Text of section effective on April 01, 2025
Sec. 548.0253.  REIMBURSEMENT PROGRAM REQUIREMENTS.  (a)  A program established under this subchapter must:
(1)  provide that home telemonitoring services are available only to an individual who:
(A)  is diagnosed with one or more of the following conditions:
(i)  pregnancy;
(ii)  diabetes;
(iii)  heart disease;
(iv)  cancer;
(v)  chronic obstructive pulmonary disease;
(vi)  hypertension;
(vii)  congestive heart failure;
(viii)  mental illness or serious emotional disturbance;
(ix)  asthma;
(x)  myocardial infarction; or
(xi)  stroke; and
(B)  exhibits two or more of the following risk factors:
(i)  two or more hospitalizations in the prior 12-month period;
(ii)  frequent or recurrent emergency room admissions;
(iii)  a documented history of poor adherence to ordered medication regimens;
(iv)  a documented history of falls in the prior six-month period;
(v)  limited or absent informal support systems;
(vi)  living alone or being home alone for extended periods; and
(vii)  a documented history of care access challenges;
(2)  ensure that clinical information gathered by a home and community support services agency or hospital while providing home telemonitoring services is shared with the patient's physician; and
(3)  ensure that the program does not duplicate disease management program services provided under Section 32.057, Human Resources Code.
(b)  Notwithstanding Subsection (a)(1), a program established under this subchapter must also provide that home telemonitoring services are available to pediatric individuals who:
(1)  are diagnosed with end-stage solid organ disease;
(2)  have received an organ transplant; or
(3)  require mechanical ventilation.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.