Texas 2021 - 87th Regular

Texas Senate Bill SB488 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R5130 JCG-D
2	2	By: Perry, et al. S.B. No. 488
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the practice of dentistry and the provision of
8	8	teledentistry dental services.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The heading to Chapter 111, Occupations Code, is
11	11	amended to read as follows:
12	12	CHAPTER 111. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH
13	13	SECTION 2. Section 111.001, Occupations Code, is amended by
14	14	amending Subdivisions (1) and (3) and adding Subdivision (2-a) to
15	15	read as follows:
16	16	(1) "Dentist," "health [Health] professional," and
17	17	"physician" have the meanings assigned by Section 1455.001,
18	18	Insurance Code.
19	19	(2-a) "Teledentistry dental service" means a health
20	20	care service delivered by a dentist, or a health professional
21	21	acting under the delegation and supervision of a dentist, acting
22	22	within the scope of the dentist's or health professional's license
23	23	or certification to a patient at a different physical location than
24	24	the dentist or health professional using telecommunications or
25	25	information technology.
26	26	(3) "Telehealth service" means a health service, other
27	27	than a telemedicine medical service or a teledentistry dental
28	28	service, delivered by a health professional licensed, certified, or
29	29	otherwise entitled to practice in this state and acting within the
30	30	scope of the health professional's license, certification, or
31	31	entitlement to a patient at a different physical location than the
32	32	health professional using telecommunications or information
33	33	technology.
34	34	SECTION 3. Section 111.002, Occupations Code, is amended to
35	35	read as follows:
36	36	Sec. 111.002. INFORMED CONSENT. (a) A treating physician,
37	37	dentist, or health professional who provides or facilitates the use
38	38	of telemedicine medical services, teledentistry dental services,
39	39	or telehealth services shall ensure that the informed consent of
40	40	the patient, or another appropriate individual authorized to make
41	41	health care treatment decisions for the patient, is obtained before
42	42	telemedicine medical services, teledentistry dental services, or
43	43	telehealth services are provided.
44	44	(b) A dentist who delegates a teledentistry dental service
45	45	shall ensure that the informed consent of the patient includes
46	46	disclosure to the patient that the dentist has delegated the
47	47	service.
48	48	SECTION 4. Section 111.003, Occupations Code, is amended to
49	49	read as follows:
50	50	Sec. 111.003. CONFIDENTIALITY. A treating physician,
51	51	dentist, or health professional who provides or facilitates the use
52	52	of telemedicine medical services, teledentistry dental services,
53	53	or telehealth services shall ensure that the confidentiality of the
54	54	patient's clinical [medical] information is maintained as required
55	55	by Chapter 159, by Subchapter C, Chapter 258, or by other applicable
56	56	law.
57	57	SECTION 5. Section 111.004, Occupations Code, is amended
58	58	to read as follows:
59	59	Sec. 111.004. RULES. (a) The Texas Medical Board, in
60	60	consultation with the commissioner of insurance, as appropriate,
61	61	may adopt rules necessary to:
62	62	(1) ensure that patients using telemedicine medical
63	63	services receive appropriate, quality care;
64	64	(2) prevent abuse and fraud in the use of telemedicine
65	65	medical services, including rules relating to the filing of claims
66	66	and records required to be maintained in connection with
67	67	telemedicine medical services;
68	68	(3) ensure adequate supervision of health
69	69	professionals who are not physicians and who provide telemedicine
70	70	medical services; and
71	71	(4) establish the maximum number of health
72	72	professionals who are not physicians that a physician may supervise
73	73	through a telemedicine medical service.
74	74	(b) The State Board of Dental Examiners, in consultation
75	75	with the commissioner of insurance, as appropriate, may adopt rules
76	76	necessary to:
77	77	(1) ensure that patients using teledentistry dental
78	78	services receive appropriate, quality care;
79	79	(2) prevent abuse and fraud in the use of
80	80	teledentistry dental services, including rules relating to the
81	81	filing of claims and records required to be maintained in
82	82	connection with teledentistry dental services;
83	83	(3) ensure adequate supervision of health
84	84	professionals who are not dentists and who provide teledentistry
85	85	dental services under the delegation and supervision of a dentist;
86	86	and
87	87	(4) establish the maximum number of health
88	88	professionals who are not dentists that a dentist may supervise
89	89	through a teledentistry dental service.
