S.B. 2529 and What It Means to You

There is a proposed bill before the TX Senate to amend Chapter 111 of the Occupations Code (that's one of the additional 9 Codes BHEC requires you as a licensee to be familiar with, right?) to include all (4) license types under BHEC's jurisdiction.

Here are our first-blush notes on the proposed SB No. 2527. Our comments are mostly limited to the portions that appear to apply to the 4 license types being proposed for inclusion.

Section 6-Proposed Inclusion of BHEC Licensees

1. This bill would make LPC/LMFT/Psych/and SW licensees subject to this code (they are currently exempt).

We assume that the 4 license types under BHEC authority will fall under the definition of "health professional" in Section 1455.001 since "dentist' and "physician" do not apply, and that the definition of "health professional" will need to be amended to include the (4) license types, if it does not already.

Section 13-Proposed Effective Date

1. Effective date on this bill would be Sept 1, 2023, if passed.

Section 2-Telehealth, Minors, and Consent

1. Counselors engaging minors via telehealth must obtain appropriate "informed consent" forms.
2. Must develop/implement protocols for seeing minors via telehealth.
3. PARENT or GUARDIAN MUST BE PRESENT AT FIRST SESSION with minor... does not say what needs to happen after that.

Section 4-Various Topics

1. Discusses the use of synchronous vs asynchronous telehealth platforms and their applicability circumstances.
2. REQUIRES that the platform used be HIPAA compliant.

What this means is that the proposed application of this code would require, by State law, that, in addition to Federal HIPAA law requirements for healthcare professionals, that all telehealth platforms utilized by healthcare professionals, including mental health counselors, be HIPAA compliant. We have been under the Federal HIPAA process and procedure requirements since HIPAA's passage, but perhaps the State is now seeing a need to enforce this?

3. Would require 72 hour records requests (vs 15 day current time frame??) to a clients PCP.
This sounds like a records request guideline and seems to conflict with Chapter 611's 15 day allowed response time for records requests. The proposed (72) hr timeframe in SB 2527 and the existing timeframe of 15 days in Chapter 611 for records requests will need to be addressed.

Section 5-Emergency Procedures and HIPAA Applicability

1. Requires the development of written emergency protocols for dealing with telehealth emergencies.

A licensee may or may not currently have verbiage in their Intake Packet addressing this already, but will almost certainly need to modify it, or at least review it for accuracy, once this proposed bill is passed.

Section 9-Controlled Substances

This section, as written, would apply only to any covered entity that is empowered to write prescriptions. There are many points to cover but given that none of BHEC's licensees are authorized to write scrips we will only offer 2-3 highlights that appear good for the overall medical community and their clients:

1. Provides clear guidelines for medical professionals utilizing telehealth regarding entering into contracts that provide compensation/kick-backs for writing scrips for controlled substances.

Does this mean that MD's will no longer be able to collect their $$$ bonuses from Big Pharma at the end of the year for writing these types of scripts? Hope so. How will the state enforce THAT?!

2. Those authorized to write controlled substance scrips, will be subject to a pattern of in-person/telehealth/in-person visits. Scrips for controlled substances cannot be written without periodic in-person visits.
3. Those authorized to write controlled substance scrips will be required to file additional annual reports to the appropriate regulatory authorities.

I think some psychiatrists are already doing this type of protocol, but maybe now there will be a law to get the rest of the psychiatrists on board. But a law is only as good as its enforcement so, we'll see!

After a careful reading of the proposed bill, these are our observations about the impact of this SB 2527 on the BHEC licensees. What are your thoughts?