The Texas Medical Board (Board) proposes amendments to §§174.1, 174.2, and 174.6, the repeal of §174.4, and new §174.7 and §174.8, concerning Telemedicine.

The amendment to §174.1, relating to Purpose, provides the statutory authority for the chapter and clarifies that the chapter does not apply to special purpose telemedicine licenses for those doctors who practice outside of Texas.

The amendment to §174.2, relating to Definitions, defines "distant-site physician", "patient-site location," and "patient-site presenter" and amends the definition for "telemedicine medical services."

The repeal of §174.4, relating to Use of the Internet in Medical Practice, repeals this section, and it is proposed as a new rule under §174.8.

The amendment to §174.6, relating to Delegation to and Supervision of Patient Site Presenters, amends language so that it is consistent with proposed changes to the definition of patient-site presenters and sets out the requirements for patient encounters and delegation and supervision of patient-site presenters.

New §174.7, relating to Medical Records for Telemedicine Medical Services, establishes the requirements for the contents and possession of medical records for telemedicine medical services.

New §174.8, relating to Use of the Internet in Medical Practice, adopts all language from the 174.4 that is being repealed and includes language that state licensure is not required for out-of-state physicians who provide episodic consultations and are exempt from having to obtain special purpose telemedicine licenses.

Nancy Leshikar, General Counsel for the Board, has determined that for each year of the first five years the sections as proposed are in effect the public benefit anticipated as a result of enforcing §174.1, will be to clarify the purpose and application of the chapter; as a result of enforcing §174.2, will be to ensure that the provision of telemedicine medical services is provided by certain licensed health care professionals; as a result of enforcing §174.4, will be to provide more clarity to the rules by moving the text of the section to a more appropriate place; as a result of enforcing §174.6, will be to ensure that the provision of telemedicine medical services is provided by certain licensed health care professionals and that the delegation of related services is done appropriately, as a result of enforcing §174.7, will be to ensure that medical records are appropriately maintained in relation to telemedicine medical services; as a result of enforcing §174.8, will be to provide more clarity to the rules.

Ms. Leshikar has also determined that for the first five-year period the sections are in effect there will be no fiscal implications to state or local government as a result of enforcing the sections as proposed. There will be no effect to individuals required to comply with the rules as proposed. There will be no effect on small or micro businesses.

Comments on the proposal may be submitted to Sally Durocher, P.O. Box 2018, Austin, Texas 78768-2018, or e-mail comments to: rules.development@tmb.state.tx.us. A public hearing will be held at a later date.

The repeal is proposed under the authority of the Texas Occupations Code Annotated, §153.001, which provides authority for the Board to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; enforce this subtitle; and establish rules related to licensure.

The repeal is also authorized by §153.004, Texas Occupations Code.

No other statutes, articles or codes are affected by the proposal.