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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit coverage provided by certain health |
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benefit plans for telemedicine medical services and telehealth |
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services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1455.001, Insurance Code, is amended by |
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adding Subdivision (2-a) to read as follows: |
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(2-a) "Platform" means the technology, system, |
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software, application, modality, or other method through which a |
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health professional remotely interfaces with a patient when |
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providing a health care service or procedure as a telemedicine |
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medical service or telehealth service. |
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SECTION 2. Section 1455.004, Insurance Code, is amended by |
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amending Subsection (a) and adding Subsections (b-1) and (d) to |
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read as follows: |
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(a) A health benefit plan: |
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(1) must provide coverage for a covered health care |
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service or procedure delivered by a preferred or contracted health |
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professional to a covered patient as a telemedicine medical service |
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or telehealth service on the same basis and to the same extent that |
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the plan provides coverage for the service or procedure in an |
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in-person setting; and |
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(2) may not: |
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(A) exclude from coverage a covered health care |
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service or procedure delivered by a preferred or contracted health |
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professional to a covered patient as a telemedicine medical service |
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or a telehealth service solely because the covered health care |
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service or procedure is not provided through an in-person |
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consultation; and |
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(B) subject to Subsection (c), limit, deny, or |
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reduce coverage for a covered health care service or procedure |
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delivered as a telemedicine medical service or telehealth service |
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based on the health professional's choice of platform for |
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delivering the service or procedure. |
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(b-1) Subsection (b) does not authorize a health benefit |
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plan to charge a separate deductible that applies only to a covered |
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health care service or procedure delivered as a telemedicine |
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medical service or telehealth service. |
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(d) A health benefit plan may not impose an annual or |
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lifetime maximum on coverage for covered health care services or |
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procedures delivered as telemedicine medical services or |
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telehealth services other than the annual or lifetime maximum, if |
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any, that applies in the aggregate to all items and services and |
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procedures covered under the plan. |
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SECTION 3. The changes to Section 1455.004, Insurance Code, |
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as amended by this Act, apply only to a health benefit plan |
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delivered, issued for delivery, or renewed on or after January 1, |
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2020. A health benefit plan delivered, issued for delivery, or |
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renewed before January 1, 2020, is governed by the law as it existed |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2019. |