HBA-TYH H.B. 518 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 518
By: Gray
Public Health
2/11/1999
Introduced



BACKGROUND AND PURPOSE 

Texas is required by the federal government to provide a specified amount
of health screening to children.  Telemedicine is one method of
facilitating child screening.  H.B.  518 requires the use of telemedicine
in the Medicaid Early and Periodic Screening, Diagnosis, and Treatment
Program if an in-person consultation is not reasonably available where the
child resides. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas State Board of Medical
Examiners, the State Board of Dental Examiners, and the Health and Human
Services Commission in SECTION 1 (Sec. 32.0242, Human Resources Code) of
this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 32.042, as follows: 

Sec.  32.0242.  TELEMEDICAL CONSULTATIONS IN CERTAIN MEDICAID PROGRAMS.
(a)  Defines "EPSDT Program" (Early and Periodic Screening, Diagnosis, and
Treatment Program) and "telemedical consultation." 

(b)  Requires the Health and Human Services Commission or an agency
operating part of the medical assistance program (department), in its rules
governing the EPSDT Program, to require a telemedical consultation for the
provision of an EPSDT Program service to a child who receives medical
assistance under this chapter, if an in-person consultation with a health
care provider is not reasonably available where the child resides or works.
Prohibits the department from requiring a telemedical consultation for the
provision of an EPSDT Program service to a child who receives medical
assistance under this chapter, if an in-person consultation with a health
care provider is reasonably available where the child resides or works.  

(c)  Requires the department, in its rules governing the EPSDT Program, to
require a health care facility that receives reimbursement for an EPSDT
Program service provided through a telemedical consultation, to establish
quality of care protocols and patient confidentiality guidelines to ensure
that the telemedical consultation meets acceptable standards of patient
care and legal requirements.  

(d)  Authorizes the Texas State Board of Medical Examiners and the State
Board of Dental Examiners, in consultation with the department, to adopt
rules as necessary to ensure that appropriate care is provided to a child
who receives an EPSDT Program service through a telemedical consultation
and prevent abuse and fraud resulting from the use of a telemedical
consultation in the EPSDT Program, including rules relating to the filing
of a claim for reimbursement and the maintaining of records related to a
telemedical consultation.  

SECTION 2.  Effective date: September 1, 1999.
 
SECTION 3.  Requires the Texas Department of Health to adopt the rules
required by Section 32.0242, Human Resources Code, as added by this Act,
not later than January 1, 2000. 

SECTION 4.  Requires a state agency affected by the provision to request
the waiver or authorization, if before implementing any provision of this
Act, the state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision.
Authorizes the agency to delay implementing that provision until the waiver
or authorization is granted. 

SECTION 5.  Emergency clause.