Texas 2025 - 89th Regular

Texas Senate Bill SB2108 Compare Versions

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

Old	New	Differences
1	1	By: Hughes S.B. No. 2108
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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
17	17	a 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. The
19	19	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;
24	24	or
25	25	(E) fee for a service, visit, or episode of care.
26	26	(2) "Direct primary care" means a primary medical care
27	27	service provided by a physician to a patient in return for payment
28	28	in accordance with a direct fee. The term include telemedicine
29	29	medical services and telehealth services, as those terms are
30	30	defined by Section 111.001, Occupations Code, provided using a
31	31	technology platform.
32	32	Sec. 1551.502. INCLUSION OF DIRECT PRIMARY CARE FEES AS
33	33	QUALIFIED MEDICAL EXPENSES. (a) Direct fees paid to a direct
34	34	primary care provider shall apply to the deductible of a
35	35	participant enrolled in the basic coverage provided under the
36	36	Employees Retirement System of Texas.
37	37	(b) The board of trustees shall adopt rules necessary to
38	38	implement this section.
39	39	SECTION 2. Chapter 1575, Insurance Code, is amended by
40	40	adding Subchapter L to read as follows:
41	41	SUBCHAPTER L. DIRECT PRIMARY CARE SERVICES
42	42	Sec. 1575.601. DEFINITIONS. In this subchapter:
43	43	(1) "Direct fee" means a fee charged by a physician to
44	44	a patient or a patient's designee for primary medical care services
45	45	provided by, or to be provided by, the physician to the patient. The
46	46	term includes a fee in any form, including a:
47	47	(A) monthly retainer;
48	48	(B) membership fee;
49	49	(C) subscription fee;
50	50	(D) fee paid under a medical service agreement;
51	51	or
52	52	(E) fee for a service, visit, or episode of care.
53	53	(2) "Direct primary care" means a primary medical care
54	54	service provided by a physician to a patient in return for payment
55	55	in accordance with a direct fee. The term include telemedicine
56	56	medical services and telehealth services, as those terms are
57	57	defined by Section 111.001, Occupations Code, provided using a
58	58	technology platform.
59	59	Sec. 1575.602. INCLUSION OF DIRECT PRIMARY CARE FEES AS
60	60	QUALIFIED MEDICAL EXPENSES. (a) Direct fees paid to a direct
61	61	primary care provider shall apply to the deductible of a
62	62	participant enrolled in the basic coverage provided under the
63	63	Teacher Retirement System of Texas.
64	64	(b) The trustee shall adopt rules necessary to implement
65	65	this section.
66	66	SECTION 3. This Act applies only to a health benefit plan
67	67	delivered, issued for delivery, or renewed on or after January 1,
68	68	2026.
69	69	SECTION 4. This Act takes effect September 1, 2025.