| 1 | 1 | | 88R2049 SCL-D |
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| 2 | 2 | | By: Schwertner S.B. No. 1359 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to reporting on the use of telemedicine medical services |
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| 8 | 8 | | and telehealth services among participating providers of certain |
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| 9 | 9 | | managed care plans. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Subtitle C, Title 8, Insurance Code, is amended |
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| 12 | 12 | | by adding Chapter 1276 to read as follows: |
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| 13 | 13 | | CHAPTER 1276. REPORTING REQUIREMENTS |
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| 14 | 14 | | SUBCHAPTER A. GENERAL PROVISIONS |
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| 15 | 15 | | Sec. 1276.001. DEFINITIONS. In this chapter: |
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| 16 | 16 | | (1) "Participating provider" means a physician or |
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| 17 | 17 | | health care provider who contracts with a health benefit plan |
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| 18 | 18 | | issuer or administrator to provide medical care or health care to |
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| 19 | 19 | | enrollees in a health benefit plan. |
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| 20 | 20 | | (2) "Telehealth service" and "telemedicine medical |
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| 21 | 21 | | service" have the meanings assigned by Section 111.001, Occupations |
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| 22 | 22 | | Code. |
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| 23 | 23 | | Sec. 1276.002. APPLICABILITY OF CHAPTER. This chapter |
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| 24 | 24 | | applies only to: |
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| 25 | 25 | | (1) a health benefit plan offered by a health |
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| 26 | 26 | | maintenance organization operating under Chapter 843; |
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| 27 | 27 | | (2) a preferred provider benefit plan, including an |
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| 28 | 28 | | exclusive provider benefit plan, offered by an insurer under |
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| 29 | 29 | | Chapter 1301; and |
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| 30 | 30 | | (3) an administrator of a health benefit plan offered |
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| 31 | 31 | | under Chapter 1551, 1575, or 1579. |
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| 32 | 32 | | Sec. 1276.003. RULES. The commissioner may adopt rules |
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| 33 | 33 | | necessary to implement this chapter. |
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| 34 | 34 | | SUBCHAPTER B. NETWORK ADEQUACY REPORTING |
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| 35 | 35 | | Sec. 1276.051. ANNUAL REPORT ON USE OF TELEMEDICINE MEDICAL |
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| 36 | 36 | | AND TELEHEALTH SERVICES FOR NETWORK. A health benefit plan issuer |
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| 37 | 37 | | or administrator shall submit an annual report to the department in |
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| 38 | 38 | | the form and manner prescribed by commissioner rule on whether each |
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| 39 | 39 | | participating provider for a health benefit plan issued or |
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| 40 | 40 | | administered by the issuer or administrator provides services |
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| 41 | 41 | | primarily: |
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| 42 | 42 | | (1) in person in the area in which the plan's enrollees |
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| 43 | 43 | | reside; or |
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| 44 | 44 | | (2) through the use of telemedicine medical services |
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| 45 | 45 | | or telehealth services. |
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| 46 | 46 | | SECTION 2. This Act takes effect September 1, 2023. |
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