90	90	SECTION 6. The heading to Section 111.005, Occupations
91	91	Code, is amended to read as follows:
92	92	Sec. 111.005. PRACTITIONER-PATIENT RELATIONSHIP FOR
93	93	TELEMEDICINE MEDICAL SERVICES OR TELEDENTISTRY DENTAL SERVICES.
94	94	SECTION 7. Section 111.005, Occupations Code, is amended by
95	95	amending Subsections (a) and (b) and adding Subsection (d) to read
96	96	as follows:
97	97	(a) For purposes of Section 562.056, a valid
98	98	practitioner-patient relationship is present between a
99	99	practitioner providing a telemedicine medical service or a
100	100	teledentistry dental service and a patient receiving the
101	101	[telemedicine medical] service as long as the practitioner complies
102	102	with the standard of care described in Section 111.007 and the
103	103	practitioner:
104	104	(1) has a preexisting practitioner-patient
105	105	relationship with the patient established in accordance with rules
106	106	adopted under Section 111.006;
107	107	(2) communicates, regardless of the method of
108	108	communication, with the patient pursuant to a call coverage
109	109	agreement established in accordance with:
110	110	(A) Texas Medical Board rules with a physician
111	111	requesting coverage of medical care for the patient; or
112	112	(B) State Board of Dental Examiners rules with a
113	113	dentist requesting coverage of dental care for the patient; or
114	114	(3) provides the telemedicine medical services or
115	115	teledentistry dental services through the use of one of the
116	116	following methods, as long as the practitioner complies with the
117	117	follow-up requirements in Subsection (b), and the method allows the
118	118	practitioner to have access to, and the practitioner uses, the
119	119	relevant clinical information that would be required in accordance
120	120	with the standard of care described in Section 111.007:
121	121	(A) synchronous audiovisual interaction between
122	122	the practitioner and the patient in another location;
123	123	(B) asynchronous store and forward technology,
124	124	including asynchronous store and forward technology in conjunction
125	125	with synchronous audio interaction between the practitioner and the
126	126	patient in another location, as long as the practitioner uses
127	127	clinical information from:
128	128	(i) clinically relevant photographic or
129	129	video images, including diagnostic images; or
130	130	(ii) the patient's relevant clinical
131	131	[medical] records, such as the relevant medical or dental history,
132	132	laboratory and pathology results, and prescriptive histories; or
133	133	(C) another form of audiovisual
134	134	telecommunication technology that allows the practitioner to
135	135	comply with the standard of care described in Section 111.007.
136	136	(b) A practitioner who provides telemedicine medical
137	137	services or teledentistry dental services to a patient as described
138	138	in Subsection (a)(3) shall:
139	139	(1) provide the patient with guidance on appropriate
140	140	follow-up care; and
141	141	(2) except as provided by Subsection (d), if the
142	142	patient consents and the patient has a primary care physician or a
143	143	regular dentist, provide to the patient's primary care physician or
144	144	regular dentist, as appropriate, within 72 hours after the
145	145	practitioner provides the services to the patient, a clinical
146	146	[medical] record or other report containing an explanation of:
147	147	(A) the treatment provided by the practitioner to
148	148	the patient; and
149	149	(B) as authorized by the law under which the
150	150	practitioner is licensed, certified, or otherwise permitted to
151	151	provide the service, the practitioner's evaluation, analysis, or
152	152	diagnosis[, as appropriate,] of the patient's condition.
153	153	(d) This subsection applies only to a teledentistry dental
154	154	service consisting of a digital three-dimensional scan of the
155	155	patient that does not affect the hard or soft tissues of the oral
156	156	cavity and that is performed at a location other than the dentist's
157	157	location. A practitioner providing a treatment based on a
158	158	teledentistry dental service to which this subsection applies is
159	159	not required to comply with Subsection (b)(2) but shall, on request
160	160	of the patient, provide to the patient the record or report
161	161	described by that subdivision after the patient has completed the
162	162	treatment.
