Texas 2021 - 87th Regular

Texas House Bill HB980 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~87R19785~~ MEW-D
	1	+	87R1901 MEW-D
2	2		By: Fierro H.B. No. 980
3		-	Substitute the following for H.B. No. 980:
4		-	By: Oliverson C.S.H.B. No. 980
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to the reimbursement and payment of claims by certain
10	8		health benefit plan issuers for telemedicine medical services and
11	9		telehealth services.
12	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	11		SECTION 1. Section 1455.001(1), Insurance Code, is amended
14	12		to read as follows:
15	13		(1) "Health professional" means:
16	14		(A) a physician;
17	15		(B) an individual who is:
18	16		(i) licensed or certified in this state to
19	17		perform health care services; and
20	18		(ii) authorized to assist a physician in
21	19		providing telemedicine medical services that are delegated and
22	20		supervised by the physician; [or]
23	21		(C) a licensed or certified health professional,
24	22		including a mental health professional, acting within the scope of
25	23		the license or certification who does not perform a telemedicine
26	24		medical service; or
27	25		(D) an individual who is credentialed to provide
28	26		qualified mental health professional community services, has
29	27		demonstrated and documented competency in the work to be performed,
30		-	is acting within the scope of the individual's license or other
31		-	authorization issued by this state and does not perform a
32		-	telemedicine medical service, and:
	28	+	and:
33	29		(i) holds a bachelor's or more advanced
34	30		degree from an accredited institution of higher education with a
35	31		minimum number of hours that is equivalent to a major in psychology,
36	32		social work, medicine, nursing, rehabilitation, counseling,
37	33		sociology, human growth and development, physician assistant
38	34		studies, gerontology, special education, educational psychology,
39	35		early childhood education, or early childhood intervention;
40	36		(ii) is a registered nurse; or
41	37		(iii) completes an alternative
42		-	credentialing process identified by the Health ~~and Human Services~~
43		-	~~Commission~~.
	38	+	credentialing process identified by the Department of State Health
	39	+	Services.
44	40		SECTION 2. Chapter 1455, Insurance Code, is amended by
45	41		adding Sections 1455.007 and 1455.008 to read as follows:
46	42		Sec. 1455.007. REIMBURSEMENT AND PAYMENT. (a) A health
47	43		benefit plan issuer must reimburse a preferred or contracted health
48	44		professional for providing a covered health care service or
49	45		procedure to a covered patient as a telemedicine medical service or
50	46		telehealth service on the same basis and at least at the same rate
51	47		that the issuer provides reimbursement to that health professional
52	48		for the service or procedure in an in-person setting.
53	49		(b) Notwithstanding Subsection (a), a health benefit plan
54		-	issuer is not required to:
55		-	(1) pay more than the billed charge on a claim for
56		-	payment by a preferred or contracted health professional; or
57		-	(2) reimburse a preferred or contracted health
58		-	professional as specified in Subsection (a) if the telemedicine
59		-	medical service or telehealth service is provided to a covered
60		-	patient by that health professional as part of a mutually agreed
61		-	upon risk-based payment arrangement.
	50	+	issuer is not required to pay more than the billed charge on a claim
	51	+	for payment by a preferred or contracted health professional.
62	52		(c) For purposes of processing payment of a claim, a health
63	53		benefit plan issuer may not require a preferred or contracted
64	54		health professional to provide documentation of a covered health
65	55		care service or procedure delivered by the health professional to a
66	56		covered patient as a telemedicine medical service or telehealth
67	57		service beyond that which is required for the service or procedure
68	58		in an in-person setting.
69	59		Sec. 1455.008. WAIVER PROHIBITED. The provisions of this
70	60		chapter may not be waived, voided, or nullified by contract.
71	61		SECTION 3. Chapter 1455, Insurance Code, as amended by this
72	62		Act, applies only to a health benefit plan delivered, issued for
73	63		delivery, or renewed on or after January 1, 2022. A health benefit
74	64		plan delivered, issued for delivery, or renewed before January 1,
75	65		2022, is governed by the law as it existed immediately before the
76	66		effective date of this Act, and that law is continued in effect for
77	67		that purpose.
78	68		SECTION 4. This Act takes effect September 1, 2021.