Bill Text: TX HB2056 | 2021-2022 | 87th Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the practice of dentistry and the provision of teledentistry dental services.
Spectrum: Bipartisan Bill
Status: (Passed) 2021-06-16 - See remarks for effective date [HB2056 Detail]
Download: Texas-2021-HB2056-Comm_Sub.html
Bill Title: Relating to the practice of dentistry and the provision of teledentistry dental services.
Spectrum: Bipartisan Bill
Status: (Passed) 2021-06-16 - See remarks for effective date [HB2056 Detail]
Download: Texas-2021-HB2056-Comm_Sub.html
87R20723 JCG-D | |||
By: Klick, Guerra | H.B. No. 2056 | ||
Substitute the following for H.B. No. 2056: | |||
By: Klick | C.S.H.B. No. 2056 |
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relating to the practice of dentistry and the provision of | ||
teledentistry dental services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. The heading to Chapter 111, Occupations Code, is | ||
amended to read as follows: | ||
CHAPTER 111. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH | ||
SECTION 2. Section 111.001, Occupations Code, is amended by | ||
amending Subdivisions (1) and (3) and adding Subdivision (2-a) to | ||
read as follows: | ||
(1) "Dentist," "health [ |
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"physician" have the meanings assigned by Section 1455.001, | ||
Insurance Code. | ||
(2-a) "Teledentistry dental service" means a health | ||
care service delivered by a dentist, or a health professional | ||
acting under the delegation and supervision of a dentist, acting | ||
within the scope of the dentist's or health professional's license | ||
or certification to a patient at a different physical location than | ||
the dentist or health professional using telecommunications or | ||
information technology. | ||
(3) "Telehealth service" means a health service, other | ||
than a telemedicine medical service or a teledentistry dental | ||
service, delivered by a health professional licensed, certified, or | ||
otherwise entitled to practice in this state and acting within the | ||
scope of the health professional's license, certification, or | ||
entitlement to a patient at a different physical location than the | ||
health professional using telecommunications or information | ||
technology. | ||
SECTION 3. Section 111.002, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 111.002. INFORMED CONSENT. (a) A treating physician, | ||
dentist, or health professional who provides or facilitates the use | ||
of telemedicine medical services, teledentistry dental services, | ||
or telehealth services shall ensure that the informed consent of | ||
the patient, or another appropriate individual authorized to make | ||
health care treatment decisions for the patient, is obtained before | ||
telemedicine medical services, teledentistry dental services, or | ||
telehealth services are provided. | ||
(b) A dentist who delegates a teledentistry dental service | ||
shall ensure that the informed consent of the patient includes | ||
disclosure to the patient that the dentist has delegated the | ||
service. | ||
SECTION 4. Section 111.003, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 111.003. CONFIDENTIALITY. A treating physician, | ||
dentist, or health professional who provides or facilitates the use | ||
of telemedicine medical services, teledentistry dental services, | ||
or telehealth services shall ensure that the confidentiality of the | ||
patient's clinical [ |
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by Chapter 159, by Subchapter C, Chapter 258, or by other applicable | ||
law. | ||
SECTION 5. Section 111.004, Occupations Code, is amended | ||
to read as follows: | ||
Sec. 111.004. RULES. (a) The Texas Medical Board, in | ||
consultation with the commissioner of insurance, as appropriate, | ||
may adopt rules necessary to: | ||
(1) ensure that patients using telemedicine medical | ||
services receive appropriate, quality care; | ||
(2) prevent abuse and fraud in the use of telemedicine | ||
medical services, including rules relating to the filing of claims | ||
and records required to be maintained in connection with | ||
telemedicine medical services; | ||
(3) ensure adequate supervision of health | ||
professionals who are not physicians and who provide telemedicine | ||
medical services; and | ||
(4) establish the maximum number of health | ||
professionals who are not physicians that a physician may supervise | ||
through a telemedicine medical service. | ||
(b) The State Board of Dental Examiners, in consultation | ||
with the commissioner of insurance, as appropriate, may adopt rules | ||
necessary to: | ||
(1) ensure that patients using teledentistry dental | ||
services receive appropriate, quality care; | ||
(2) prevent abuse and fraud in the use of | ||
teledentistry dental services, including rules relating to the | ||
filing of claims and records required to be maintained in | ||
connection with teledentistry dental services; | ||
(3) ensure adequate supervision of health | ||
professionals who are not dentists and who provide teledentistry | ||
dental services under the delegation and supervision of a dentist; | ||
and | ||
(4) authorize a dentist to simultaneously delegate to | ||
and supervise through a teledentistry dental service not more than | ||