163	163	SECTION 8. Section 111.006, Occupations Code, is amended by
164	164	adding Subsection (c) to read as follows:
165	165	(c) The State Board of Dental Examiners and the Texas State
166	166	Board of Pharmacy shall jointly adopt rules that establish the
167	167	determination of a valid prescription in accordance with Section
168	168	111.005. Rules adopted under this subsection must allow for the
169	169	establishment of a practitioner-patient relationship by a
170	170	teledentistry dental service provided by a dentist to a patient in a
171	171	manner that complies with Section 111.005(a)(3) and must be
172	172	substantially similar to the rules adopted under Subsection (a) of
173	173	this section. The State Board of Dental Examiners and the Texas
174	174	State Board of Pharmacy shall jointly develop and publish on each
175	175	respective board's Internet website responses to frequently asked
176	176	questions relating to the determination of a valid prescription
177	177	issued in the course of the provision of teledentistry dental
178	178	services.
179	179	SECTION 9. Section 111.007, Occupations Code, is amended to
180	180	read as follows:
181	181	Sec. 111.007. STANDARD OF CARE FOR TELEMEDICINE MEDICAL
182	182	SERVICES, TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES.
183	183	(a) A health professional providing a health care service or
184	184	procedure as a telemedicine medical service, a teledentistry dental
185	185	service, or a telehealth service is subject to the standard of care
186	186	that would apply to the provision of the same health care service or
187	187	procedure in an in-person setting.
188	188	(b) An agency with regulatory authority over a health
189	189	professional may not adopt rules pertaining to telemedicine medical
190	190	services, teledentistry dental services, or telehealth services
191	191	that would impose a higher standard of care than the standard
192	192	described in Subsection (a).
193	193	SECTION 10. Chapter 111, Occupations Code, is amended by
194	194	adding Section 111.0075 to read as follows:
195	195	Sec. 111.0075. LICENSING FOR TELEDENTISTRY DENTAL
196	196	SERVICES. A health professional providing a health care service or
197	197	procedure as a teledentistry dental service is subject to the
198	198	licensing requirements that would apply to the provision of the
199	199	same health care service or procedure in an in-person setting.
200	200	SECTION 11. Chapter 111, Occupations Code, is amended by
201	201	adding Section 111.009 to read as follows:
202	202	Sec. 111.009. LIMITATION ON CERTAIN PRESCRIPTIONS. (a) In
203	203	this section, "controlled substance" and "prescribe" have the
204	204	meanings assigned by Section 481.002, Health and Safety Code.
205	205	(b) The State Board of Dental Examiners by rule shall
206	206	establish limits on the quantity of a controlled substance that a
207	207	dentist may prescribe to a patient as a teledentistry dental
208	208	service. The rules may not authorize a dentist to prescribe more
209	209	than a five-day supply of the controlled substance.
210	210	SECTION 12. Section 251.003, Occupations Code, is amended
211	211	by adding Subsection (d) to read as follows:
212	212	(d) For purposes of this subtitle, a person located in
213	213	another state practices dentistry in this state and is required to
214	214	hold a license to practice dentistry in this state if the person
215	215	through the use of any medium, including an electronic medium,
216	216	performs an act that constitutes the practice of dentistry on a
217	217	patient in this state.
218	218	SECTION 13. Chapter 254, Occupations Code, is amended by
219	219	adding Section 254.0035 to read as follows:
220	220	Sec. 254.0035. RULES REGARDING CALL COVERAGE AGREEMENTS.
221	221	The board shall adopt rules governing a call coverage agreement
222	222	between dentists.
223	223	SECTION 14. Section 258.001, Occupations Code, is amended
224	224	to read as follows:
225	225	Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not
226	226	delegate:
227	227	(1) an act to an individual who, by board order, is
228	228	prohibited from performing the act;
229	229	(2) any of the following acts to a person not licensed
230	230	as a dentist or dental hygienist:
231	231	(A) the removal of calculus, deposits, or
232	232	accretions from the natural and restored surfaces of exposed human
233	233	teeth and restorations in the human mouth;
234	234	(B) root planing or the smoothing and polishing
235	235	of roughened root surfaces or exposed human teeth; or
236	236	(C) any other act the delegation of which is
237	237	prohibited by board rule;
238	238	(3) any of the following acts to a person not licensed
239	239	as a dentist:
240	240	(A) comprehensive examination or diagnosis and
241	241	treatment planning;
242	242	(B) a surgical or cutting procedure on hard or
243	243	soft tissue;
244	244	(C) the prescription of a drug, medication, or
245	245	work authorization;
246	246	(D) the taking of an impression for a final
247	247	restoration, appliance, or prosthesis;
248	248	(E) the making of an intraoral occlusal
249	249	adjustment;
250	250	(F) direct pulp capping, pulpotomy, or any other
251	251	endodontic procedure;
252	252	(G) the final placement and intraoral adjustment
253	253	of a fixed or removable appliance; or
254	254	(H) the placement of any final restoration; or
255	255	(4) the authority to an individual to administer a
256	256	local anesthetic agent, inhalation sedative agent, parenteral
257	257	sedative agent, or general anesthetic agent, including as a
258	258	teledentistry dental service as that term is defined by Section
259	259	111.001, if the individual is not licensed as:
260	260	(A) a dentist with a permit issued by the board
261	261	for the procedure being performed, if a permit is required;
262	262	(B) a certified registered nurse anesthetist
263	263	licensed by the Texas Board of Nursing, only if the delegating
264	264	dentist holds a permit issued by the board for the procedure being
265	265	performed, if a permit is required; or
266	266	(C) a physician anesthesiologist licensed by the
267	267	Texas Medical Board.
