TMB Resource Helps Clarify New Telemedicine Rules

The Texas Medical Board (TMB) adopted rules April 10 concerning telemedicine and requirements for prescribing drugs and controlled substances. Since then, there has been some confusion regarding the impact of the new rules.

TMB has created a document titled TMB Adopts Rules Expanding Telemedicine Opportunities that outlines the types of telemedicine permitted under the board’s rules, including the use of telemedicine to provide services in remote areas with the assistance of a patient site presenter, such as a licensed vocational nurse or medical assistant. The rules also allow for circumstances in which a site presenter is not required to provide telemedicine services.

The TMB document states, "[t]he rules expand opportunities for patients to interact with their physicians beyond the traditional office visit and clarify that a physician-patient relationship can be established through a 'face-to-face' visit held either in person or via telemedicine. Essentially the only scenario prohibited in Texas is one in which a physician treats an unknown patient using telemedicine, without any objective diagnostic data, and no ability to follow up with the patient."

The TMB document clarifies the new rules do not: 

  • Limit a patient to an in-person visit to establish a physician-patient relationship before receiving treatment; the relationship can also be established via appropriate face-to-face telemedicine.
  • Change traditional on-call coverage used by many physician offices. Physicians, who are in the same medical specialty and provide reciprocal services, may provide on-call telemedicine medical services for each other's active patients.
  • Severely restrict the types of telemedicine scenarios authorized in Texas. The rules expand the scenarios already allowed to include greater access to treatment from a patient's home and greater access to treatment for behavioral and mental health.

According to the rules, physicians may see a patient via telemedicine for the first time — without a prior in-person visit — if the patient is at a location that allows a physician to adequately examine and communicate with the patient in real time with the assistance of technology and a patient site presenter. The new telemedicine rules also permit mental health services to be provided at a patient's home, including residential treatment facilities, nursing homes, jails, detention centers, and assisted living centers, through real-time audio and video technology.

As stated in a recent TMB press release, a rule summary is expected be published in the Texas Register, and the new rules are scheduled to go into effect June 3, 2015.

Action, June 1, 2015

Last Updated On

May 12, 2016

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