Texas was set to approve legislation that would give the state’s Medicaid program and other public health plans more freedom to cover telehealth, RPM Services and allow audio-only telehealth services in some situations.
In July, 2021, Governor Greg Abbott signed HB 4 and HB 5 into law this week, joining more than 20 other states that have permanently expanded telehealth coverage and access beyond the coronavirus pandemic. Both bills were already approved by the state’s Legislature in June, 2021.

HB 4 opens the door for Medicaid and public health plans to use connected health platforms for preventive health and wellness screenings, case management services, physical, occupational, and speech therapy, nutritional counseling, assessments, and behavioral health services, including those delivered by audio-only telehealth if deemed appropriate
It also establishes reimbursement through the Medicaid managed care program for “telemonitoring services,” or RPM. And it allows for the creation of guidelines on how providers can use e-mail or text messages to communicate with patients.
It adds rural health clinics to the list of providers (which includes federally qualified health centers) who can be reimbursed for the originating site facility fee or distant site practitioner fee, or both, for services delivered via telehealth.
“Whether you’re a rural health clinic, FQHC, a private provider, Medicaid, we really extended the benefits of telehealth and telemedicine through this bill and through bills we’ve previously passed,” State Rep. Four Price
HB 5 expands the make-up and duties of the state’s new Broadband Development Office and council, which would monitor the progress of broadband expansion in the state, identify barriers to internet access in certain communities and work to expand those resources.
Lack of broadband connectivity is a consistent barrier to the expansion of telehealth and RPM programs, particularly in rural areas and among underserved populations.
“With expanded broadband across the entire state, we will see better use of the technology to access so many things that we do every single day,” State Rep. Four Price, said. “Job training, commerce, education, healthcare, these are just a few of the things that we rely on, reliable internet access for really to conduct the business every single day.”
The bill is one of many across the country – including several in Texas – that aim to expand telehealth access and coverage past the pandemic. A few states have chosen to extend emergency provisions for a while in hopes of seeing Congress set federal telehealth policy, but others are pushing ahead with their own laws, creating pockets of permanence around the country.
Review the HB4 and HB5 bills in detail here, HB4, HB5
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