Texas Association Of Health Underwriters: Medical Board’s Telemedicine Rule Conflicts With Existing Law

The Texas Association of Health Underwriters is arguing that a recent Texas Medical Board rule that will limit telemedicine exists in opposition to existing insurance law.

Quoting a release: “The new rule, which is scheduled to become effective on June 3, goes against §1455.004 of the Texas Insurance Code which reads: ‘A health benefit plan may not exclude a telemedicine medical service or a telehealth service from coverage under the plan solely because the service is not provided through a face-to-face consultation.’”

On April 10, the Texas Medical Board passed an amendment to a rule that requires an established face-to-face relationship between physician and patient before that practitioner can provide telemedicine services.

If seeing a specialist or a primary care physician who the patient doesn’t have that defined relationship with, the rules require a physician, nurse practitioner, or physician assistant to be physically present with the patient during the telehealth consult before medicine is prescribed or ailment is diagnosed. Behavioral health services are exempt. The new rule will go into effect on June 3, barring legislative action. Last week, three bills were up for debate that would ease the restrictions.

A spokesman for the Texas Medical Board has not responded to a request for comment. Lee Manross, a lobbyist for TAHU, sent the following:

“We will continue to encourage the Legislature to move forward on any or all of the three bills that would prevent the TMB restriction on telemedicine. The merits of the bills have been pretty self-evident all along. We hope that realizing this conflict between existing law and an agency’s administrative rule exists would be sufficient motivation for legislators to take positive action.”

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