five health professionals who are not dentists. | ||
SECTION 6. The heading to Section 111.005, Occupations | ||
Code, is amended to read as follows: | ||
Sec. 111.005. PRACTITIONER-PATIENT RELATIONSHIP FOR | ||
TELEMEDICINE MEDICAL SERVICES OR TELEDENTISTRY DENTAL SERVICES. | ||
SECTION 7. Section 111.005(a), Occupations Code, is amended | ||
to read as follows: | ||
(a) For purposes of Section 562.056, a valid | ||
practitioner-patient relationship is present between a | ||
practitioner providing a telemedicine medical service or a | ||
teledentistry dental service and a patient receiving the | ||
[ |
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with the standard of care described in Section 111.007 and the | ||
practitioner: | ||
(1) has a preexisting practitioner-patient | ||
relationship with the patient established in accordance with rules | ||
adopted under Section 111.006; | ||
(2) communicates, regardless of the method of | ||
communication, with the patient pursuant to a call coverage | ||
agreement established in accordance with: | ||
(A) Texas Medical Board rules with a physician | ||
requesting coverage of medical care for the patient; or | ||
(B) State Board of Dental Examiners rules with a | ||
dentist requesting coverage of dental care for the patient; or | ||
(3) provides the telemedicine medical services or | ||
teledentistry dental services through the use of one of the | ||
following methods, as long as the practitioner complies with the | ||
follow-up requirements in Subsection (b), and the method allows the | ||
practitioner to have access to, and the practitioner uses, the | ||
relevant clinical information that would be required in accordance | ||
with the standard of care described in Section 111.007: | ||
(A) synchronous audiovisual interaction between | ||
the practitioner and the patient in another location; | ||
(B) asynchronous store and forward technology, | ||
including asynchronous store and forward technology in conjunction | ||
with synchronous audio interaction between the practitioner and the | ||
patient in another location, as long as the practitioner uses | ||
clinical information from: | ||
(i) clinically relevant photographic or | ||
video images, including diagnostic images; or | ||
(ii) the patient's relevant clinical | ||
[ |
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laboratory and pathology results, and prescriptive histories; or | ||
(C) another form of audiovisual | ||
telecommunication technology that allows the practitioner to | ||
comply with the standard of care described in Section 111.007. | ||
SECTION 8. Section 111.006, Occupations Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) The State Board of Dental Examiners and the Texas State | ||
Board of Pharmacy shall jointly adopt rules that establish the | ||
determination of a valid prescription in accordance with Section | ||
111.005. Rules adopted under this subsection must allow for the | ||
establishment of a practitioner-patient relationship by a | ||
teledentistry dental service provided by a dentist to a patient in a | ||
manner that complies with Section 111.005(a)(3) and must be | ||
substantially similar to the rules adopted under Subsection (a) of | ||
this section. The State Board of Dental Examiners and the Texas | ||
State Board of Pharmacy shall jointly develop and publish on each | ||
respective board's Internet website responses to frequently asked | ||
questions relating to the determination of a valid prescription | ||
issued in the course of the provision of teledentistry dental | ||
services. | ||
SECTION 9. Section 111.007, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 111.007. STANDARD OF CARE FOR TELEMEDICINE MEDICAL | ||
SERVICES, TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES. | ||
(a) A health professional providing a health care service or | ||
procedure as a telemedicine medical service, a teledentistry dental | ||
service, or a telehealth service is subject to the standard of care | ||
that would apply to the provision of the same health care service or | ||
procedure in an in-person setting. | ||
(b) An agency with regulatory authority over a health | ||
professional may not adopt rules pertaining to telemedicine medical | ||
services, teledentistry dental services, or telehealth services | ||
that would impose a higher standard of care than the standard | ||
described in Subsection (a). | ||
SECTION 10. Chapter 111, Occupations Code, is amended by | ||
adding Section 111.0075 to read as follows: | ||
Sec. 111.0075. LICENSING FOR TELEDENTISTRY DENTAL | ||
SERVICES. A health professional providing a health care service or | ||
procedure as a teledentistry dental service is subject to the | ||
licensing requirements that would apply to the provision of the | ||
same health care service or procedure in an in-person setting. | ||
SECTION 11. Chapter 111, Occupations Code, is amended by | ||
adding Section 111.009 to read as follows: | ||
Sec. 111.009. LIMITATION ON CERTAIN PRESCRIPTIONS. (a) In | ||
this section: | ||
(1) "Controlled substance," "opiate," and "prescribe" | ||
have the meanings assigned by Section 481.002, Health and Safety | ||
Code. | ||
(2) "National holiday" means a day described by | ||
Section 662.003(a), Government Code. | ||
