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The DWC intends to expand the use of telemedicine in Texas’ workers’ compensation system. An informal rule proposal is being floated to system participants for comment. The reasoning behind this change is that the agency wants to be proactive, and believes that this will make the system more efficient by saving employers and injured workers travel time and expense without sacrificing quality of care. It used to be that under the Medicare reimbursement restrictions telemedicine could only be used in underserved areas. DWC is using as its justification the 2017 bill passed by the Texas Legislature which addressed telemedicine in Texas to expand the use of telemedicine. The Texas Medical Board is in the process of drafting rules to implement the legislative changes. DWC’s rules are expected to be in line with those rules.
We found one company with sites in Texas – XstremeMD– that provides telemedicine services. A visit to their website might be worth your while in order to see the facilities they currently maintain in Texas. No doubt when this concept becomes widely accepted by insurance carriers and injured workers we will see a larger presence of these companies. We are curious how existing workers’ compensation doctors will react to these changes.
The proposed DWC rule references the Texas Occupations Code Chapter 111, which allows the Texas Medical Board to adopt rules necessary to ensure the delivery of good care, prevent abuse and fraud, ensure adequate supervision of non-physician health care professionals who provide telemedicine medical services, and describe when an actual face-to-face consultation between a patient and his physician must take place. A preliminary review of the Texas Medical Board rules shows that the services have to be performed at an “established medical site” and may be used for all patient visits, including initial evaluations, to establish a physician-patient relationship, regardless of whether the physician is physically present at the telemedicine site. A “distant site provider” may delegate tasks and activities to a “patient site presenter.” The patient site presenter must be licensed or certified in Texas to perform health care services – we assume this would most likely be physician assistants or nurse practictioners, but that remains to be clarified. The rule has other provisions, such as notice and privacy requirements, but the gist of the concept is that medical services will be provided by telemetric means. We will be watching the rules closely to see what the DWC has in mind that is specific to workers’ comp. Jane Stone, Stone Loughlin & Swanson, LLP