Texas 2025 - 89th Regular

Texas House Bill HB3015 Compare Versions

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

Old	New	Differences
1	1	By: Alders H.B. No. 3015
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6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to the inclusion of direct primary care fees as qualified
9	9	medical expenses applied toward insurance deductibles in certain
10	10	state health benefit plans.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 1551, Insurance Code, is amended by
13	13	adding Subchapter K to read as follows:
14	14	SUBCHAPTER K. DIRECT PRIMARY CARE SERVICES
15	15	Sec. 1551.501. DEFINITIONS. In this subchapter:
16	16	(1) "Direct fee" means a fee charged by a physician to a
17	17	patient or a patient's designee for primary medical care services
18	18	provided by, or to be provided by, the physician to the patient.
19	19	The term includes a fee in any form, including a:
20	20	(A) monthly retainer;
21	21	(B) membership fee;
22	22	(C) subscription fee;
23	23	(D) fee paid under a medical service agreement; or
24	24	(E) fee for a service, visit, or episode of care.
25	25	(2) "Direct primary care" means a primary medical care
26	26	service provided by a physician to a patient in return for payment
27	27	in accordance with a direct fee. The term include telemedicine
28	28	medical services and telehealth services, as those terms are
29	29	defined by Section 111.001, Occupations Code, provided using a
30	30	technology platform.
31	31	Sec. 1551.502. INCLUSION OF DIRECT PRIMARY CARE FEES AS
32	32	QUALIFIED MEDICAL EXPENSES. (a) Direct fees paid to a direct
33	33	primary care provider shall apply to the deductible of a
34	34	participant enrolled in the basic coverage provided under the
35	35	Employees Retirement System of Texas.
36	36	(b) The board of trustees shall adopt rules necessary to
37	37	implement this section.
38	38	SECTION 2. Chapter 1575, Insurance Code, is amended by
39	39	adding Subchapter L to read as follows:
40	40	SUBCHAPTER L. DIRECT PRIMARY CARE SERVICES
41	41	Sec. 1575.601. DEFINITIONS. In this subchapter:
42	42	(1) "Direct fee" means a fee charged by a physician to a
43	43	patient or a patient's designee for primary medical care services
44	44	provided by, or to be provided by, the physician to the patient.
45	45	The term includes a fee in any form, including a:
46	46	(A) monthly retainer;
47	47	(B) membership fee;
48	48	(C) subscription fee;
49	49	(D) fee paid under a medical service agreement; or
50	50	(E) fee for a service, visit, or episode of care.
51	51	(2) "Direct primary care" means a primary medical care
52	52	service provided by a physician to a patient in return for payment
53	53	in accordance with a direct fee. The term include telemedicine
54	54	medical services and telehealth services, as those terms are
55	55	defined by Section 111.001, Occupations Code, provided using a
56	56	technology platform.
57	57	Sec. 1575.602. INCLUSION OF DIRECT PRIMARY CARE FEES AS
58	58	QUALIFIED MEDICAL EXPENSES. (a) Direct fees paid to a direct
59	59	primary care provider shall apply to the deductible of a
60	60	participant enrolled in the basic coverage provided under the
61	61	Teacher Retirement System of Texas.
62	62	(b) The trustee shall adopt rules necessary to implement
63	63	this section.
64	64	SECTION 3. This Act applies only to a health benefit plan
65	65	delivered, issued for delivery, or renewed on or after January 1,
66	66	2026.
67	67	SECTION 4. This Act takes effect September 1, 2025.