Texas 2021 - 87th Regular

Texas House Bill HB2056 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 2056
	1	+	By: Klick, Guerra (Senate Sponsor - Perry) H.B. No. 2056
	2	+	(In the Senate - Received from the House May 10, 2021;
	3	+	May 10, 2021, read first time and referred to Committee on Health &
	4	+	Human Services; May 20, 2021, reported favorably by the following
	5	+	vote: Yeas 8, Nays 0; May 20, 2021, sent to printer.)
	6	+	Click here to see the committee vote
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5	11		relating to the practice of dentistry and the provision of
6	12		teledentistry dental services.
7	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	14		SECTION 1. The heading to Chapter 111, Occupations Code, is
9	15		amended to read as follows:
10	16		CHAPTER 111. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH
11	17		SECTION 2. Section 111.001, Occupations Code, is amended by
12	18		amending Subdivisions (1) and (3) and adding Subdivision (2-a) to
13	19		read as follows:
14	20		(1) "Dentist," "health [Health] professional," and
15	21		"physician" have the meanings assigned by Section 1455.001,
16	22		Insurance Code.
17	23		(2-a) "Teledentistry dental service" means a health
18	24		care service delivered by a dentist, or a health professional
19	25		acting under the delegation and supervision of a dentist, acting
20	26		within the scope of the dentist's or health professional's license
21	27		or certification to a patient at a different physical location than
22	28		the dentist or health professional using telecommunications or
23	29		information technology.
24	30		(3) "Telehealth service" means a health service, other
25	31		than a telemedicine medical service or a teledentistry dental
26	32		service, delivered by a health professional licensed, certified, or
27	33		otherwise entitled to practice in this state and acting within the
28	34		scope of the health professional's license, certification, or
29	35		entitlement to a patient at a different physical location than the
30	36		health professional using telecommunications or information
31	37		technology.
32	38		SECTION 3. Section 111.002, Occupations Code, is amended to
33	39		read as follows:
34	40		Sec. 111.002. INFORMED CONSENT. (a) A treating physician,
35	41		dentist, or health professional who provides or facilitates the use
36	42		of telemedicine medical services, teledentistry dental services,
37	43		or telehealth services shall ensure that the informed consent of
38	44		the patient, or another appropriate individual authorized to make
39	45		health care treatment decisions for the patient, is obtained before
40	46		telemedicine medical services, teledentistry dental services, or
41	47		telehealth services are provided.
42	48		(b) A dentist who delegates a teledentistry dental service
43	49		shall ensure that the informed consent of the patient includes
44	50		disclosure to the patient that the dentist has delegated the
45	51		service.
46	52		SECTION 4. Section 111.003, Occupations Code, is amended to
47	53		read as follows:
48	54		Sec. 111.003. CONFIDENTIALITY. A treating physician,
49	55		dentist, or health professional who provides or facilitates the use
50	56		of telemedicine medical services, teledentistry dental services,
51	57		or telehealth services shall ensure that the confidentiality of the
52	58		patient's clinical [medical] information is maintained as required
53	59		by Chapter 159, by Subchapter C, Chapter 258, or by other applicable
54	60		law.
55	61		SECTION 5. Section 111.004, Occupations Code, is amended
56	62		to read as follows:
57	63		Sec. 111.004. RULES. (a) The Texas Medical Board, in
58	64		consultation with the commissioner of insurance, as appropriate,
59	65		may adopt rules necessary to:
60	66		(1) ensure that patients using telemedicine medical
61	67		services receive appropriate, quality care;
62	68		(2) prevent abuse and fraud in the use of telemedicine
63	69		medical services, including rules relating to the filing of claims
64	70		and records required to be maintained in connection with
65	71		telemedicine medical services;
66	72		(3) ensure adequate supervision of health
67	73		professionals who are not physicians and who provide telemedicine
68	74		medical services; and
69	75		(4) establish the maximum number of health
70	76		professionals who are not physicians that a physician may supervise
71	77		through a telemedicine medical service.
