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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision and delivery of certain health, mental |
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health, and educational services in this state, including the |
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delivery of those services using telecommunications or information |
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technology. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.02165 to read as follows: |
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Sec. 531.02165. SERVICE COORDINATION USING |
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TELECOMMUNICATIONS OR INFORMATION TECHNOLOGY. (a) In this |
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section, "service coordination" includes: |
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(1) development and maintenance of a plan of care, |
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including an individual service plan, that meets the needs of a |
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Medicaid recipient or child health plan program enrollee; |
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(2) coordination, including with providers, to assist |
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the recipient or enrollee in accessing Medicaid or child health |
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plan program benefits, including benefits under a Section 1915(c) |
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waiver program; |
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(3) coordination, including with providers as |
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appropriate, to assist the recipient or enrollee in accessing |
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services provided by other community entities or service providers, |
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including nonmedical providers; |
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(4) transition planning to assist the recipient in |
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preparing for changes in life circumstances and in available health |
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care services to ease the recipient's shift into adulthood; and |
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(5) with respect to the STAR Health program, |
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assistance provided to the caregiver of the recipient to help the |
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caregiver manage information, including information needed for |
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court hearings. |
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(b) The commission shall ensure that, to the extent |
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appropriate, a Medicaid recipient or child health plan program |
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enrollee who is eligible to receive service coordination benefits, |
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including a recipient or enrollee receiving program benefits |
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through a managed care delivery model, has the option to receive |
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delivery of those benefits as a telehealth service or otherwise |
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using telecommunications or information technology. |
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(c) The executive commissioner shall adopt rules necessary |
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to implement this section, including rules governing when the |
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delivery of service coordination benefits using telecommunications |
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or information technology is appropriate. |
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SECTION 2. Section 1455.001(1-a), Insurance Code, is |
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amended to read as follows: |
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(1-a) "Health professional" means: |
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(A) a physician; |
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(B) an individual who is: |
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(i) licensed or certified in this state to |
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perform health care services; and |
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(ii) authorized to assist: |
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(a) a physician in providing |
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telemedicine medical services that are delegated and supervised by |
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the physician; or |
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(b) a dentist in providing |
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teledentistry dental services that are delegated and supervised by |
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the dentist; |
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(C) a licensed or certified health professional |
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acting within the scope of the license or certification who does not |
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perform a telemedicine medical service or a teledentistry dental |
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service; [or] |
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(D) a dentist; or |
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(E) an individual who is credentialed to provide |
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qualified mental health professional community services, has |
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demonstrated and documented competency in the work to be performed, |
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and: |
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(i) holds a bachelor's or more advanced |
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degree from an accredited institution of higher education with a |
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minimum number of hours that is equivalent to a major in psychology, |
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social work, medicine, nursing, rehabilitation, counseling, |
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sociology, human growth and development, physician assistant |
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studies, gerontology, special education, educational psychology, |
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early childhood education, or early childhood intervention; |
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(ii) is a registered nurse; or |
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(iii) completes an alternative |
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credentialing process identified by the Health and Human Services |
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Commission. |
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SECTION 3. Chapter 1455, Insurance Code, is amended by |
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adding Sections 1455.007 and 1455.008 to read as follows: |
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Sec. 1455.007. REIMBURSEMENT AND PAYMENT. (a) A health |
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benefit plan issuer must reimburse a preferred or contracted health |
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professional for providing a covered health care service or |
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procedure to a covered patient as a telemedicine medical service or |
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telehealth service on the same basis and at least at the same rate |
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that the issuer provides reimbursement to that health professional |
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for the service or procedure in an in-person setting. |
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(b) Notwithstanding Subsection (a), a health benefit plan |
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issuer is not required to pay more than the billed charge on a claim |
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for payment by a preferred or contracted health professional. |
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(c) For purposes of processing payment of a claim, a health |
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benefit plan issuer may not require a preferred or contracted |
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health professional to provide documentation of a covered health |
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care service or procedure delivered by the health professional to a |
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covered patient as a telemedicine medical service or telehealth |
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service beyond that which is required for the service or procedure |
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in an in-person setting. |
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Sec. 1455.008. WAIVER PROHIBITED. The provisions of this |
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chapter may not be waived, voided, or nullified by contract. |
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SECTION 4. Subchapter E, Chapter 401, Occupations Code, is |
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amended by adding Section 401.2022 to read as follows: |
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Sec. 401.2022. RULES FOR FITTING AND DISPENSING OF HEARING |
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INSTRUMENTS BY TELEPRACTICE. (a) In this section, "telepractice" |
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means the use of telecommunications technology by a license holder |
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for an assessment, intervention, or consultation regarding a |
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speech-language pathology or audiology client. |
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(b) With the assistance of the advisory board and the |
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Hearing Instrument Fitters and Dispensers Advisory Board, the |
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commission by rule shall establish requirements for the fitting and |
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dispensing of hearing instruments through the use of telepractice |
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for purposes of this chapter and Chapter 402, including rules that |
