BILL ANALYSIS

C.S.H.B. 3942

By: Bhojani

Insurance

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Telehealth is effective, efficient, and accessible for patients who need health care services, including rural communities, underserved and vulnerable patient populations, and individuals unable to secure in-person care. Current law does not explicitly state that health benefit plans must cover telehealth appointments regardless of the originating and distant site. "Originating site" refers to the location of a patient during their telehealth appointment, and "distant site" refers to the location of the physician during a telehealth appointment. C.S.H.B. 3942 seeks to make telehealth services more accessible for Texans by requiring a health benefit plan to provide coverage for telemedicine medical services, teledentistry dental services, and telehealth services with an originating site or distant site located outside Texas on the same basis and to the same extent that coverage would be provided if such sites were located in Texas.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 3942 amends the Insurance Code to require a health benefit plan to 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 Texas 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 Texas if the following conditions are satisfied:

· the individual who receives the service resides primarily in Texas; and

· the health professional who provides the service is licensed or otherwise authorized to provide the service in Texas and has a physical office in Texas.

C.S.H.B. 3942 defines "originating site" as the location where an individual receives a telemedicine medical service, teledentistry dental service, or telehealth service and "distant site" as the location where a health professional provides such a service. The bill applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2024.

EFFECTIVE DATE

September 1, 2023.

COMPARISON OF INTRODUCED AND SUBSTITUTE

While C.S.H.B. 3942 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

The substitute includes a provision absent from the introduced that conditions the bill's requirement on the individual who receives the service residing primarily in Texas and on the health professional who provides the service being licensed or otherwise authorized to provide the service in Texas and having a physical office in Texas.