(b) The State Board of Dental Examiners by rule shall | ||
establish limits on the quantity of a controlled substance, | ||
including an opiate, that a dentist may prescribe to a patient as a | ||
teledentistry dental service. Except as provided by Subsection | ||
(c), the rules may not authorize a dentist to prescribe more than is | ||
necessary to supply a patient for: | ||
(1) if the prescription is for an opiate, a two-day | ||
period; or | ||
(2) if the prescription is for a controlled substance | ||
other than an opiate, a five-day period. | ||
(c) For each day in a period described by Subsection (b)(1) | ||
or (2) that is a Saturday, Sunday, or national holiday, the period | ||
is extended to include the next day that is not a Saturday, Sunday, | ||
or national holiday. | ||
(d) Rules adopted under this section must comply with | ||
applicable federal laws and rules. | ||
SECTION 12. Section 251.003, Occupations Code, is amended | ||
by adding Subsection (d) to read as follows: | ||
(d) For purposes of this subtitle, a person located in | ||
another state practices dentistry in this state and is required to | ||
hold a license to practice dentistry in this state if the person | ||
through the use of any medium, including an electronic medium, | ||
performs an act that constitutes the practice of dentistry on a | ||
patient in this state. | ||
SECTION 13. Chapter 254, Occupations Code, is amended by | ||
adding Section 254.0035 to read as follows: | ||
Sec. 254.0035. RULES REGARDING CALL COVERAGE AGREEMENTS. | ||
The board shall adopt rules governing a call coverage agreement | ||
between dentists. | ||
SECTION 14. Section 258.001, Occupations Code, is amended | ||
to read as follows: | ||
Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not | ||
delegate: | ||
(1) an act to an individual who, by board order, is | ||
prohibited from performing the act; | ||
(2) any of the following acts to a person not licensed | ||
as a dentist or dental hygienist: | ||
(A) the removal of calculus, deposits, or | ||
accretions from the natural and restored surfaces of exposed human | ||
teeth and restorations in the human mouth; | ||
(B) root planing or the smoothing and polishing | ||
of roughened root surfaces or exposed human teeth; or | ||
(C) any other act the delegation of which is | ||
prohibited by board rule; | ||
(3) any of the following acts to a person not licensed | ||
as a dentist: | ||
(A) comprehensive examination or diagnosis and | ||
treatment planning; | ||
(B) a surgical or cutting procedure on hard or | ||
soft tissue; | ||
(C) the prescription of a drug, medication, or | ||
work authorization; | ||
(D) the taking of an impression for a final | ||
restoration, appliance, or prosthesis; | ||
(E) the making of an intraoral occlusal | ||
adjustment; | ||
(F) direct pulp capping, pulpotomy, or any other | ||
endodontic procedure; | ||
(G) the final placement and intraoral adjustment | ||
of a fixed or removable appliance; or | ||
(H) the placement of any final restoration; or | ||
(4) the authority to an individual to administer a | ||
local anesthetic agent, inhalation sedative agent, parenteral | ||
sedative agent, or general anesthetic agent, including as a | ||
teledentistry dental service as that term is defined by Section | ||
111.001, if the individual is not licensed as: | ||
(A) a dentist with a permit issued by the board | ||
for the procedure being performed, if a permit is required; | ||
(B) a certified registered nurse anesthetist | ||
licensed by the Texas Board of Nursing, only if the delegating | ||
dentist holds a permit issued by the board for the procedure being | ||
performed, if a permit is required; or | ||
(C) a physician anesthesiologist licensed by the | ||
Texas Medical Board. | ||
SECTION 15. Section 262.152, Occupations Code, is amended | ||
to read as follows: | ||
Sec. 262.152. PERFORMANCE OF DELEGATED DUTIES. (a) Except | ||
as provided by Section 262.1515, a dental hygienist shall practice | ||
dental hygiene: | ||
(1) in the dental office of a supervising dentist | ||
licensed by the board; or | ||
(2) in an alternate setting, including a nursing home, | ||
the patient's home, a school, a hospital, a state institution, a | ||
public health clinic, or another institution, under the supervision | ||
of a supervising dentist. | ||
(b) For purposes of this section, a dental hygienist who | ||
practices dental hygiene as a teledentistry dental service, as | ||
defined by Section 111.001, is practicing in an alternate setting | ||
in compliance with Subsection (a)(2). | ||
SECTION 16. Section 562.056(c), Occupations Code, is | ||
amended to read as follows: | ||
(c) For purposes of this section and Section 562.112, a | ||
valid practitioner-patient relationship is present between a | ||
practitioner providing telemedicine medical services or | ||
teledentistry dental services and the patient receiving the | ||
[ |
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with the requirements for establishing such a relationship in | ||
accordance with Section 111.005. | ||
SECTION 17. Section 531.001, Government Code, is amended by | ||
amending Subdivision (4-d) and adding Subdivision (6-a) to read as | ||
follows: | ||
(4-d) "Platform" means the technology, system, | ||
