Texas Legislature poised to pass telehealth expansion

Texas will likely soon implement broad telehealth expansion across the state — a bipartisan priority for legislators and central goal for Gov. Greg Abbott. HB 4, a bill that would make the telehealth expansions put in place by the pandemic permanent, unanimously passed its second chamber Monday.


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If HB 4 passes, public health insurance programs (Medicaid, child health plans and any other health insurance program offered by the government) will be required to cover certain services provided via telehealth, such as preventive health services and physical therapy. 

The bill also requires public health insurance to cover audio-only behavioral health services, and allows the executive commissioner of the Health and Human Services Commission (HHSC) to identify other service areas where audio-only services must be covered.

Rural access hospitals and federally qualified health centers would be eligible for reimbursements for originating site facility fees or distant site practitioner fees resulting from services conducted via telehealth.

The legislation is awaiting concurrence from the House before heading to Abbott’s desk for final approval. Nora Belcher, executive director of the Texas e-Health Alliance, told State of Reform she is “cautiously optimistic” about the bill becoming law at this point. 

The bill needs a second House approval because of an amendment the Senate added during negotiations, which Belcher says was a minor change to align with language from a similar bill that had already passed. She expects the House to approve, meaning the bill’s main final hurdle will be Abbott’s signature.

The governor has advocated for permanently expanding telehealth since early 2021. While Abbott hasn’t publicly declared a position on HB 4, Belcher called him a “champion for telemedicine and telehealth,” and — barring any last-minute concerns on Abbott’s end — he is likely to sign the permanent telehealth expansions into law.