268	268	SECTION 15. Section 262.152, Occupations Code, is amended
269	269	to read as follows:
270	270	Sec. 262.152. PERFORMANCE OF DELEGATED DUTIES. (a) Except
271	271	as provided by Section 262.1515, a dental hygienist shall practice
272	272	dental hygiene:
273	273	(1) in the dental office of a supervising dentist
274	274	licensed by the board; or
275	275	(2) in an alternate setting, including a nursing home,
276	276	the patient's home, a school, a hospital, a state institution, a
277	277	public health clinic, or another institution, under the supervision
278	278	of a supervising dentist.
279	279	(b) For purposes of this section, a dental hygienist who
280	280	practices dental hygiene as a teledentistry dental service, as
281	281	defined by Section 111.001, is practicing in an alternate setting
282	282	in compliance with Subsection (a)(2).
283	283	SECTION 16. Section 562.056(c), Occupations Code, is
284	284	amended to read as follows:
285	285	(c) For purposes of this section and Section 562.112, a
286	286	valid practitioner-patient relationship is present between a
287	287	practitioner providing telemedicine medical services or
288	288	teledentistry dental services and the patient receiving the
289	289	[telemedicine medical] services if the practitioner has complied
290	290	with the requirements for establishing such a relationship in
291	291	accordance with Section 111.005.
292	292	SECTION 17. Section 531.001, Government Code, is amended by
293	293	amending Subdivision (4-d) and adding Subdivision (6-a) to read as
294	294	follows:
295	295	(4-d) "Platform" means the technology, system,
296	296	software, application, modality, or other method through which a
297	297	health professional remotely interfaces with a patient when
298	298	providing a health care service or procedure as a telemedicine
299	299	medical service, teledentistry dental service, or telehealth
300	300	service.
301	301	(6-a) "Teledentistry dental service" has the meaning
302	302	assigned by Section 111.001, Occupations Code.
303	303	SECTION 18. Section 531.0216, Government Code, is amended
304	304	to read as follows:
305	305	Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF
306	306	TELEMEDICINE MEDICAL SERVICE PROVIDERS, TELEDENTISTRY DENTAL
307	307	SERVICE PROVIDERS, AND TELEHEALTH SERVICE PROVIDERS UNDER
308	308	MEDICAID. (a) The executive commissioner by rule shall develop and
309	309	implement a system to reimburse providers of services under
310	310	Medicaid for services performed using telemedicine medical
311	311	services, teledentistry dental services, or telehealth services.
312	312	(c) The commission shall encourage health care providers
313	313	and health care facilities to provide telemedicine medical
314	314	services, teledentistry dental services, and telehealth services
315	315	in the health care delivery system. The commission may not require
316	316	that a service be provided to a patient through telemedicine
317	317	medical services, teledentistry dental services, or telehealth
318	318	services.
319	319	(c-1) The commission shall explore opportunities to
320	320	increase STAR Health program providers' use of telemedicine medical
321	321	services in medically underserved areas of this state.
322	322	(d) Subject to Sections 111.004 and [Section] 153.004,
323	323	Occupations Code, the executive commissioner may adopt rules as
324	324	necessary to implement this section. In the rules adopted under
325	325	this section, the executive commissioner shall:
326	326	(1) refer to the site where the patient is physically
327	327	located as the patient site; and
328	328	(2) refer to the site where the physician, dentist, or
329	329	health professional providing the telemedicine medical service,
330	330	teledentistry dental service, or telehealth service is physically
331	331	located as the distant site.
