87R1926 KFF-D
By: Blanco S.B. No. 434
A BILL TO BE ENTITLED
AN ACT
relating to the provision and delivery of certain health, mental
health, and educational services in this state, including the
delivery of those services using telecommunications or information
technology.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.02161 to read as follows:
Sec. 531.02161. SERVICE COORDINATION USING
TELECOMMUNICATIONS OR INFORMATION TECHNOLOGY. (a) In this section,
"service coordination" includes:
(1) development and maintenance of a plan of care,
including an individual service plan, that meets the needs of a
Medicaid recipient or child health plan program enrollee;
(2) coordination, including with providers, to assist
the recipient or enrollee in accessing Medicaid or child health
plan program benefits, including benefits under a Section 1915(c)
waiver program;
(3) coordination, including with providers as
appropriate, to assist the recipient or enrollee in accessing
services provided by other community entities or service providers,
including nonmedical providers;
(4) transition planning to assist the recipient in
preparing for changes in life circumstances and in available health
care services to ease the recipient's shift into adulthood; and
(5) with respect to the STAR Health program,
assistance provided to the caregiver of the recipient to help the
caregiver manage information, including information needed for
court hearings.
(b) The commission shall ensure that, to the extent
appropriate, a Medicaid recipient or child health plan program
enrollee who is eligible to receive service coordination benefits,
including a recipient or enrollee receiving program benefits
through a managed care delivery model, has the option to receive
delivery of those benefits as a telehealth service or otherwise
using telecommunications or information technology.
(c) The executive commissioner shall adopt rules necessary
to implement this section, including rules governing when the
delivery of service coordination benefits using telecommunications
or information technology is appropriate.
SECTION 2. Section 1455.001(1), Insurance Code, is amended
to read as follows:
(1) "Health professional" means:
(A) a physician;
(B) an individual who is:
(i) licensed or certified in this state to
perform health care services; and
(ii) authorized to assist a physician in
providing telemedicine medical services that are delegated and
supervised by the physician; [or]
(C) a licensed or certified health professional,
including a mental health professional, acting within the scope of
the license or certification who does not perform a telemedicine
medical service; or
(D) an individual who is credentialed to provide
qualified mental health professional community services, has
demonstrated and documented competency in the work to be performed,
and:
(i) holds a bachelor's or more advanced
degree from an accredited institution of higher education with a
minimum number of hours that is equivalent to a major in psychology,
social work, medicine, nursing, rehabilitation, counseling,
sociology, human growth and development, physician assistant
studies, gerontology, special education, educational psychology,
early childhood education, or early childhood intervention;
(ii) is a registered nurse; or
(iii) completes an alternative
credentialing process identified by the Department of State Health
Services.
SECTION 3. Chapter 1455, Insurance Code, is amended by
adding Sections 1455.007 and 1455.008 to read as follows:
Sec. 1455.007. REIMBURSEMENT AND PAYMENT. (a) A health
benefit plan issuer must reimburse a preferred or contracted health
professional for providing a covered health care service or
procedure to a covered patient as a telemedicine medical service or
telehealth service on the same basis and at least at the same rate
that the issuer provides reimbursement to that health professional
for the service or procedure in an in-person setting.
(b) Notwithstanding Subsection (a), a health benefit plan
issuer is not required to pay more than the billed charge on a claim
for payment by a preferred or contracted health professional.
(c) For purposes of processing payment of a claim, a health
benefit plan issuer may not require a preferred or contracted
health professional to provide documentation of a covered health
care service or procedure delivered by the health professional to a
covered patient as a telemedicine medical service or telehealth
service beyond that which is required for the service or procedure
in an in-person setting.
Sec. 1455.008. WAIVER PROHIBITED. The provisions of this
chapter may not be waived, voided, or nullified by contract.
SECTION 4. Section 401.2022, Occupations Code, is amended
by adding Subsection (c) to read as follows:
(c) Notwithstanding any other law, in adopting a rule under
this section, the commission:
(1) shall authorize:
(A) a license holder, including a licensed intern
or licensed assistant, to provide services by telepractice through
the use of any interactive audiovisual communication system,
whether real-time or two-way, including a smartphone; and
(B) any supervision requirement for an applicant
under this chapter to be fulfilled wholly or partly by use of
telecommunications technology; and
(2) may not:
(A) require a license holder's initial
professional contact with a client to be in-person; or
(B) impose any limitation on a license holder's
selection of a facilitator to assist the license holder in
providing services by telepractice.
SECTION 5. Section 402.1023, Occupations Code, is amended
by adding Subsection (c) to read as follows:
(c) Notwithstanding any other law, in adopting a rule under
this section, the commission:
(1) shall authorize a license holder to provide
services by telepractice through the use of any interactive
audiovisual communication system, whether real-time or two-way,
including a smartphone; and
(2) may not:
(A) require a license holder's initial
professional contact with a client to be in-person; or
(B) impose any limitation on a license holder's
selection of a facilitator to assist the license holder in
providing services by telepractice.
SECTION 6. Section 402.255(a), Occupations Code, is amended
to read as follows:
(a) A supervisor of a temporary training permit holder must:
(1) be licensed to fit and dispense hearing
instruments under this chapter or Chapter 401, other than Section
401.311 or 401.312; and
(2) [currently practice in an established place of
business; and
[(3)] be responsible for the direct supervision and
education of a temporary training permit holder.
SECTION 7. Section 403.151, Occupations Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) Notwithstanding Subsection (a), a licensed dyslexia
practitioner may practice outside of an educational setting to the
extent necessary to provide a service that would otherwise be
provided in an educational setting that is not reasonably
accessible to the licensed dyslexia practitioner or client.
SECTION 8. Subchapter D, Chapter 403, Occupations Code, is
amended by adding Section 403.153 to read as follows:
Sec. 403.153. USE OF TELECOMMUNICATIONS TECHNOLOGY.
Notwithstanding any other law, a license holder may provide a
service solely through the use of an interactive audiovisual
communication system, whether real-time or two-way, including a
smartphone.
SECTION 9. Section 506.003, Occupations Code, is amended by
adding Subsection (c-1) to read as follows:
(c-1) Notwithstanding Subsection (c)(1), applied behavior
analysis interventions may be based on observation and measurement
of behavior and environment through the use of telecommunications
technology if approved by the certifying entity.
SECTION 10. Section 506.055, Occupations Code, is amended
to read as follows:
Sec. 506.055. STUDENTS, INTERNS, AND FELLOWS. (a) This
chapter does not apply to an applied behavior analysis activity or
service of a college or university student, intern, or fellow if:
(1) the activity or service is part of a defined
behavior analysis program of study, course, practicum, internship,
or postdoctoral fellowship;
(2) the activity or service is directly supervised by
a licensed behavior analyst or an instructor in a course sequence
approved by the certifying entity; and
(3) the person is designated as a "student," "intern,"
"fellow," or "trainee."
(b) Notwithstanding Subsection (a)(2), a licensed behavior
analyst or an instructor may supervise a behavior analysis activity
or service through the use of telecommunications technology if
approved by the applicable college or university and the certifying
entity.
SECTION 11. Section 554.005, Occupations Code, is amended
by adding Subsection (d) to read as follows:
(d) In implementing Subsection (a)(3)(C)(iv), the board may
not require the in-person counseling of patients.
SECTION 12. Chapter 1455, Insurance Code, as amended by
this Act, applies only to a health benefit plan delivered, issued
for delivery, or renewed on or after January 1, 2022. A health
benefit plan 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 13. If before implementing any provision of this
Act a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 14. This Act takes effect September 1, 2021.