72	78		(b) The State Board of Dental Examiners, in consultation
73	79		with the commissioner of insurance, as appropriate, may adopt rules
74	80		necessary to:
75	81		(1) ensure that patients using teledentistry dental
76	82		services receive appropriate, quality care;
77	83		(2) prevent abuse and fraud in the use of
78	84		teledentistry dental services, including rules relating to the
79	85		filing of claims and records required to be maintained in
80	86		connection with teledentistry dental services;
81	87		(3) ensure adequate supervision of health
82	88		professionals who are not dentists and who provide teledentistry
83	89		dental services under the delegation and supervision of a dentist;
84	90		and
85	91		(4) authorize a dentist to simultaneously delegate to
86	92		and supervise through a teledentistry dental service not more than
87	93		five health professionals who are not dentists.
88	94		SECTION 6. The heading to Section 111.005, Occupations
89	95		Code, is amended to read as follows:
90	96		Sec. 111.005. PRACTITIONER-PATIENT RELATIONSHIP FOR
91	97		TELEMEDICINE MEDICAL SERVICES OR TELEDENTISTRY DENTAL SERVICES.
92	98		SECTION 7. Section 111.005(a), Occupations Code, is amended
93	99		to read as follows:
94	100		(a) For purposes of Section 562.056, a valid
95	101		practitioner-patient relationship is present between a
96	102		practitioner providing a telemedicine medical service or a
97	103		teledentistry dental service and a patient receiving the
98	104		[telemedicine medical] service as long as the practitioner complies
99	105		with the standard of care described in Section 111.007 and the
100	106		practitioner:
101	107		(1) has a preexisting practitioner-patient
102	108		relationship with the patient established in accordance with rules
103	109		adopted under Section 111.006;
104	110		(2) communicates, regardless of the method of
105	111		communication, with the patient pursuant to a call coverage
106	112		agreement established in accordance with:
107	113		(A) Texas Medical Board rules with a physician
108	114		requesting coverage of medical care for the patient; or
109	115		(B) State Board of Dental Examiners rules with a
110	116		dentist requesting coverage of dental care for the patient; or
111	117		(3) provides the telemedicine medical services or
112	118		teledentistry dental services through the use of one of the
113	119		following methods, as long as the practitioner complies with the
114	120		follow-up requirements in Subsection (b), and the method allows the
115	121		practitioner to have access to, and the practitioner uses, the
116	122		relevant clinical information that would be required in accordance
117	123		with the standard of care described in Section 111.007:
118	124		(A) synchronous audiovisual interaction between
119	125		the practitioner and the patient in another location;
120	126		(B) asynchronous store and forward technology,
121	127		including asynchronous store and forward technology in conjunction
122	128		with synchronous audio interaction between the practitioner and the
123	129		patient in another location, as long as the practitioner uses
124	130		clinical information from:
125	131		(i) clinically relevant photographic or
126	132		video images, including diagnostic images; or
127	133		(ii) the patient's relevant clinical
128	134		[medical] records, such as the relevant medical or dental history,
129	135		laboratory and pathology results, and prescriptive histories; or
130	136		(C) another form of audiovisual
131	137		telecommunication technology that allows the practitioner to
132	138		comply with the standard of care described in Section 111.007.
133	139		SECTION 8. Section 111.006, Occupations Code, is amended by
134	140		adding Subsection (c) to read as follows:
135	141		(c) The State Board of Dental Examiners and the Texas State
136	142		Board of Pharmacy shall jointly adopt rules that establish the
137	143		determination of a valid prescription in accordance with Section
138	144		111.005. Rules adopted under this subsection must allow for the
139	145		establishment of a practitioner-patient relationship by a
140	146		teledentistry dental service provided by a dentist to a patient in a
141	147		manner that complies with Section 111.005(a)(3) and must be
142	148		substantially similar to the rules adopted under Subsection (a) of
143	149		this section. The State Board of Dental Examiners and the Texas
144	150		State Board of Pharmacy shall jointly develop and publish on each
145	151		respective board's Internet website responses to frequently asked
146	152		questions relating to the determination of a valid prescription
147	153		issued in the course of the provision of teledentistry dental
148	154		services.
149	155		SECTION 9. Section 111.007, Occupations Code, is amended to
150	156		read as follows:
151	157		Sec. 111.007. STANDARD OF CARE FOR TELEMEDICINE MEDICAL
152	158		SERVICES, TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES.
153	159		(a) A health professional providing a health care service or
154	160		procedure as a telemedicine medical service, a teledentistry dental
155	161		service, or a telehealth service is subject to the standard of care
156	162		that would apply to the provision of the same health care service or
157	163		procedure in an in-person setting.