332	332	(f) Not later than December 1 of each even-numbered year,
333	333	the commission shall report to the speaker of the house of
334	334	representatives and the lieutenant governor on the effects of
335	335	telemedicine medical services, teledentistry dental services,
336	336	telehealth services, and home telemonitoring services on Medicaid
337	337	in the state, including the number of physicians, dentists, health
338	338	professionals, and licensed health care facilities using
339	339	telemedicine medical services, teledentistry dental services,
340	340	telehealth services, or home telemonitoring services, the
341	341	geographic and demographic disposition of the physicians,
342	342	dentists, and health professionals, the number of patients
343	343	receiving telemedicine medical services, teledentistry dental
344	344	services, telehealth services, and home telemonitoring services,
345	345	the types of services being provided, the cost of utilization, and
346	346	the cost savings of telemedicine medical services, teledentistry
347	347	dental services, telehealth services, and home telemonitoring
348	348	services to Medicaid.
349	349	(g) The commission shall ensure that a Medicaid managed care
350	350	organization:
351	351	(1) does not deny reimbursement for a covered health
352	352	care service or procedure delivered by a health care provider with
353	353	whom the managed care organization contracts to a Medicaid
354	354	recipient as a telemedicine medical service, a teledentistry dental
355	355	service, or a telehealth service solely because the covered service
356	356	or procedure is not provided through an in-person consultation;
357	357	(2) does not limit, deny, or reduce reimbursement for
358	358	a covered health care service or procedure delivered by a health
359	359	care provider with whom the managed care organization contracts to
360	360	a Medicaid recipient as a telemedicine medical service, a
361	361	teledentistry dental service, or a telehealth service based on the
362	362	health care provider's choice of platform for providing the health
363	363	care service or procedure; and
364	364	(3) ensures that the use of telemedicine medical
365	365	services, teledentistry dental services, or telehealth services
366	366	promotes and supports patient-centered medical homes by allowing a
367	367	Medicaid recipient to receive a telemedicine medical service,
368	368	teledentistry dental service, or telehealth service from a provider
369	369	other than the recipient's primary care physician or provider,
370	370	except as provided by Section 531.0217(c-4), only if:
371	371	(A) the telemedicine medical service,
372	372	teledentistry dental service, or telehealth service is provided in
373	373	accordance with the law and contract requirements applicable to the
374	374	provision of the same health care service in an in-person setting,
375	375	including requirements regarding care coordination; and
376	376	(B) the provider of the telemedicine medical
377	377	service, teledentistry dental service, or telehealth service gives
378	378	notice to the Medicaid recipient's primary care physician or
379	379	provider regarding the [telemedicine medical service or
380	380	telehealth] service, including a summary of the service, exam
381	381	findings, a list of prescribed or administered medications, and
382	382	patient instructions, for the purpose of sharing medical
383	383	information, provided that the recipient has a primary care
384	384	physician or provider and the recipient or, if appropriate, the
385	385	recipient's parent or legal guardian, consents to the notice.
386	386	(h) The commission shall develop, document, and implement a
387	387	monitoring process to ensure that a Medicaid managed care
388	388	organization ensures that the use of telemedicine medical services,
389	389	teledentistry dental services, or telehealth services promotes and
390	390	supports patient-centered medical homes and care coordination in
391	391	accordance with Subsection (g)(3). The process must include
392	392	monitoring of the rate at which a telemedicine medical service,
393	393	teledentistry dental service, or telehealth service provider gives
394	394	notice in accordance with Subsection (g)(3)(B).
395	395	(i) The executive commissioner by rule shall ensure that a
396	396	federally-qualified [federally qualified] health center as defined
397	397	by 42 U.S.C. Section 1396d(l)(2)(B) may be reimbursed for the
398	398	originating site facility fee or the distant site practitioner fee
399	399	or both, as appropriate, for a covered telemedicine medical
400	400	service, teledentistry dental service, or telehealth service
401	401	delivered by a health care provider to a Medicaid recipient. The
402	402	commission is required to implement this subsection only if the
403	403	legislature appropriates money specifically for that purpose. If
404	404	the legislature does not appropriate money specifically for that
405	405	purpose, the commission may, but is not required to, implement this
406	406	subsection using other money available to the commission for that
407	407	purpose.
