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September 25, 2017

DWC rule helps expand the use of telemedicine in workers’ compensation system

The Texas Division of Workers’ Compensation (DWC) posted an informal rule that aims to help expand the use of telemedicine – sometimes called ‘telehealth’ – in the state’s workers’ compensation system.

“Most states, including Texas, are limited in what they are doing with telemedicine,” says Texas Commissioner of Workers’ Compensation Ryan Brannan. “We’re introducing this rule with the future growth of telemedicine in mind.”

Telemedicine – typically defined as a doctor or health care professional using computer or electronic video systems to examine a patient at another location – is already allowed in Texas. Currently however, telemedicine within the workers’ compensation system is limited by Medicare based reimbursement restrictions relating to “underserved” areas, which are typically rural regions with insufficient access to health care providers, and must be provided in a doctor’s office, hospital, or certain clinics.

The informal DWC rule would eliminate the Medicare based reimbursement restrictions that limit the use of telemedicine in workers’ compensation to these underserved areas. This will allow the use of telemedicine everywhere in Texas. The informal rule also eliminates the Medicare based requirement that the telemedicine service be provided in a doctor’s office, hospital, or certain clinic. Instead, an injured employee can be anywhere at the time they receive telemedicine services.

“We want to be proactive when we can to make the Texas workers’ compensation system more efficient, and this is one way to do that,” Brannan said. “Telemedicine can be a huge benefit to employers and injured employees, saving them travel time and expenses, without sacrificing quality of care.”

In 2017, the Texas Legislature passed a comprehensive bill addressing telemedicine in Texas, specifically removing certain limitations on its use. Currently, the Texas Medical Board is implementing these changes through rulemaking. The informal DWC rule is consistent with the legislation and proposed rulemaking.

“Our priority is to be consistent with the spirt of the legislation, and to make telemedicine services available to the extent we can,” says Martha Luevano, director of Medical Fee Dispute Resolution at DWC.

Luevano said all other existing rules for telemedicine – such as those governing quality of service and documentation requirements – would still apply.

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Last updated: 7/16/2018