158	164		(b) An agency with regulatory authority over a health
159	165		professional may not adopt rules pertaining to telemedicine medical
160	166		services, teledentistry dental services, or telehealth services
161	167		that would impose a higher standard of care than the standard
162	168		described in Subsection (a).
163	169		SECTION 10. Chapter 111, Occupations Code, is amended by
164	170		adding Section 111.0075 to read as follows:
165	171		Sec. 111.0075. LICENSING FOR TELEDENTISTRY DENTAL
166	172		SERVICES. A health professional providing a health care service or
167	173		procedure as a teledentistry dental service is subject to the
168	174		licensing requirements that would apply to the provision of the
169	175		same health care service or procedure in an in-person setting.
170	176		SECTION 11. Chapter 111, Occupations Code, is amended by
171	177		adding Section 111.009 to read as follows:
172	178		Sec. 111.009. LIMITATION ON CERTAIN PRESCRIPTIONS. (a) In
173	179		this section:
174	180		(1) "Controlled substance," "opiate," and "prescribe"
175	181		have the meanings assigned by Section 481.002, Health and Safety
176	182		Code.
177	183		(2) "National holiday" means a day described by
178	184		Section 662.003(a), Government Code.
179	185		(b) The State Board of Dental Examiners by rule shall
180	186		establish limits on the quantity of a controlled substance,
181	187		including an opiate, that a dentist may prescribe to a patient as a
182	188		teledentistry dental service. Except as provided by Subsection
183	189		(c), the rules may not authorize a dentist to prescribe more than is
184	190		necessary to supply a patient for:
185	191		(1) if the prescription is for an opiate, a two-day
186	192		period; or
187	193		(2) if the prescription is for a controlled substance
188	194		other than an opiate, a five-day period.
189	195		(c) For each day in a period described by Subsection (b)(1)
190	196		or (2) that is a Saturday, Sunday, or national holiday, the period
191	197		is extended to include the next day that is not a Saturday, Sunday,
192	198		or national holiday.
193	199		(d) Rules adopted under this section must comply with
194	200		applicable federal laws and rules.
195	201		SECTION 12. Section 251.003, Occupations Code, is amended
196	202		by adding Subsection (d) to read as follows:
197	203		(d) For purposes of this subtitle, a person located in
198	204		another state practices dentistry in this state and is required to
199	205		hold a license to practice dentistry in this state if the person
200	206		through the use of any medium, including an electronic medium,
201	207		performs an act that constitutes the practice of dentistry on a
202	208		patient in this state.
203	209		SECTION 13. Chapter 254, Occupations Code, is amended by
204	210		adding Section 254.0035 to read as follows:
205	211		Sec. 254.0035. RULES REGARDING CALL COVERAGE AGREEMENTS.
206	212		The board shall adopt rules governing a call coverage agreement
207	213		between dentists.
208	214		SECTION 14. Section 258.001, Occupations Code, is amended
209	215		to read as follows:
210	216		Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not
211	217		delegate:
212	218		(1) an act to an individual who, by board order, is
213	219		prohibited from performing the act;
214	220		(2) any of the following acts to a person not licensed
215	221		as a dentist or dental hygienist:
216	222		(A) the removal of calculus, deposits, or
217	223		accretions from the natural and restored surfaces of exposed human
218	224		teeth and restorations in the human mouth;
219	225		(B) root planing or the smoothing and polishing
220	226		of roughened root surfaces or exposed human teeth; or
221	227		(C) any other act the delegation of which is
222	228		prohibited by board rule;
223	229		(3) any of the following acts to a person not licensed
224	230		as a dentist:
225	231		(A) comprehensive examination or diagnosis and
226	232		treatment planning;
227	233		(B) a surgical or cutting procedure on hard or
228	234		soft tissue;
229	235		(C) the prescription of a drug, medication, or
230	236		work authorization;
231	237		(D) the taking of an impression for a final
232	238		restoration, appliance, or prosthesis;
233	239		(E) the making of an intraoral occlusal
234	240		adjustment;
235	241		(F) direct pulp capping, pulpotomy, or any other
236	242		endodontic procedure;
237	243		(G) the final placement and intraoral adjustment
238	244		of a fixed or removable appliance; or
239	245		(H) the placement of any final restoration; or
240	246		(4) the authority to an individual to administer a
241	247		local anesthetic agent, inhalation sedative agent, parenteral
242	248		sedative agent, or general anesthetic agent, including as a
243	249		teledentistry dental service as that term is defined by Section
244	250		111.001, if the individual is not licensed as:
245	251		(A) a dentist with a permit issued by the board
246	252		for the procedure being performed, if a permit is required;
247	253		(B) a certified registered nurse anesthetist
248	254		licensed by the Texas Board of Nursing, only if the delegating
249	255		dentist holds a permit issued by the board for the procedure being
250	256		performed, if a permit is required; or
251	257		(C) a physician anesthesiologist licensed by the
252	258		Texas Medical Board.