408	408	(j) In complying with state and federal requirements to
409	409	provide access to medically necessary services under the Medicaid
410	410	managed care program, a Medicaid managed care organization
411	411	determining whether reimbursement for a telemedicine medical
412	412	service, teledentistry dental service, or telehealth service is
413	413	appropriate shall continue to consider other factors, including
414	414	whether reimbursement is cost-effective and whether the provision
415	415	of the service is clinically effective.
416	416	SECTION 19. The heading to Section 531.02162, Government
417	417	Code, is amended to read as follows:
418	418	Sec. 531.02162. MEDICAID SERVICES PROVIDED THROUGH
419	419	TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY DENTAL SERVICES, AND
420	420	TELEHEALTH SERVICES TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS.
421	421	SECTION 20. Sections 531.02162(b) and (c), Government Code,
422	422	are amended to read as follows:
423	423	(b) The executive commissioner by rule shall establish
424	424	policies that permit reimbursement under Medicaid and the child
425	425	health plan program for services provided through telemedicine
426	426	medical services, teledentistry dental services, and telehealth
427	427	services to children with special health care needs.
428	428	(c) The policies required under this section must:
429	429	(1) be designed to:
430	430	(A) prevent unnecessary travel and encourage
431	431	efficient use of telemedicine medical services, teledentistry
432	432	dental services, and telehealth services for children with special
433	433	health care needs in all suitable circumstances; and
434	434	(B) ensure in a cost-effective manner the
435	435	availability to a child with special health care needs of services
436	436	appropriately performed using telemedicine medical services,
437	437	teledentistry dental services, and telehealth services that are
438	438	comparable to the same types of services available to that child
439	439	without the use of telemedicine medical services, teledentistry
440	440	dental services, and telehealth services; and
441	441	(2) provide for reimbursement of multiple providers of
442	442	different services who participate in a single session of
443	443	telemedicine medical services, teledentistry dental services,
444	444	[and] telehealth services, or any combination of those services,
445	445	[session] for a child with special health care needs, if the
446	446	commission determines that reimbursing each provider for the
447	447	session is cost-effective in comparison to the costs that would be
448	448	involved in obtaining the services from providers without the use
449	449	of telemedicine medical services, teledentistry dental services,
450	450	and telehealth services, including the costs of transportation and
451	451	lodging and other direct costs.
452	452	SECTION 21. Subchapter B, Chapter 531, Government Code, is
453	453	amended by adding Section 531.02172 to read as follows:
454	454	Sec. 531.02172. REIMBURSEMENT FOR TELEDENTISTRY DENTAL
455	455	SERVICES. (a) The commission by rule shall require each health and
456	456	human services agency that administers a part of the Medicaid
457	457	program to provide Medicaid reimbursement for teledentistry dental
458	458	services provided by a dentist licensed to practice dentistry in
459	459	this state.
460	460	(b) The commission shall require reimbursement for a
461	461	teledentistry dental service at the same rate as the Medicaid
462	462	program reimburses for the same in-person dental service. A
463	463	request for reimbursement may not be denied solely because an
464	464	in-person dental service between a dentist and a patient did not
465	465	occur. The commission may not limit a dentist's choice of platform
466	466	for providing a teledentistry dental service by requiring that the
467	467	dentist use a particular platform to receive reimbursement for the
468	468	service.
469	469	(c) The State Board of Dental Examiners, in consultation
470	470	with the commission and the commission's office of inspector
471	471	general, as appropriate, may adopt rules as necessary to:
472	472	(1) ensure that appropriate care, including quality of
473	473	care, is provided to patients who receive teledentistry dental
474	474	services; and
475	475	(2) prevent abuse and fraud through the use of
476	476	teledentistry dental services, including rules relating to filing
477	477	claims and the records required to be maintained in connection with
478	478	teledentistry dental services.
479	479	SECTION 22. The heading to Section 62.157, Health and
480	480	Safety Code, is amended to read as follows:
481	481	Sec. 62.157. TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY
482	482	DENTAL SERVICES, AND TELEHEALTH SERVICES FOR CHILDREN WITH SPECIAL
483	483	HEALTH CARE NEEDS.
