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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for speech therapy |
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services provided through telehealth services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1455.002, Insurance Code, is amended to |
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read as follows: |
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Sec. 1455.002. APPLICABILITY OF CHAPTER. Except as |
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otherwise provided by this chapter, this [This] chapter applies |
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only to a health benefit plan that: |
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(1) provides benefits for medical or surgical expenses |
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incurred as a result of a health condition, accident, or sickness, |
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including: |
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(A) an individual, group, blanket, or franchise |
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insurance policy or insurance agreement, a group hospital service |
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contract, or an individual or group evidence of coverage that is |
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offered by: |
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(i) an insurance company; |
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(ii) a group hospital service corporation |
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operating under Chapter 842; |
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(iii) a fraternal benefit society operating |
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under Chapter 885; |
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(iv) a stipulated premium company operating |
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under Chapter 884; or |
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(v) a health maintenance organization |
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operating under Chapter 843; and |
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(B) to the extent permitted by the Employee |
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Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et |
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seq.), a health benefit plan that is offered by: |
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(i) a multiple employer welfare arrangement |
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as defined by Section 3 of that Act; or |
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(ii) another analogous benefit |
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arrangement; or |
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(2) is offered by an approved nonprofit health |
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corporation that holds a certificate of authority under Chapter |
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844. |
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SECTION 2. Chapter 1455, Insurance Code, is amended by |
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adding Section 1455.0041 to read as follows: |
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Sec. 1455.0041. COVERAGE FOR SPEECH THERAPY TELEHEALTH |
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SERVICES. (a) This section applies to a health benefit plan |
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described by Section 1455.002. |
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(b) Notwithstanding any other law, this section applies to: |
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(1) a standard health benefit plan issued under |
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Chapter 1507; |
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(2) a basic coverage plan under Chapter 1551; |
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(3) a basic plan under Chapter 1575; |
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(4) a primary care coverage plan under Chapter 1579; |
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(5) a plan providing basic coverage under Chapter |
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1601; |
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(6) group health coverage made available by a school |
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district in accordance with Section 22.004, Education Code; |
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(7) the state Medicaid program, including the Medicaid |
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managed care program operated under Chapter 533, Government Code; |
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and |
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(8) the child health plan program under Chapter 62, |
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Health and Safety Code. |
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(c) A health benefit plan that provides coverage for speech |
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therapy services must provide coverage for speech therapy services |
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provided through a telehealth service in the same manner as |
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coverage required under Section 1455.004. |
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(d) A health benefit plan must reimburse a preferred or |
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contracted health professional for providing speech therapy |
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services to a covered patient as a telehealth service on the same |
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basis and at least at the same rate that the issuer provides |
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reimbursement to that health professional for speech therapy |
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services in an in-person setting. |
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SECTION 3. The change in law made by this Act applies only |
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to a health benefit plan that is delivered, issued for delivery, or |
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renewed on or after January 1, 2022. A health benefit plan that is |
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delivered, issued for delivery, or renewed before January 1, 2022, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 4. This Act takes effect September 1, 2021. |