions (3) and (4) to
  read as follows:
               (2)  "Residence" means a place where a person resides
  and includes a home, a nursing home, a convalescent home, or a
  residential unit ['Telehealth service' and 'telemedicine medical
  service' have the meanings assigned by Section 57.042, Utilities
  Code].
               (3)  "Telehealth service" means a health service, other
  than a telemedicine medical service, that is delivered by a
  licensed or certified health professional acting within the scope
  of the health professional's license or certification who does not
  perform a telemedicine medical service and that requires the use of
  advanced telecommunications technology, including:
                     (A)  compressed digital interactive video, audio,
  or data transmission;
                     (B)  clinical data transmission using computer
  imaging by way of still-image capture and store and forward; and
                     (C)  other technology that facilitates access to
  health care services or medical specialty expertise.
               (4)  "Telemedicine medical service" means a health care
  service that is initiated by a physician or provided by a health
  professional acting under physician delegation and supervision,
  that is provided for purposes of patient assessment by a health
  professional, diagnosis or consultation by a physician, or
  treatment, or for the transfer of medical data, and that requires
  the use of advanced telecommunications technology, including:
                     (A)  compressed digital interactive video, audio,
  or data transmission;
                     (B)  clinical data transmission using computer
  imaging by way of still-image capture and store and forward; and
                     (C)  other technology that facilitates access to
  health care services or medical specialty expertise.
         SECTION 2.  Section 111.002, Occupations Code, is amended to
  read as follows:
         Sec. 111.002.  INFORMED CONSENT. (a) Except as provided by
  Subsection (c), a [A] treating physician or health professional who
  provides or facilitates the use of telemedicine medical services or
  telehealth services shall ensure that the informed consent of the
  patient, or another appropriate individual authorized to make
  health care treatment decisions for the patient, is obtained before
  telemedicine medical services or telehealth services are provided.
         (b)  A copy of an informed consent form signed by a patient in
  accordance with Subsection (a) must be retained in the patient's
  medical record and provided to the patient or the patient's legally
  authorized representative on request. 
         (c)  A treating physician or health professional who
  provides or facilitates the use of telemedicine medical services or
  telehealth services to provide emergency medical care, as that term
  is defined in Section 773.003, Health and Safety Code, is not
  required to obtain informed consent before telemedicine medical
  services or telehealth services are provided if:
               (1)  the patient is unable to give the patient's
  informed consent; and
               (2)  an individual authorized to make health care
  treatment decisions for the patient is unavailable to give the
  individual's informed consent. 
         SECTION 3.  Chapter 111, Occupations Code, is amended by
  adding Section 111.0021 to read as follows:
         Sec. 111.0021.  RIGHT TO REFUSE. (a) A patient may refuse
  at any time to receive telemedicine medical services or telehealth
  services.
         (b)  A patient's refusal to receive telemedicine medical
  services or telehealth services may not affect the patient's:
               (1)  right to future care, diagnosis, or treatment; or
               (2)  receipt of benefits under the Medicaid program.
         SECTION 4.  Section 111.004, Occupations Code, is amended to
  read as follows:
         Sec. 111.004.  RULES. The Texas [State Board of] Medical
  Board [Examiners], in consultation with the commissioner of
  insurance, as appropriate, may adopt rules necessary to:
               (1)  ensure that patients using telemedicine medical
  services receive appropriate, quality care;
               (2)  prevent abuse and fraud in the use of telemedicine
  medical services, including rules relating to the filing of claims
  and records required to be maintained in connection with
  telemedicine medical services;
               (3)  ensure adequate supervision of health
  professionals who are not physicians and who provide telemedicine
  medical services; and
               (4)  establish the maximum number of health
  professionals who are not physicians that a physician may supervise
  through a telemedicine medical service[; and
               [(5)     require a face-to-face consultation between a
  patient and a physician providing a telemedicine medical service
  within a certain number of days following an initial telemedicine
  medical service only if the physician has never seen the patient].
         SECTION 5.  Chapter 111, Occupations Code, is amended by
  adding Section 111.005 to read as follows:
         Sec. 111.005.  PROVISION OF SERVICES. (a) A treating
  physician who provides telemedicine medical services shall
  determine whether the presence of a physician or health
  professional is required at the site where the patient is receiving
  the services.
         (b)  A treating physician who provides telemedicine medical
  services or a treating health professional who provides telehealth
  services shall determine if a patient's residence is an appropriate
  site at which the patient may receive the services.
         SECTION 6.  Not later than January 1, 2016, the executive
  commissioner of the Health and Human Services Commission and the
  Texas Medical Board shall adopt any rules necessary to implement
  the changes in law made by this Act.
         SECTION 7.  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 8.  This Act takes effect September 1, 2015.