Hello fellow Texas PAs:

While we are amid the COVID-19 pandemic, TAPA leadership has been working conscientiously with government leaders and health leaders to ensure that the PAs in Texas will be protected and allowed to practice at the top of our licenses.  

The Declaration of Disaster by Governor Abbott on March 13, 2020 allows for 60 days of unrestricted telemedicine visits including telephone only. This declaration may be extended for another 60 days by the Governor depending on the activity of the virus.  See the link from Texas Department of Insurance.

PAs can also volunteer during the COVID-19 Declaration of Disaster without a supervising physician.

TAPA is aware that this pandemic is affecting the PA programs and PA students across the state. We are also aware that PAs in certain specialties are at risk of being furloughed or losing their jobs. Furthermore, we know that PAs on the frontlines in Emergency Medicine, Urgent Care, Family Medicine and many other areas will be pushed to the limit while providing care to patients affected by COVID-19.

TAPA has been communicating with key legislators, the Lieutenant Governor, and the Governor to ensure that there are no barriers to prevent PAs from practicing during the COVID-19 pandemic. We understand that some of the laws and statutes regarding supervision and limitations are a hinderance to our ability to care for our patients currently. (Click here to see our letter to Governor Abbott.)

We want to reassure all PAs in Texas that TAPA is supporting you as we all maneuver through this difficult time. We know that PAs are equipped to be a part of the solution during this pandemic and are and essential part of the healthcare workforce. While you are on the frontlines of this crisis, know that TAPA is working diligently to ensure PAs are protected. 

Visit the TAPA website for the latest updates regarding COVID-19.

 

Sincerely,

 

TAPA BOD

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§291.30. Medication Limitations

Effective: March 20, 2020

  No prescription or medication order for chloroquine, hydroxychloroquine, mefloquine, or azithromycin may be dispensed or distributed unless all the following apply:

(1) the prescription or medication order bears a written diagnosis from the prescriber consistent with the evidence for its use;

(2) the prescription or medication order is limited to no more than a fourteen (14) day supply, unless the patient was previously established on the medication prior to the effective date of this rule; and no refills may be permitted unless a new prescription or medication order is furnished.

Source: Texas State Board of Pharmacy


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TMB Waiver for Chronic Pain Patients Granted by Governor Abbott

Effective: March 19, 2020

Governor Abbott approved TMB’s request to temporarily suspend Title 22, Chapter 174.5 (e) (2)(A) of the Texas Administrative Code. The Texas Medical Board asserts that strict compliance with these laws could prevent, hinder, or delay timely delivery of necessary medical services in relation to efforts to cope with the declared disaster.

This waiver allows telephone refill(s) of a valid prescription for treatment of chronic pain by a physician with an established chronic pain patient. Due to the seriousness of the opioid crisis and the need to ensure there is proper oversight of chronic pain management, this suspension is only in effect until April 10, 2020.

Additionally, this waiver enables health care providers to provide necessary continuity of care for their chronic pain patients, while at the same time better preventing the risk of unnecessary exposure of the physician or their delegates to COVID-19.

The physician(s) remains responsible for meeting the standard of care and all other laws and rules related to the practice of medicine. The standard of care must still be maintained related to the treatment of chronic pain patients.

This waiver follows the Drug Enforcement Agency (DEA) announcement that healthcare professionals can prescribe controlled substances, including opioids, via telemedicine during the current coronavirus public health emergency.

Source:Texas State Board of Pharmacy


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Governor Abbott Waives Certain Regulations For Telemedicine Care In Texas

Effective: March 17, 2020

Governor Greg Abbott waived certain regulations and directed that the Texas Department of Insurance (TDI) issue an emergency rule, all relating to telemedicine care for patients with state-regulated insurance plans to help doctors across Texas continue to treat their patients while mitigating the spread of COVID-19. The suspensions and emergency rule will work together to allow telemedicine visits for patients with state-regulated plans to be paid the same as in-office visits for insurance purposes. These actions build upon waivers the Governor issued previously of portions in the Occupations Code to expand provider flexibility in providing medical services over the phone.

“As the State of Texas responds to COVID-19, we continue to work to maintain regular health care services and operations throughout the state, and telemedicine is one of the most valuable tools we have to ensure Texans continue to receive the health services they need,” said Governor Abbott. “Expanding telemedicine options will help protect the health of patients and health care professionals, and help Texas mitigate the spread of COVID-19.”

Doctors will be eligible for payment from insurance plans regulated by TDI for medical visits they conduct over the phone instead of in-person at the same rate they would receive for in-person visits. 

As a reminder, Texans covered by CHIP or Medicaid will not be charged copays for test or telemedicine consults. Individuals covered by Medicare or large employer plans should check with their health plan administrator to determine their specific benefits. 

Source: Office of the Texas Governor


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§35.1. Telemedicine Medical and Telehealth Services

Effective: March 17, 2020

(a) This section applies as follows:

(1) This section applies to health benefit plans as specified in Insurance Code  §1455.002 and §1455.003.
(2) The requirements of this section apply only to a health care service or procedure delivered on or after the effective date of this section.

(b) Words and terms defined in Insurance Code §1455.001*+ have the same meaning when used in this section. The term "health professional" includes a mental health professional providing services under 22 TAC §174.9. 

(c) A health benefit plan must provide coverage for a covered health care service or procedure delivered by a preferred or contracted health professional to a covered patient as a telemedicine medical service or telehealth service on the same basis and to the same extent that the plan provides coverage for the service or procedure in an in- person setting. 

(d) A health benefit plan must reimburse a preferred or contracted health professional for providing a covered health care service or procedure to a covered patient as a telemedicine medical service or telehealth service on the same basis and at least at the same rate that the plan is responsible for reimbursement to that health professional for the same service or procedure in an in-person setting. 

(e) Notwithstanding subsection (d) of this section, a health benefit plan is not required to pay more than the billed charge on a claim. 

(f) Except as provided by Insurance Code §1455.004(c), to the extent §1455.004(c) is not suspended, a health benefit plan may not limit, deny, or reduce coverage for a covered health care service or procedure delivered as a telemedicine medical service or telehealth service based on the health professional's choice of platform for delivering the service or procedure. 

(g) For purposes of processing payment of a claim, a health benefit plan may not require a health professional to provide documentation of a health care service or procedure delivered as a telemedicine medical service or telehealth service beyond what is required for the same service or procedure in an in-person setting. 

(h) The provisions of this section may not be waived, voided, or nullified by contract. 

Source: Texas Department of Insurance

*+The definitions of Health Provide under Sec 1455.001 are

(A) a physician;

(B) an individual who is:

      (i)licensed or certified in this state to perform health care services; and

      (II) authorized to assist a physician in providing telemedicine medical services that are delegated and supervised by the physician; or

(C) a licensed or certified health professional acting within the scope of the license or certification who does not perform a telemedicine medical service.


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