253	259		SECTION 15. Section 262.152, Occupations Code, is amended
254	260		to read as follows:
255	261		Sec. 262.152. PERFORMANCE OF DELEGATED DUTIES. (a) Except
256	262		as provided by Section 262.1515, a dental hygienist shall practice
257	263		dental hygiene:
258	264		(1) in the dental office of a supervising dentist
259	265		licensed by the board; or
260	266		(2) in an alternate setting, including a nursing home,
261	267		the patient's home, a school, a hospital, a state institution, a
262	268		public health clinic, or another institution, under the supervision
263	269		of a supervising dentist.
264	270		(b) For purposes of this section, a dental hygienist who
265	271		practices dental hygiene as a teledentistry dental service, as
266	272		defined by Section 111.001, is practicing in an alternate setting
267	273		in compliance with Subsection (a)(2).
268	274		SECTION 16. Section 562.056(c), Occupations Code, is
269	275		amended to read as follows:
270	276		(c) For purposes of this section and Section 562.112, a
271	277		valid practitioner-patient relationship is present between a
272	278		practitioner providing telemedicine medical services or
273	279		teledentistry dental services and the patient receiving the
274	280		[telemedicine medical] services if the practitioner has complied
275	281		with the requirements for establishing such a relationship in
276	282		accordance with Section 111.005.
277	283		SECTION 17. Section 531.001, Government Code, is amended by
278	284		amending Subdivision (4-d) and adding Subdivision (6-a) to read as
279	285		follows:
280	286		(4-d) "Platform" means the technology, system,
281	287		software, application, modality, or other method through which a
282	288		health professional remotely interfaces with a patient when
283	289		providing a health care service or procedure as a telemedicine
284	290		medical service, teledentistry dental service, or telehealth
285	291		service.
286	292		(6-a) "Teledentistry dental service" has the meaning
287	293		assigned by Section 111.001, Occupations Code.
288	294		SECTION 18. Section 531.0216, Government Code, is amended
289	295		to read as follows:
290	296		Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF
291	297		TELEMEDICINE MEDICAL SERVICE PROVIDERS, TELEDENTISTRY DENTAL
292	298		SERVICE PROVIDERS, AND TELEHEALTH SERVICE PROVIDERS UNDER
293	299		MEDICAID. (a) The executive commissioner by rule shall develop and
294	300		implement a system to reimburse providers of services under
295	301		Medicaid for services performed using telemedicine medical
296	302		services, teledentistry dental services, or telehealth services.
297	303		(c) The commission shall encourage health care providers
298	304		and health care facilities to provide telemedicine medical
299	305		services, teledentistry dental services, and telehealth services
300	306		in the health care delivery system. The commission may not require
301	307		that a service be provided to a patient through telemedicine
302	308		medical services, teledentistry dental services, or telehealth
303	309		services.
304	310		(c-1) The commission shall explore opportunities to
305	311		increase STAR Health program providers' use of telemedicine medical
306	312		services in medically underserved areas of this state.
307	313		(d) Subject to Sections 111.004 and [Section] 153.004,
308	314		Occupations Code, the executive commissioner may adopt rules as
309	315		necessary to implement this section. In the rules adopted under
310	316		this section, the executive commissioner shall:
311	317		(1) refer to the site where the patient is physically
312	318		located as the patient site; and
313	319		(2) refer to the site where the physician, dentist, or
314	320		health professional providing the telemedicine medical service,
315	321		teledentistry dental service, or telehealth service is physically
316	322		located as the distant site.