484	484	SECTION 23. Sections 62.157(a) and (b), Health and Safety
485	485	Code, are amended to read as follows:
486	486	(a) In providing covered benefits to a child with special
487	487	health care needs, a health plan provider must permit benefits to be
488	488	provided through telemedicine medical services, teledentistry
489	489	dental services, and telehealth services in accordance with
490	490	policies developed by the commission.
491	491	(b) The policies must provide for:
492	492	(1) the availability of covered benefits
493	493	appropriately provided through telemedicine medical services,
494	494	teledentistry dental services, and telehealth services that are
495	495	comparable to the same types of covered benefits provided without
496	496	the use of telemedicine medical services, teledentistry dental
497	497	services, and telehealth services; and
498	498	(2) the availability of covered benefits for different
499	499	services performed by multiple health care providers during a
500	500	single [telemedicine medical services and telehealth services]
501	501	session of telemedicine medical services, teledentistry dental
502	502	services, telehealth services, or any combination of those
503	503	services, if the executive commissioner determines that delivery of
504	504	the covered benefits in that manner is cost-effective in comparison
505	505	to the costs that would be involved in obtaining the services from
506	506	providers without the use of telemedicine medical services,
507	507	teledentistry dental services, and telehealth services, including
508	508	the costs of transportation and lodging and other direct costs.
509	509	SECTION 24. Section 62.1571, Health and Safety Code, is
510	510	amended to read as follows:
511	511	Sec. 62.1571. TELEMEDICINE MEDICAL SERVICES AND
512	512	TELEDENTISTRY DENTAL SERVICES. (a) In providing covered benefits
513	513	to a child, a health plan provider must permit benefits to be
514	514	provided through telemedicine medical services and teledentistry
515	515	dental services in accordance with policies developed by the
516	516	commission.
517	517	(b) The policies must provide for:
518	518	(1) the availability of covered benefits
519	519	appropriately provided through telemedicine medical services and
520	520	teledentistry dental services that are comparable to the same types
521	521	of covered benefits provided without the use of telemedicine
522	522	medical services and teledentistry dental services; and
523	523	(2) the availability of covered benefits for different
524	524	services performed by multiple health care providers during a
525	525	single session of telemedicine medical services, teledentistry
526	526	dental services, or both services, if the executive commissioner
527	527	determines that delivery of the covered benefits in that manner is
528	528	cost-effective in comparison to the costs that would be involved in
529	529	obtaining the services from providers without the use of
530	530	telemedicine medical services or teledentistry dental services,
531	531	including the costs of transportation and lodging and other direct
532	532	costs.
533	533	(c) [(d)] In this section, "teledentistry dental service"
534	534	and "telemedicine medical service" have [has] the meanings
535	535	[meaning] assigned by Section 531.001, Government Code.
536	536	SECTION 25. The heading to Chapter 1455, Insurance Code, is
537	537	amended to read as follows:
538	538	CHAPTER 1455. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH
539	539	SECTION 26. Section 1455.001, Insurance Code, is amended by
540	540	amending Subdivisions (1) and (3) and adding Subdivision (1-a) to
541	541	read as follows:
542	542	(1) "Dentist" means a person licensed to practice
543	543	dentistry in this state under Subtitle D, Title 3, Occupations
544	544	Code.
545	545	(1-a) "Health professional" means:
546	546	(A) a physician;
547	547	(B) an individual who is:
548	548	(i) licensed or certified in this state to
549	549	perform health care services; and
550	550	(ii) authorized to assist:
551	551	(a) a physician in providing
552	552	telemedicine medical services that are delegated and supervised by
553	553	the physician; or
554	554	(b) a dentist in providing
555	555	teledentistry dental services that are delegated and supervised by
556	556	the dentist;
557	557	(C) a licensed or certified health professional
558	558	acting within the scope of the license or certification who does not
559	559	perform a telemedicine medical service or a teledentistry dental
560	560	service; or
561	561	(D) a dentist.
562	562	(3) "Teledentistry dental service," "telehealth
563	563	["Telehealth] service," and "telemedicine medical service" have
564	564	the meanings assigned by Section 111.001, Occupations Code.
