Office of House Bill AnalysisH.B. 1801
By: Maxey
Public Health


Telemedicine provides heath care professionals the opportunity to diagnose
and treat conditions at a distance using interactive audio and video
communications.  Although the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 prohibits substituting telemedicine
for personal home health care visits in federal programs, individual states
have the option under Medicaid to utilize telemedicine services to
supplement personal home health care visits.  Ideally, a physician would
authorize telemedicine as part of the patient's overall plan of care which
would include personal visits as well.  In this way, telemedicine may
improve patients' self-care and reduce unnecessary physician visits,
inpatient admissions, and emergency room visits.  A pilot program for
telemedicine home health care services may help answer questions related to
reimbursement, cost effectiveness, and the types of patients who can
benefit from telemedicine.  House Bill 1801 requires the Health and Human
Services Commission to establish a pilot program to provide telemedicine
home health care services to certain Medicaid recipients. 


It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Health and Human Services
Commission in SECTION 1 (Section 32.053, Human Resources Code) of this


House Bill 1801 amends the Human Resources Code to require the Health and
Human Services Commission (HHSC) to establish a pilot program under which
certain recipients of Medicaid assistance receive home health care services
through telemedicine in addition to other home health care services for
which the recipients are eligible.  H.B. 1801 sets forth eligibility
criteria that HHSC is required to adopt. The bill requires HHSC to
determine the home health care services that will be provided to program
participants through telemedicine.  In designing and implementing the
program, HHSC is required to ensure that: 

 _home health care services supplement rather than replace necessary
in-person home visits by home health care providers; 
 _a program participant receives for the duration of services, at no cost
to the participant, telemedicine equipment other than a telephone line and
telephone  necessary for receipt of services; 
 _a program participant or the participant's regular caregiver receives
personal training and written instructions in the use and maintenance of
the telemedicine equipment; and   
 _the quality of the telemedicine services and the program participant's
satisfaction is frequently monitored and evaluated. 

The bill also requires HHSC to adopt all rules necessary for the
implementation of the program.  No later  than December 1, 2004, HHSC is
required to submit a report to the legislature including the program's
cost-effectiveness, the program's effect on the quality of health care
received by program participants, and recommendations related to the future
of the program. 

September 1, 2001.