317	323		(f) Not later than December 1 of each even-numbered year,
318	324		the commission shall report to the speaker of the house of
319	325		representatives and the lieutenant governor on the effects of
320	326		telemedicine medical services, teledentistry dental services,
321	327		telehealth services, and home telemonitoring services on Medicaid
322	328		in the state, including the number of physicians, dentists, health
323	329		professionals, and licensed health care facilities using
324	330		telemedicine medical services, teledentistry dental services,
325	331		telehealth services, or home telemonitoring services, the
326	332		geographic and demographic disposition of the physicians,
327	333		dentists, and health professionals, the number of patients
328	334		receiving telemedicine medical services, teledentistry dental
329	335		services, telehealth services, and home telemonitoring services,
330	336		the types of services being provided, the cost of utilization, and
331	337		the cost savings of telemedicine medical services, teledentistry
332	338		dental services, telehealth services, and home telemonitoring
333	339		services to Medicaid.
334	340		(g) The commission shall ensure that a Medicaid managed care
335	341		organization:
336	342		(1) does not deny reimbursement for a covered health
337	343		care service or procedure delivered by a health care provider with
338	344		whom the managed care organization contracts to a Medicaid
339	345		recipient as a telemedicine medical service, a teledentistry dental
340	346		service, or a telehealth service solely because the covered service
341	347		or procedure is not provided through an in-person consultation;
342	348		(2) does not limit, deny, or reduce reimbursement for
343	349		a covered health care service or procedure delivered by a health
344	350		care provider with whom the managed care organization contracts to
345	351		a Medicaid recipient as a telemedicine medical service, a
346	352		teledentistry dental service, or a telehealth service based on the
347	353		health care provider's choice of platform for providing the health
348	354		care service or procedure; and
349	355		(3) ensures that the use of telemedicine medical
350	356		services, teledentistry dental services, or telehealth services
351	357		promotes and supports patient-centered medical homes by allowing a
352	358		Medicaid recipient to receive a telemedicine medical service,
353	359		teledentistry dental service, or telehealth service from a provider
354	360		other than the recipient's primary care physician or provider,
355	361		except as provided by Section 531.0217(c-4), only if:
356	362		(A) the telemedicine medical service,
357	363		teledentistry dental service, or telehealth service is provided in
358	364		accordance with the law and contract requirements applicable to the
359	365		provision of the same health care service in an in-person setting,
360	366		including requirements regarding care coordination; and
361	367		(B) the provider of the telemedicine medical
362	368		service, teledentistry dental service, or telehealth service gives
363	369		notice to the Medicaid recipient's primary care physician or
364	370		provider regarding the [telemedicine medical service or
365	371		telehealth] service, including a summary of the service, exam
366	372		findings, a list of prescribed or administered medications, and
367	373		patient instructions, for the purpose of sharing medical
368	374		information, provided that the recipient has a primary care
369	375		physician or provider and the recipient or, if appropriate, the
370	376		recipient's parent or legal guardian, consents to the notice.
371	377		(h) The commission shall develop, document, and implement a
372	378		monitoring process to ensure that a Medicaid managed care
373	379		organization ensures that the use of telemedicine medical services,
374	380		teledentistry dental services, or telehealth services promotes and
375	381		supports patient-centered medical homes and care coordination in
376	382		accordance with Subsection (g)(3). The process must include
377	383		monitoring of the rate at which a telemedicine medical service,
378	384		teledentistry dental service, or telehealth service provider gives
379	385		notice in accordance with Subsection (g)(3)(B).
380	386		(i) The executive commissioner by rule shall ensure that a
381	387		federally-qualified [federally qualified] health center as defined
382	388		by 42 U.S.C. Section 1396d(l)(2)(B) may be reimbursed for the
383	389		originating site facility fee or the distant site practitioner fee
384	390		or both, as appropriate, for a covered telemedicine medical
385	391		service, teledentistry dental service, or telehealth service
386	392		delivered by a health care provider to a Medicaid recipient. The
387	393		commission is required to implement this subsection only if the
388	394		legislature appropriates money specifically for that purpose. If
389	395		the legislature does not appropriate money specifically for that
390	396		purpose, the commission may, but is not required to, implement this
391	397		subsection using other money available to the commission for that
392	398		purpose.
393	399		(j) In complying with state and federal requirements to
394	400		provide access to medically necessary services under the Medicaid
395	401		managed care program, a Medicaid managed care organization
396	402		determining whether reimbursement for a telemedicine medical
397	403		service, teledentistry dental service, or telehealth service is
398	404		appropriate shall continue to consider other factors, including
399	405		whether reimbursement is cost-effective and whether the provision
400	406		of the service is clinically effective.
