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Texas Telemedicine Rules Are Changing. Here’s What You Can Expect.

A telepsychiatry demonstration at Dr. Bobby Jain's office in Midland in 2018.
Caroline Covington/Texas Standard
A telepsychiatry demonstration at Dr. Bobby Jain's office in Midland in 2018.

From Texas Standard:

Rules about telemedicine are about to change in Texas, now that the state of emergency here is set to expire July 31. That could mean some adjustments for patients who got used to a more relaxed approach to remote visits with their doctor or therapist during the pandemic.

Texas Medical Board president, Dr. Sherif Zaafran, told Texas Standard that some of the biggest changes involve how a patient establishes a relationship with their provider, as well as rules about insurance reimbursement.

When emergency rules expire, patients won't be able to establish a new relationship with a health care provider merely by telephone; it will have to be through audiovisual means like Zoom, which complies with federal privacy rules. During the pandemic, Texas made it easier for patients seeking care to reach out to new doctors by telephone only. But that will end 30 days after Texas' state of emergency expires, which is scheduled for July 31.

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The rules are stricter for Texans who are prescribed opioids for chronic pain. Before the pandemic, all appointments had to be in person because opioid pain medication is a controlled substance. During the pandemic, telemedicine treatment has been allowed but only after a patient had established a relationship with a provider in person first. The rules are set to revert back to requiring all in-person visits, but in an email, the Texas Medical Board said that more options for chronic-pain management via telemedicine might be allowed in the future.

The good news is that many health care providers already set up videoconferencing programs during the pandemic, and will continue to use them moving forward, Zaafran says.

One snag is that videoconferencing isn't easy for Texans who lack broadband access. Telephone-only appointments helped them get around that roadblock. Zaafran says the medical board and the Legislature are working to expand broadband services to Texans in need.

"It's going to be very difficult to have telemedicine services in rural areas if you're not able to have the connectivity to be able to actually have that happen," he said. "Making sure that we have appropriate rural broadband access to help facilitate that is going to be something that's extremely important."

Insurance companies will also no longer be required to reimburse doctors for telemedicine visits at the same rate they would for in-person visits. The pandemic emergency rules required reimbursement parity, but that is set to end in late August, too. Zaafran says the only way to permanently require insurers to pay the same rate for telemedicine and in-person visits is to change the law.

"There are certain things that we can do from the regulatory standpoint and make it permanent. There are other things like ,like the whole reimbursement issue, that would have to be more of a statutory change," he said. "So, where we can, we are doing it. Other things would have to be more of a legislative change later on."

Zaafran says most doctors support the move toward expanded telemedicine. The only drawback for them, he says, is the cost of setting up the virtual side of their practice.

"To be honest with you, there really isn't much resistance at all, especially from physicians who want to be able to see their patients virtually," he said.

Clarification: Emergency rules about telemedicine are in effect for 30 days after Texas' state of emergency expires, which is planned for July 31. This story has been updated to make that more clear. More information can be found here, under the "Texas" entry.

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Caroline Covington is Texas Standard's digital producer/reporter. She joined the team full time after finishing her master's in journalism at the UT J-School. She specializes in mental health reporting, and has a growing interest in data visualization. Before Texas Standard, Caroline was a freelancer for public radio, digital news outlets and podcasts, and produced a podcast pilot for Audible. Prior to journalism, she wrote and edited for marketing teams in the pharmaceutical and cosmetics industries. She has a bachelor's in biology from UC Santa Barbara and a master's in French Studies from NYU.
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