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establish the qualifications and duties of license holders who use |
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telepractice. |
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(c) Notwithstanding any other law, in adopting a rule under |
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this section, the commission: |
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(1) shall authorize: |
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(A) a license holder, including a licensed intern |
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or licensed assistant, to provide services by telepractice through |
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the use of any interactive audiovisual communication system, |
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whether real-time or two-way, including a smartphone; and |
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(B) any supervision requirement for an applicant |
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under this chapter to be fulfilled wholly or partly by use of |
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telecommunications technology; and |
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(2) may not: |
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(A) require a license holder's initial |
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professional contact with a client to be in-person; or |
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(B) impose any limitation on a license holder's |
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selection of a facilitator to assist the license holder in |
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providing services by telepractice. |
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SECTION 5. Subchapter C, Chapter 402, Occupations Code, is |
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amended by adding Section 402.1023 to read as follows: |
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Sec. 402.1023. RULES FOR FITTING AND DISPENSING OF HEARING |
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INSTRUMENTS BY TELEPRACTICE. (a) In this section, "telepractice" |
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means the use of telecommunications technology by a license holder |
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for the fitting and dispensing of hearing instruments. |
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(b) With the assistance of the advisory board and the |
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Speech-Language Pathologists and Audiologists Advisory Board, the |
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commission by rule shall establish requirements for the fitting and |
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dispensing of hearing instruments through the use of telepractice |
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for purposes of this chapter and Chapter 401, including rules that |
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establish the qualifications and duties of license holders who use |
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telepractice. |
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(c) Notwithstanding any other law, in adopting a rule under |
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this section, the commission: |
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(1) shall authorize a license holder to provide |
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services by telepractice through the use of any interactive |
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audiovisual communication system, whether real-time or two-way, |
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including a smartphone; and |
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(2) may not: |
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(A) require a license holder's initial |
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professional contact with a client to be in-person; or |
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(B) impose any limitation on a license holder's |
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selection of a facilitator to assist the license holder in |
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providing services by telepractice. |
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SECTION 6. Section 402.255(a), Occupations Code, is amended |
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to read as follows: |
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(a) A supervisor of a temporary training permit holder must: |
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(1) be licensed to fit and dispense hearing |
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instruments under this chapter or Chapter 401, other than Section |
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401.311 or 401.312; and |
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(2) [currently practice in this state under a license |
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described by Subdivision (1); and |
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[(3)] be responsible for the direct supervision and |
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education of a temporary training permit holder. |
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SECTION 7. Section 403.151, Occupations Code, is amended by |
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adding Subsection (d) to read as follows: |
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(d) Notwithstanding this section, a licensed dyslexia |
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practitioner may practice outside of an educational setting to the |
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extent necessary to provide a service that would otherwise be |
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provided in an educational setting that is not reasonably |
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accessible to the licensed dyslexia practitioner or client. |
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SECTION 8. Subchapter D, Chapter 403, Occupations Code, is |
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amended by adding Section 403.153 to read as follows: |
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Sec. 403.153. USE OF TELECOMMUNICATIONS TECHNOLOGY. |
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Notwithstanding any other law, a license holder may provide a |
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service solely through the use of an interactive audiovisual |
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communication system, whether real-time or two-way, including a |
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smartphone. |
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SECTION 9. Section 506.003, Occupations Code, is amended by |
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adding Subsection (c-1) to read as follows: |
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(c-1) Notwithstanding Subsection (c)(1), applied behavior |
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analysis interventions may be based on observation and measurement |
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of behavior and environment through the use of telecommunications |
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technology if approved by the certifying entity. |
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SECTION 10. Section 506.055, Occupations Code, is amended |
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to read as follows: |
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Sec. 506.055. STUDENTS, INTERNS, AND FELLOWS. (a) This |
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chapter does not apply to an applied behavior analysis activity or |
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service of a college or university student, intern, or fellow if: |
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(1) the activity or service is part of a defined |
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behavior analysis program of study, course, practicum, internship, |
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or postdoctoral fellowship; |
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(2) the activity or service is directly supervised by |
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a licensed behavior analyst or an instructor in a course sequence |
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approved by the certifying entity; and |
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(3) the person is designated as a "student," "intern," |
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"fellow," or "trainee." |
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(b) Notwithstanding Subsection (a)(2), a licensed behavior |
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analyst or an instructor may supervise a behavior analysis activity |
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or service through the use of telecommunications technology if |
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approved by the applicable college or university and the certifying |
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entity. |
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SECTION 11. Section 554.005, Occupations Code, is amended |
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by adding Subsection (d) to read as follows: |
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(d) In implementing Subsection (a)(3)(C)(iv), the board may |
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not require the in-person counseling of patients. |
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SECTION 12. Chapter 1455, Insurance Code, as amended by |
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this Act, applies only to a health benefit plan delivered, issued |
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for delivery, or renewed on or after January 1, 2024. A health |
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benefit plan delivered, issued for delivery, or renewed before |
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January 1, 2024, is governed by the law as it existed immediately |
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before the effective date of this Act, and that law is continued in |
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effect for that purpose. |
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SECTION 13. If before implementing any provision of this |
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Act a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 14. This Act takes effect September 1, 2023. |