401	407		SECTION 19. The heading to Section 531.02162, Government
402	408		Code, is amended to read as follows:
403	409		Sec. 531.02162. MEDICAID SERVICES PROVIDED THROUGH
404	410		TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY DENTAL SERVICES, AND
405	411		TELEHEALTH SERVICES TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS.
406	412		SECTION 20. Sections 531.02162(b) and (c), Government Code,
407	413		are amended to read as follows:
408	414		(b) The executive commissioner by rule shall establish
409	415		policies that permit reimbursement under Medicaid and the child
410	416		health plan program for services provided through telemedicine
411	417		medical services, teledentistry dental services, and telehealth
412	418		services to children with special health care needs.
413	419		(c) The policies required under this section must:
414	420		(1) be designed to:
415	421		(A) prevent unnecessary travel and encourage
416	422		efficient use of telemedicine medical services, teledentistry
417	423		dental services, and telehealth services for children with special
418	424		health care needs in all suitable circumstances; and
419	425		(B) ensure in a cost-effective manner the
420	426		availability to a child with special health care needs of services
421	427		appropriately performed using telemedicine medical services,
422	428		teledentistry dental services, and telehealth services that are
423	429		comparable to the same types of services available to that child
424	430		without the use of telemedicine medical services, teledentistry
425	431		dental services, and telehealth services; and
426	432		(2) provide for reimbursement of multiple providers of
427	433		different services who participate in a single session of
428	434		telemedicine medical services, teledentistry dental services,
429	435		[and] telehealth services, or any combination of those services,
430	436		[session] for a child with special health care needs, if the
431	437		commission determines that reimbursing each provider for the
432	438		session is cost-effective in comparison to the costs that would be
433	439		involved in obtaining the services from providers without the use
434	440		of telemedicine medical services, teledentistry dental services,
435	441		and telehealth services, including the costs of transportation and
436	442		lodging and other direct costs.
437	443		SECTION 21. Subchapter B, Chapter 531, Government Code, is
438	444		amended by adding Section 531.02172 to read as follows:
439	445		Sec. 531.02172. REIMBURSEMENT FOR TELEDENTISTRY DENTAL
440	446		SERVICES. (a) The commission by rule shall require each health and
441	447		human services agency that administers a part of the Medicaid
442	448		program to provide Medicaid reimbursement for teledentistry dental
443	449		services provided by a dentist licensed to practice dentistry in
444	450		this state.
445	451		(b) The commission shall require reimbursement for a
446	452		teledentistry dental service at the same rate as the Medicaid
447	453		program reimburses for the same in-person dental service. A
448	454		request for reimbursement may not be denied solely because an
449	455		in-person dental service between a dentist and a patient did not
450	456		occur. The commission may not limit a dentist's choice of platform
451	457		for providing a teledentistry dental service by requiring that the
452	458		dentist use a particular platform to receive reimbursement for the
453	459		service.
454	460		(c) The State Board of Dental Examiners, in consultation
455	461		with the commission and the commission's office of inspector
456	462		general, as appropriate, may adopt rules as necessary to:
457	463		(1) ensure that appropriate care, including quality of
458	464		care, is provided to patients who receive teledentistry dental
459	465		services; and
460	466		(2) prevent abuse and fraud through the use of
461	467		teledentistry dental services, including rules relating to filing
462	468		claims and the records required to be maintained in connection with
463	469		teledentistry dental services.
464	470		SECTION 22. The heading to Section 62.157, Health and
465	471		Safety Code, is amended to read as follows:
466	472		Sec. 62.157. TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY
467	473		DENTAL SERVICES, AND TELEHEALTH SERVICES FOR CHILDREN WITH SPECIAL
468	474		HEALTH CARE NEEDS.
469	475		SECTION 23. Sections 62.157(a) and (b), Health and Safety
470	476		Code, are amended to read as follows:
471	477		(a) In providing covered benefits to a child with special
472	478		health care needs, a health plan provider must permit benefits to be
473	479		provided through telemedicine medical services, teledentistry
474	480		dental services, and telehealth services in accordance with
475	481		policies developed by the commission.