565	565	SECTION 27. Section 1455.004, Insurance Code, is amended to
566	566	read as follows:
567	567	Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES,
568	568	TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES. (a) A
569	569	health benefit plan:
570	570	(1) must provide coverage for a covered health care
571	571	service or procedure delivered by a preferred or contracted health
572	572	professional to a covered patient as a telemedicine medical
573	573	service, teledentistry dental service, or telehealth service on the
574	574	same basis and to the same extent that the plan provides coverage
575	575	for the service or procedure in an in-person setting; and
576	576	(2) may not:
577	577	(A) exclude from coverage a covered health care
578	578	service or procedure delivered by a preferred or contracted health
579	579	professional to a covered patient as a telemedicine medical
580	580	service, a teledentistry dental service, or a telehealth service
581	581	solely because the covered health care service or procedure is not
582	582	provided through an in-person consultation; and
583	583	(B) subject to Subsection (c), limit, deny, or
584	584	reduce coverage for a covered health care service or procedure
585	585	delivered as a telemedicine medical service, teledentistry dental
586	586	service, or telehealth service based on the health professional's
587	587	choice of platform for delivering the service or procedure.
588	588	(b) A health benefit plan may require a deductible, a
589	589	copayment, or coinsurance for a covered health care service or
590	590	procedure delivered by a preferred or contracted health
591	591	professional to a covered patient as a telemedicine medical
592	592	service, a teledentistry dental service, or a telehealth service.
593	593	The amount of the deductible, copayment, or coinsurance may not
594	594	exceed the amount of the deductible, copayment, or coinsurance
595	595	required for the covered health care service or procedure provided
596	596	through an in-person consultation.
597	597	(b-1) Subsection (b) does not authorize a health benefit
598	598	plan to charge a separate deductible that applies only to a covered
599	599	health care service or procedure delivered as a telemedicine
600	600	medical service, teledentistry dental service, or telehealth
601	601	service.
602	602	(c) Notwithstanding Subsection (a), a health benefit plan
603	603	is not required to provide coverage for a telemedicine medical
604	604	service, a teledentistry dental service, or a telehealth service
605	605	provided by only synchronous or asynchronous audio interaction,
606	606	including:
607	607	(1) an audio-only telephone consultation;
608	608	(2) a text-only e-mail message; or
609	609	(3) a facsimile transmission.
610	610	(d) A health benefit plan may not impose an annual or
611	611	lifetime maximum on coverage for covered health care services or
612	612	procedures delivered as telemedicine medical services,
613	613	teledentistry dental services, or telehealth services other than
614	614	the annual or lifetime maximum, if any, that applies in the
615	615	aggregate to all items and services and procedures covered under
616	616	the plan.
617	617	SECTION 28. Section 1455.006, Insurance Code, is amended to
618	618	read as follows:
619	619	Sec. 1455.006. TELEMEDICINE MEDICAL SERVICES,
620	620	TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES STATEMENT.
621	621	(a) Each issuer of a health benefit plan shall adopt and display in
622	622	a conspicuous manner on the health benefit plan issuer's Internet
623	623	website the issuer's policies and payment practices for
624	624	telemedicine medical services, teledentistry dental services, and
625	625	telehealth services.
626	626	(b) This section does not require an issuer of a health
627	627	benefit plan to display negotiated contract payment rates for
628	628	health professionals who contract with the issuer to provide
629	629	telemedicine medical services, teledentistry dental services, or
630	630	telehealth services.
631	631	SECTION 29. Not later than March 1, 2022:
632	632	(1) the State Board of Dental Examiners and the Texas
633	633	State Board of Pharmacy shall jointly adopt rules as required by
634	634	Section 111.006(c), Occupations Code, as added by this Act;
635	635	(2) the State Board of Dental Examiners shall adopt:
636	636	(A) rules necessary to implement Chapter 111,
637	637	Occupations Code, as amended by this Act; and
638	638	(B) rules as required by Section 254.0035,
639	639	Occupations Code, as added by this Act; and
640	640	(3) the Health and Human Services Commission shall
641	641	adopt rules as required by Section 531.02172, Government Code, as
642	642	added by this Act.
643	643	SECTION 30. If before implementing any provision of this
644	644	Act a state agency determines that a waiver or authorization from a
645	645	federal agency is necessary for implementation of that provision,
646	646	the agency affected by the provision shall request the waiver or
647	647	authorization and may delay implementing that provision until the
648	648	waiver or authorization is granted.
649	649	SECTION 31. (a) Except as provided by Subsection (b) of
650	650	this section, this Act takes effect September 1, 2021.
651	651	(b) Sections 1455.004 and 1455.006, Insurance Code, as
652	652	amended by this Act, take effect January 1, 2022.