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Compromise bill could resolve lengthy Texas telemedicine fight

February 10, 2017
by Thomas Dworetzky , Contributing Reporter
Thanks to compromise legislation, telemedicine may soon be coming to Texas patients – especially in rural areas – after years of bitter battling by medical and industry groups.

"I think we will have a bill very soon," Senate Health and Human Services Committee Chairman Charles Schwertner (R-Georgetown) told the Houston Chronicle. The orthopedic surgeon told the paper he plans to sponsor the legislation that would permit doctors to see patients via remote technology.

If the deal passes, it could help rein in health care costs of taxpayer-funded programs, as well as being of “considerable” value for patients, he stressed.

Virtual health visits have been used in Texas prisons for decades, and their power to slash costs has been clear – the penal system has saved millions of dollars. According to the paper, one estimate puts potential savings from the use of telemedicine in Texas communities at as much as $12.6 billion a year.

Besides the money, there is a shortage of primary care doctors in the state. One 2015 study found that 80 of Texas' 254 counties had just 5 or fewer physicians – and 35 had none. Shortages are particularly extreme it rural areas, where roughly 3 million Texans live.

Despite this recent announcement, however, Schwertner's bill could still hit roadblocks in the Legislature, where a number of telehealth bills were introduced but died last year.

The feuding over remote care in Texas has involved physicians, telemedicine interests and insurers, and Schwertner told the paper that all were part of the compromise effort.

The issue came to a head in 2011. At that time the Texas Medical Board warned doctors they could lose their license to practice medicine, if they did not have at least an initial live meeting with the patient, which the board said would result in their "failing to establish a proper professional relationship with the patient."

As a result of that effort, telehealth company Teladoc went to court over the effort by the board to mandate the in-person requirement, and U.S. District Judge Robert Pitman issued an injunction against the board, according to mHealth Intelligence.

However, while the stalemate continued, the interested parties began private talks to try to find common ground.

“What we used to be fighting about is, 'What can technology do?'” said Nora Belcher in mid-2016, executive director of the Texas e-Health Alliance, according to the news site. “Now we’re talking about what technology should do.”

Pressure for a resolution also came from the powerful Texas Association of Business. "Texas has some of the most onerous regulatory hurdles for telemedicine technologies," its then-CEO Bill Hammond stated during that period, noting that, "the industry's potential to help Texas patients and companies maximize access to care and reduce the cost of care is being held back by limitations imposed by regulators who accept the status quo as sufficient." Hammond added.

The compromise effort appears to be paying off – and all the parties involved seem satisfied that patients will get proper care, that payments will be appropriately made, costs reduced, and the entire telemedicine landscape able to function free of unduly onerous regulation.

"This is significant, and will be a winner for everyone," said Belcher. "This is going to get us a fair and open market for telemedicine in Texas."

The Texas Medical Association likewise was supportive of the effort. Dr. Ray Callas, chair of the Texas Medical Association Council on Legislation. praised Senator Schwertner “for his leadership in helping us all pursue a compromise telemedicine bill on our patients' behalf."

Although Callas did advise that, "while we are pleased that the seed of a legislative agreement is in place, we acknowledge that more work remains before it can grow into a new law to guide this valuable form of patient care for the future."

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