85R18810 EES-D     By: Guerra, Longoria, Sheffield, H.B. No. 727       Davis of Harris, Laubenberg     A BILL TO BE ENTITLED   AN ACT   relating to the use of home telemonitoring services under Medicaid.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 531.02164, Government Code, is amended   by amending Subsection (c) and adding Subsections (c-1) and (c-2)   to read as follows:          (c)  The program required under this section must:                (1)  provide that home telemonitoring services are   available only to a person [persons] who:                      (A)  is [are] diagnosed with one or more of the   following conditions:                            (i)  pregnancy;                            (ii)  diabetes;                            (iii)  heart disease;                            (iv)  cancer;                            (v)  chronic obstructive pulmonary disease;                            (vi)  hypertension;                            (vii)  congestive heart failure;                            (viii)  mental illness or serious emotional   disturbance;                            (ix)  asthma;                            (x)  myocardial infarction; or                            (xi)  stroke; and                      (B)  exhibits [exhibit] two or more of the   following risk factors:                            (i)  two or more hospitalizations in the   prior 12-month period;                            (ii)  frequent or recurrent emergency room   admissions;                            (iii)  a documented history of poor   adherence to ordered medication regimens;                            (iv)  a documented history of falls in the   prior six-month period;                            (v)  limited or absent informal support   systems;                            (vi)  living alone or being home alone for   extended periods of time; and                            (vii)  a documented history of care access   challenges;                (2)  ensure that clinical information gathered by a   home and community support services agency or hospital while   providing home telemonitoring services is shared with the patient's   physician; [and]                (3)  ensure that the program does not duplicate disease   management program services provided under Section 32.057, Human   Resources Code; and                (4)  provide reimbursement for home telemonitoring   services in the event of an unsuccessful data transmission if the   provider of the services attempts to communicate with the patient   by telephone or in person to establish a successful data   transmission.          (c-1)  Notwithstanding Subsection (c)(1), the program   required under this section may also provide that home   telemonitoring services are available to pediatric patients with   chronic or complex medical needs who:                (1)  are being concurrently treated by at least three   medical specialists;                (2)  are diagnosed with end-stage solid organ disease;                (3)  have received an organ transplant; or                (4)  are diagnosed with severe asthma.          (c-2)  A provider that is reimbursed under Subsection (c)(4)   for home telemonitoring services provided to a patient may not also   be reimbursed for communicating with the patient by telephone or in   person to establish a successful data transmission as described by   Subsection (c)(4).          SECTION 2.  As soon as practicable after the effective date   of this Act, the executive commissioner of the Health and Human   Services Commission shall adopt necessary rules to implement the   changes in law made by this Act.          SECTION 3.  If before implementing any provision of this Act   a state agency determines that a waiver or authorization from a   federal agency is necessary for implementation of that provision,   the agency affected by the provision shall request the waiver or   authorization and may delay implementing that provision until the   waiver or authorization is granted.          SECTION 4.  This Act takes effect September 1, 2017.