| 1 | 1 | | 89R3350 RDR-D |
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| 2 | 2 | | By: Bhojani H.B. No. 1052 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to health benefit plan coverage of telemedicine, |
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| 10 | 10 | | teledentistry, and telehealth appointments with an originating |
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| 11 | 11 | | site or distant site located outside this state. |
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| 12 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 13 | 13 | | SECTION 1. Section 1455.001, Insurance Code, is amended by |
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| 14 | 14 | | amending Subdivision (1-a) and adding Subdivisions (1-b) and (1-c) |
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| 15 | 15 | | to read as follows: |
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| 16 | 16 | | (1-a) "Distant site" means the location where a health |
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| 17 | 17 | | professional provides a telemedicine medical service, |
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| 18 | 18 | | teledentistry dental service, or telehealth service. |
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| 19 | 19 | | (1-b) "Health professional" means: |
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| 20 | 20 | | (A) a physician; |
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| 21 | 21 | | (B) an individual who is: |
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| 22 | 22 | | (i) licensed or certified in this state to |
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| 23 | 23 | | perform health care services; and |
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| 24 | 24 | | (ii) authorized to assist: |
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| 25 | 25 | | (a) a physician in providing |
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| 26 | 26 | | telemedicine medical services that are delegated and supervised by |
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| 27 | 27 | | the physician; or |
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| 28 | 28 | | (b) a dentist in providing |
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| 29 | 29 | | teledentistry dental services that are delegated and supervised by |
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| 30 | 30 | | the dentist; |
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| 31 | 31 | | (C) a licensed or certified health professional |
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| 32 | 32 | | acting within the scope of the license or certification who does not |
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| 33 | 33 | | perform a telemedicine medical service or a teledentistry dental |
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| 34 | 34 | | service; or |
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| 35 | 35 | | (D) a dentist. |
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| 36 | 36 | | (1-c) "Originating site" means the location where an |
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| 37 | 37 | | individual receives a telemedicine medical service, teledentistry |
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| 38 | 38 | | dental service, or telehealth service. |
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| 39 | 39 | | SECTION 2. Section 1455.004, Insurance Code, is amended by |
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| 40 | 40 | | adding Subsection (e) to read as follows: |
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| 41 | 41 | | (e) A health benefit plan must provide coverage for a |
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| 42 | 42 | | covered health care service or procedure delivered as a |
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| 43 | 43 | | telemedicine medical service, teledentistry dental service, or |
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| 44 | 44 | | telehealth service with an originating site or distant site located |
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| 45 | 45 | | outside this state on the same basis and to the same extent that the |
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| 46 | 46 | | plan provides coverage for the service or procedure delivered as a |
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| 47 | 47 | | telemedicine medical service, teledentistry dental service, or |
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| 48 | 48 | | telehealth service with an originating site and distant site |
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| 49 | 49 | | located in this state if: |
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| 50 | 50 | | (1) the individual who receives the service resides |
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| 51 | 51 | | primarily in this state; and |
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| 52 | 52 | | (2) the health professional who provides the service: |
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| 53 | 53 | | (A) is licensed or otherwise authorized to |
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| 54 | 54 | | provide the service in this state; and |
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| 55 | 55 | | (B) has a physical office in this state. |
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| 56 | 56 | | SECTION 3. Section 1455.004, Insurance Code, as amended by |
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| 57 | 57 | | this Act, applies only to a health benefit plan delivered, issued |
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| 58 | 58 | | for delivery, or renewed on or after January 1, 2026. A health |
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| 59 | 59 | | benefit plan delivered, issued for delivery, or renewed before |
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| 60 | 60 | | January 1, 2026, is governed by the law as it existed immediately |
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| 61 | 61 | | before the effective date of this Act, and that law is continued in |
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| 62 | 62 | | effect for that purpose. |
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| 63 | 63 | | SECTION 4. This Act takes effect September 1, 2025. |
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