July 12, 2017
Texas physicians and telehealth
providers are now playing by the same rules to treat patients by phone,
computer, and other new technologies — the same as when physicians see patients
face-to-face in a traditional doctor’s office visit. Senate Bill 1107, passed
this session by the Texas Legislature and signed into law by Gov. Greg Abbott in
late May, clarifies the
framework to evaluate, diagnose, and treat patients remotely via telecommunication
technology. Telemedicine can be a helpful tool for physicians to see some
patients who cannot travel hundreds of miles — or even one mile — to the
doctor’s office. Imagine “seeing” your physician via your computer or
smartphone.
The bill-signing by the
governor ends months of debate in the Texas legislature and caps more than a
year’s worth of collaborative input by the Texas
Medical Association (TMA), the Texas e-Health Alliance (TEHA), the Texas
Academy of Family Physicians (TAFP), and numerous telemedicine stakeholders.
“I am happy and ecstatic for
the patients of Texas,” said Ray
Callas, MD, a TMA Board trustee and immediate past-chair of TMA’s Council on
Legislation. “As technology advances, patients will have more access to
physicians, resulting in fewer ER visits for minor ailments; and more patients,
especially in rural areas, will have access to primary care at home via
telemedicine technology.”
Sen. Charles Schwertner, MD
(R-Georgetown), the author of SB 1107 and chair of the Senate Health and Human
Services Committee, played a key role early in the session to bridge an impasse
among competing telemedicine interests to define telemedicine and hold
telemedicine services to a single standard of care. Rep. Four Price
(R-Amarillo) sponsored the companion bill, House Bill 2697, and he also played
a key role in crafting language to require health insurance plans to cover
telemedicine as a service provided by the physicians they have under contract. If
policyholders’ insurance covers this type of care, more physicians might be
able to offer it to those patients. In fact, the law also requires health plans
to post telemedicine payment policies — minus their contracted rates they will
pay for this service — to their websites, to inform physicians.
The months of negotiation by TMA, TEHA, and TAFP to expand the use of technology in Texas medicine resulted
in the core language of SB 1107, including:
- The
standard of care for a telemedicine visit is the same as a patient/ physician
in-person visit;
- The
definition of a true patient-physician relationship to conduct
telemedicine;
- A
physician must be able to access — and must use — clinically-relevant data
in rendering a diagnosis in accordance with the standard of care; and
- Health
plans must cover telemedicine as a means of providing services to their
insureds when a contracted physician performs the care.
“We are now seeing
opportunities to access physicians and providers from anywhere at anytime for
most any reason, thanks to technology. But technology by itself is not the
solution to our healthcare challenges," said Austin-based telemedicine
internist and psychiatrist Thomas Kim, MD, who testified for TMA in support of
the bill, and helped craft its language. “At the end of the day,
telemedicine care is medical care and should be held to the same standards and
guidelines.”
The bottom line, doctors
say, is telemedicine is a means of providing care to a patient; it is not a
service in and of itself. It is a tool in the physician’s toolbox.
The new law is
expected to expand the use of technology in health care. “Is this the end all,
be all? No,” said Dr. Callas, “but it is the start of something that will allow
patients to get the best care, and for physicians to be the captain of the ship
to delegate and supervise the care of all Texans.”
Some of the
law’s elements took effect when the governor signed it, while the insurance
related provisions go into effect on Jan. 1, 2018.
TMA is the largest state medical society in the nation,
representing more than 50,000 physician and medical student members. It is
located in Austin and has 110 component county medical societies around the
state. TMA’s key objective since 1853 is to improve the health of all Texans.
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Contact: Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear[at]texmed[dot]org
Marcus Cooper (512)
370-1382; cell: (512) 650-5336; email: marcus.cooper[at]texmed[dot]org
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