87R10088 MEW-D
By: Hinojosa S.B. No. 1329
A BILL TO BE ENTITLED
AN ACT
relating to health benefit plan coverage for speech therapy
services provided through telehealth services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1455.002, Insurance Code, is amended to
read as follows:
Sec. 1455.002. APPLICABILITY OF CHAPTER. Except as
otherwise provided by this chapter, this [This] chapter applies
only to a health benefit plan that:
(1) provides benefits for medical or surgical expenses
incurred as a result of a health condition, accident, or sickness,
including:
(A) an individual, group, blanket, or franchise
insurance policy or insurance agreement, a group hospital service
contract, or an individual or group evidence of coverage that is
offered by:
(i) an insurance company;
(ii) a group hospital service corporation
operating under Chapter 842;
(iii) a fraternal benefit society operating
under Chapter 885;
(iv) a stipulated premium company operating
under Chapter 884; or
(v) a health maintenance organization
operating under Chapter 843; and
(B) to the extent permitted by the Employee
Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
seq.), a health benefit plan that is offered by:
(i) a multiple employer welfare arrangement
as defined by Section 3 of that Act; or
(ii) another analogous benefit
arrangement; or
(2) is offered by an approved nonprofit health
corporation that holds a certificate of authority under Chapter
844.
SECTION 2. Chapter 1455, Insurance Code, is amended by
adding Section 1455.0041 to read as follows:
Sec. 1455.0041. COVERAGE FOR SPEECH THERAPY TELEHEALTH
SERVICES. (a) This section applies to a health benefit plan
described by Section 1455.002.
(b) Notwithstanding any other law, this section applies to:
(1) a standard health benefit plan issued under
Chapter 1507;
(2) a basic coverage plan under Chapter 1551;
(3) a basic plan under Chapter 1575;
(4) a primary care coverage plan under Chapter 1579;
(5) a plan providing basic coverage under Chapter
1601;
(6) group health coverage made available by a school
district in accordance with Section 22.004, Education Code;
(7) the state Medicaid program, including the Medicaid
managed care program operated under Chapter 533, Government Code;
and
(8) the child health plan program under Chapter 62,
Health and Safety Code.
(c) A health benefit plan that provides coverage for speech
therapy services must provide coverage for speech therapy services
provided through a telehealth service in the same manner as
coverage required under Section 1455.004.
(d) A health benefit plan must reimburse a preferred or
contracted health professional for providing speech therapy
services to a covered patient as a telehealth service on the same
basis and at least at the same rate that the issuer provides
reimbursement to that health professional for speech therapy
services in an in-person setting.
SECTION 3. The change in law made by this Act applies only
to a health benefit plan that is delivered, issued for delivery, or
renewed on or after January 1, 2022. A health benefit plan that is
delivered, issued for delivery, or renewed before January 1, 2022,
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, 2021.