Is Telemedicine Legal in Texas?
Texas is one of the states in the US that has been in the limelight with regards to Telemedicine. Texas is known for having a huge segment of its population residing in the rural areas. Given the shortage of specialist in the medical sector, there had been a huge gap created with regard to access to specialized medical services for the rural population. What Bellaire ER and many other residents of this great state see as a step towards the right direction, the government has made changes in the legislation that paves way for telemedicine to bridge the gap that exists.
Telemedicine has been legal in Texas for years now but on a limited basis. For the last six years, telehealth providers have had a difficult time trying to cope with the legislation that initially existed. The emergency rules that were declared by Texas Medical Board required that there be a pre-existing relationship between the patient and the medical professional or a face-to-face communication medium in order to provide telemedicine services. The enactment of these new rules was met with great opposition from telehealth providers who went to court.
The court process has been ongoing for years with the telehealth companies having several victories that in the court against the Texas Medical Board. Sometime in 2016, the board agreed that they would promote legislation in the state parliament that would remove the many hurdles the previous rules created in the path of telemedicine. The legislation to be sponsored would permit telehealth practices, including asynchronous communication in the absence of telehealth presenters and live interactive encounters.
The negotiations resulted in the birth of SB 1107. The bill detailed the following:
A licensed Texas physician is allowed to establish a physician-patient relationship that is valid without having to conduct an in-person exam or the patient having to be in the presence of another health care provider. The bill allowed the physician to use telehealth exclusively in their interactions with their patients using real-time audio and/or visual platforms as well as asynchronous platforms.
The bill required the physicians rendering telehealth to provide their patients with close guidance and the appropriate follow-up care after they have been treated. Also, the physician must seek consent from the patient’s primary care physician – if they have one – and a report of the encounter should be sent to the primary care physician within a period not exceeding three days.
Medical prescriptions are part of treatment and the bill provided room for that. The Texas Medical Board, the Texas Board of Pharmacy and the Texas Board of Nursing are the ones charged with the mandate of establishing the specific rules that would validate prescriptions that are issued through this kind of physician-patient encounter.
The standards of care that govern in-person medical services were the ones that would be applicable for telemedicine and no other standards set by other agencies would not be set for telemedicine services.
With regards to insurance, bill SB 1107 clearly states that telemedicine services only rendered through facsimile or audio interactions will not be affected by Texas Telemedicine parity law. This means that insurance providers in Texas were prohibited from using telemedicine as a ground for restricting coverage with the exception of when the services have been rendered through fax or phone. The insurance providers in Texas were also required to post on their website their telehealth coverage policies as well as their payment practices to allow consumers to determine the amount of coverage available.
Earlier on this year, the Texas Senate approved the bill, and later in May, Texas Governor Greg Abbott put his signature on the bill and signed it into law. This marked a new era for telemedicine in this state and an end to years of legal battle between telehealth providers and the Texas Medical Board. Teladoc was the greatest winner given that it was one of the main parties that engaged the Texas Medical Board in years of court battle. While these companies are the ones that set the stage and triggered the amendments of the initial laws, the bill grants victory to the residents of Texas, particularly those from the rural parts of the state.
With the bill in place and the hurdles in the path of Telemedicine out, the Texas Medical Board is now charged with the task of ensuring that they set and adopt new regulations to govern telemedicine in the state. Some focus areas are:
• Ensuring that the patients who employ telemedicine services receive health care that is at par with the quality standards set.
• Preventing fraud and abuse through telemedicine by setting strong rules with regards to filing claims and keeping records of telemedicine encounters.
• Ensuring that there is adequate supervision of medical professionals to ensure that fraudulent physicians do not exploit unknowing patients.
• Establishing the maximum number of nurse practitioners and physician assistants a physician may supervise.