476	482		(b) The policies must provide for:
477	483		(1) the availability of covered benefits
478	484		appropriately provided through telemedicine medical services,
479	485		teledentistry dental services, and telehealth services that are
480	486		comparable to the same types of covered benefits provided without
481	487		the use of telemedicine medical services, teledentistry dental
482	488		services, and telehealth services; and
483	489		(2) the availability of covered benefits for different
484	490		services performed by multiple health care providers during a
485	491		single [telemedicine medical services and telehealth services]
486	492		session of telemedicine medical services, teledentistry dental
487	493		services, telehealth services, or any combination of those
488	494		services, if the executive commissioner determines that delivery of
489	495		the covered benefits in that manner is cost-effective in comparison
490	496		to the costs that would be involved in obtaining the services from
491	497		providers without the use of telemedicine medical services,
492	498		teledentistry dental services, and telehealth services, including
493	499		the costs of transportation and lodging and other direct costs.
494	500		SECTION 24. Section 62.1571, Health and Safety Code, is
495	501		amended to read as follows:
496	502		Sec. 62.1571. TELEMEDICINE MEDICAL SERVICES AND
497	503		TELEDENTISTRY DENTAL SERVICES. (a) In providing covered benefits
498	504		to a child, a health plan provider must permit benefits to be
499	505		provided through telemedicine medical services and teledentistry
500	506		dental services in accordance with policies developed by the
501	507		commission.
502	508		(b) The policies must provide for:
503	509		(1) the availability of covered benefits
504	510		appropriately provided through telemedicine medical services and
505	511		teledentistry dental services that are comparable to the same types
506	512		of covered benefits provided without the use of telemedicine
507	513		medical services and teledentistry dental services; and
508	514		(2) the availability of covered benefits for different
509	515		services performed by multiple health care providers during a
510	516		single session of telemedicine medical services, teledentistry
511	517		dental services, or both services, if the executive commissioner
512	518		determines that delivery of the covered benefits in that manner is
513	519		cost-effective in comparison to the costs that would be involved in
514	520		obtaining the services from providers without the use of
515	521		telemedicine medical services or teledentistry dental services,
516	522		including the costs of transportation and lodging and other direct
517	523		costs.
518	524		(c) [(d)] In this section, "teledentistry dental service"
519	525		and "telemedicine medical service" have [has] the meanings
520	526		[meaning] assigned by Section 531.001, Government Code.
521	527		SECTION 25. The heading to Chapter 1455, Insurance Code, is
522	528		amended to read as follows:
523	529		CHAPTER 1455. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH
524	530		SECTION 26. Section 1455.001, Insurance Code, is amended by
525	531		amending Subdivisions (1) and (3) and adding Subdivision (1-a) to
526	532		read as follows:
527	533		(1) "Dentist" means a person licensed to practice
528	534		dentistry in this state under Subtitle D, Title 3, Occupations
529	535		Code.
530	536		(1-a) "Health professional" means:
531	537		(A) a physician;
532	538		(B) an individual who is:
533	539		(i) licensed or certified in this state to
534	540		perform health care services; and
535	541		(ii) authorized to assist:
536	542		(a) a physician in providing
537	543		telemedicine medical services that are delegated and supervised by
538	544		the physician; or
539	545		(b) a dentist in providing
540	546		teledentistry dental services that are delegated and supervised by
541	547		the dentist;
542	548		(C) a licensed or certified health professional
543	549		acting within the scope of the license or certification who does not
544	550		perform a telemedicine medical service or a teledentistry dental
545	551		service; or
546	552		(D) a dentist.
547	553		(3) "Teledentistry dental service," "telehealth
548	554		["Telehealth] service," and "telemedicine medical service" have
549	555		the meanings assigned by Section 111.001, Occupations Code.
550	556		SECTION 27. Section 1455.004, Insurance Code, is amended to
551	557		read as follows:
552	558		Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES,
553	559		TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES. (a) A
554	560		health benefit plan:
555	561		(1) must provide coverage for a covered health care
556	562		service or procedure delivered by a preferred or contracted health
557	563		professional to a covered patient as a telemedicine medical
558	564		service, teledentistry dental service, or telehealth service on the
559	565		same basis and to the same extent that the plan provides coverage
560	566		for the service or procedure in an in-person setting; and
561	567		(2) may not:
562	568		(A) exclude from coverage a covered health care
563	569		service or procedure delivered by a preferred or contracted health
564	570		professional to a covered patient as a telemedicine medical
565	571		service, a teledentistry dental service, or a telehealth service
566	572		solely because the covered health care service or procedure is not
567	573		provided through an in-person consultation; and
568	574		(B) subject to Subsection (c), limit, deny, or
569	575		reduce coverage for a covered health care service or procedure
570	576		delivered as a telemedicine medical service, teledentistry dental
571	577		service, or telehealth service based on the health professional's
572	578		choice of platform for delivering the service or procedure.
