| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to health benefit plan coverage of telemedicine, |
|
|
teledentistry, and telehealth appointments with an originating |
|
|
site or distant site located outside this state. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 1455.001, Insurance Code, is amended by |
|
|
amending Subdivision (1-a) and adding Subdivisions (1-b) and (1-c) |
|
|
to read as follows: |
|
|
(1-a) "Distant site" means the location where a health |
|
|
professional provides a telemedicine medical service, |
|
|
teledentistry dental service, or telehealth service. |
|
|
(1-b) "Health professional" means: |
|
|
(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) a physician in providing |
|
|
telemedicine medical services that are delegated and supervised by |
|
|
the physician; or |
|
|
(b) a dentist in providing |
|
|
teledentistry dental services that are delegated and supervised by |
|
|
the dentist; |
|
|
(C) a licensed or certified health professional |
|
|
acting within the scope of the license or certification who does not |
|
|
perform a telemedicine medical service or a teledentistry dental |
|
|
service; or |
|
|
(D) a dentist. |
|
|
(1-c) "Originating site" means the location where an |
|
|
individual receives a telemedicine medical service, teledentistry |
|
|
dental service, or telehealth service. |
|
|
SECTION 2. Section 1455.004, Insurance Code, is amended by |
|
|
adding Subsection (e) to read as follows: |
|
|
(e) A health benefit plan must provide coverage for a |
|
|
covered health care service or procedure delivered as a |
|
|
telemedicine medical service, teledentistry dental service, or |
|
|
telehealth service with an originating site or distant site located |
|
|
outside this state on the same basis and to the same extent that the |
|
|
plan provides coverage for the service or procedure delivered as a |
|
|
telemedicine medical service, teledentistry dental service, or |
|
|
telehealth service with an originating site and distant site |
|
|
located in this state if: |
|
|
(1) the individual who receives the service resides |
|
|
primarily in this state; and |
|
|
(2) the health professional who provides the service: |
|
|
(A) is licensed or otherwise authorized to |
|
|
provide the service in this state; and |
|
|
(B) has a physical office in this state. |
|
|
SECTION 3. Section 1455.004, Insurance Code, as amended by |
|
|
this Act, applies only to a health benefit plan delivered, issued |
|
|
for delivery, or renewed on or after January 1, 2026. A health |
|
|
benefit plan delivered, issued for delivery, or renewed before |
|
|
January 1, 2026, is governed by the law as it existed immediately |
|
|
before the effective date of this Act, and that law is continued in |
|
|
effect for that purpose. |
|
|
SECTION 4. This Act takes effect September 1, 2025. |