86R12278 PMO-F
By: Price, Lucio III, Paul, Guillen, Lambert, H.B. No. 3345
et al.
A BILL TO BE ENTITLED
AN ACT
relating to health benefit coverage provided by certain health
benefit plans for telemedicine medical services and telehealth
services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1455.001, Insurance Code, is amended by
adding Subdivision (2-a) to read as follows:
(2-a) "Platform" means the technology, system,
software, application, modality, or other method through which a
health professional remotely interfaces with a patient when
providing a health care service or procedure as a telemedicine
medical service or telehealth service.
SECTION 2. Section 1455.004, Insurance Code, is amended by
amending Subsection (a) and adding Subsections (b-1) and (d) to
read as follows:
(a) A health benefit plan:
(1) must provide coverage for a covered health care
service or procedure delivered by a preferred or contracted health
professional to a covered patient as a telemedicine medical service
or telehealth service on the same basis and to the same extent that
the plan provides coverage for the service or procedure in an
in-person setting; and
(2) may not:
(A) exclude from coverage a covered health care
service or procedure delivered by a preferred or contracted health
professional to a covered patient as a telemedicine medical service
or a telehealth service solely because the covered health care
service or procedure is not provided through an in-person
consultation; and
(B) subject to Subsection (c), limit, deny, or
reduce coverage for a covered health care service or procedure
delivered as a telemedicine medical service or telehealth service
based on the health professional's choice of platform for
delivering the service or procedure.
(b-1) Subsection (b) does not authorize a health benefit
plan to charge a separate deductible that applies only to a covered
health care service or procedure delivered as a telemedicine
medical service or telehealth service.
(d) A health benefit plan may not impose an annual or
lifetime maximum on coverage for covered health care services or
procedures delivered as telemedicine medical services or
telehealth services other than the annual or lifetime maximum, if
any, that applies in the aggregate to all items and services and
procedures covered under the plan.
SECTION 3. The changes to Section 1455.004, Insurance Code,
as amended by this Act, apply only to a health benefit plan
delivered, issued for delivery, or renewed on or after January 1,
2020. A health benefit plan delivered, issued for delivery, or
renewed before January 1, 2020, 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, 2019.