573	579		(b) A health benefit plan may require a deductible, a
574	580		copayment, or coinsurance for a covered health care service or
575	581		procedure delivered by a preferred or contracted health
576	582		professional to a covered patient as a telemedicine medical
577	583		service, a teledentistry dental service, or a telehealth service.
578	584		The amount of the deductible, copayment, or coinsurance may not
579	585		exceed the amount of the deductible, copayment, or coinsurance
580	586		required for the covered health care service or procedure provided
581	587		through an in-person consultation.
582	588		(b-1) Subsection (b) does not authorize a health benefit
583	589		plan to charge a separate deductible that applies only to a covered
584	590		health care service or procedure delivered as a telemedicine
585	591		medical service, teledentistry dental service, or telehealth
586	592		service.
587	593		(c) Notwithstanding Subsection (a), a health benefit plan
588	594		is not required to provide coverage for a telemedicine medical
589	595		service, a teledentistry dental service, or a telehealth service
590	596		provided by only synchronous or asynchronous audio interaction,
591	597		including:
592	598		(1) an audio-only telephone consultation;
593	599		(2) a text-only e-mail message; or
594	600		(3) a facsimile transmission.
595	601		(d) A health benefit plan may not impose an annual or
596	602		lifetime maximum on coverage for covered health care services or
597	603		procedures delivered as telemedicine medical services,
598	604		teledentistry dental services, or telehealth services other than
599	605		the annual or lifetime maximum, if any, that applies in the
600	606		aggregate to all items and services and procedures covered under
601	607		the plan.
602	608		SECTION 28. Section 1455.006, Insurance Code, is amended to
603	609		read as follows:
604	610		Sec. 1455.006. TELEMEDICINE MEDICAL SERVICES,
605	611		TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES STATEMENT.
606	612		(a) Each issuer of a health benefit plan shall adopt and display in
607	613		a conspicuous manner on the health benefit plan issuer's Internet
608	614		website the issuer's policies and payment practices for
609	615		telemedicine medical services, teledentistry dental services, and
610	616		telehealth services.
611	617		(b) This section does not require an issuer of a health
612	618		benefit plan to display negotiated contract payment rates for
613	619		health professionals who contract with the issuer to provide
614	620		telemedicine medical services, teledentistry dental services, or
615	621		telehealth services.
616	622		SECTION 29. Not later than March 1, 2022:
617	623		(1) the State Board of Dental Examiners and the Texas
618	624		State Board of Pharmacy shall jointly adopt rules as required by
619	625		Section 111.006(c), Occupations Code, as added by this Act;
620	626		(2) the State Board of Dental Examiners shall adopt:
621	627		(A) rules necessary to implement Chapter 111,
622	628		Occupations Code, as amended by this Act; and
623	629		(B) rules as required by Section 254.0035,
624	630		Occupations Code, as added by this Act; and
625	631		(3) the Health and Human Services Commission shall
626	632		adopt rules as required by Section 531.02172, Government Code, as
627	633		added by this Act.
628	634		SECTION 30. If before implementing any provision of this
629	635		Act a state agency determines that a waiver or authorization from a
630	636		federal agency is necessary for implementation of that provision,
631	637		the agency affected by the provision shall request the waiver or
632	638		authorization and may delay implementing that provision until the
633	639		waiver or authorization is granted.
634	640		SECTION 31. (a) Except as provided by Subsection (b) of
635	641		this section, this Act takes effect September 1, 2021.
636	642		(b) Sections 1455.004 and 1455.006, Insurance Code, as
637	643		amended by this Act, take effect January 1, 2022.
638		-	______________________________ ______________________________
639		-	President of the Senate Speaker of the House
640		-	I certify that H.B. No. 2056 was passed by the House on May 8,
641		-	2021, by the following vote: Yeas 130, Nays 9, 2 present, not
642		-	voting.
643		-	______________________________
644		-	Chief Clerk of the House
645		-	I certify that H.B. No. 2056 was passed by the Senate on May
646		-	24, 2021, by the following vote: Yeas 30, Nays 0.
647		-	______________________________
648		-	Secretary of the Senate
649		-	APPROVED: _____________________
650		-	Date
651		-	_____________________
652		-	Governor
	644	+	* * * * *