software, application, modality, or other method through which a | ||
health professional remotely interfaces with a patient when | ||
providing a health care service or procedure as a telemedicine | ||
medical service, teledentistry dental service, or telehealth | ||
service. | ||
(6-a) "Teledentistry dental service" has the meaning | ||
assigned by Section 111.001, Occupations Code. | ||
SECTION 18. Section 531.0216, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.0216. PARTICIPATION AND REIMBURSEMENT OF | ||
TELEMEDICINE MEDICAL SERVICE PROVIDERS, TELEDENTISTRY DENTAL | ||
SERVICE PROVIDERS, AND TELEHEALTH SERVICE PROVIDERS UNDER | ||
MEDICAID. (a) The executive commissioner by rule shall develop and | ||
implement a system to reimburse providers of services under | ||
Medicaid for services performed using telemedicine medical | ||
services, teledentistry dental services, or telehealth services. | ||
(c) The commission shall encourage health care providers | ||
and health care facilities to provide telemedicine medical | ||
services, teledentistry dental services, and telehealth services | ||
in the health care delivery system. The commission may not require | ||
that a service be provided to a patient through telemedicine | ||
medical services, teledentistry dental services, or telehealth | ||
services. | ||
(c-1) The commission shall explore opportunities to | ||
increase STAR Health program providers' use of telemedicine medical | ||
services in medically underserved areas of this state. | ||
(d) Subject to Sections 111.004 and [ |
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Occupations Code, the executive commissioner may adopt rules as | ||
necessary to implement this section. In the rules adopted under | ||
this section, the executive commissioner shall: | ||
(1) refer to the site where the patient is physically | ||
located as the patient site; and | ||
(2) refer to the site where the physician, dentist, or | ||
health professional providing the telemedicine medical service, | ||
teledentistry dental service, or telehealth service is physically | ||
located as the distant site. | ||
(f) Not later than December 1 of each even-numbered year, | ||
the commission shall report to the speaker of the house of | ||
representatives and the lieutenant governor on the effects of | ||
telemedicine medical services, teledentistry dental services, | ||
telehealth services, and home telemonitoring services on Medicaid | ||
in the state, including the number of physicians, dentists, health | ||
professionals, and licensed health care facilities using | ||
telemedicine medical services, teledentistry dental services, | ||
telehealth services, or home telemonitoring services, the | ||
geographic and demographic disposition of the physicians, | ||
dentists, and health professionals, the number of patients | ||
receiving telemedicine medical services, teledentistry dental | ||
services, telehealth services, and home telemonitoring services, | ||
the types of services being provided, the cost of utilization, and | ||
the cost savings of telemedicine medical services, teledentistry | ||
dental services, telehealth services, and home telemonitoring | ||
services to Medicaid. | ||
(g) The commission shall ensure that a Medicaid managed care | ||
organization: | ||
(1) does not deny reimbursement for a covered health | ||
care service or procedure delivered by a health care provider with | ||
whom the managed care organization contracts to a Medicaid | ||
recipient as a telemedicine medical service, a teledentistry dental | ||
service, or a telehealth service solely because the covered service | ||
or procedure is not provided through an in-person consultation; | ||
(2) does not limit, deny, or reduce reimbursement for | ||
a covered health care service or procedure delivered by a health | ||
care provider with whom the managed care organization contracts to | ||
a Medicaid recipient as a telemedicine medical service, a | ||
teledentistry dental service, or a telehealth service based on the | ||
health care provider's choice of platform for providing the health | ||
care service or procedure; and | ||
(3) ensures that the use of telemedicine medical | ||
services, teledentistry dental services, or telehealth services | ||
promotes and supports patient-centered medical homes by allowing a | ||
Medicaid recipient to receive a telemedicine medical service, | ||
teledentistry dental service, or telehealth service from a provider | ||
other than the recipient's primary care physician or provider, | ||
except as provided by Section 531.0217(c-4), only if: | ||
(A) the telemedicine medical service, | ||
teledentistry dental service, or telehealth service is provided in | ||
accordance with the law and contract requirements applicable to the | ||
provision of the same health care service in an in-person setting, | ||
including requirements regarding care coordination; and | ||
(B) the provider of the telemedicine medical | ||
service, teledentistry dental service, or telehealth service gives | ||
notice to the Medicaid recipient's primary care physician or | ||
provider regarding the [ |
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findings, a list of prescribed or administered medications, and | ||
patient instructions, for the purpose of sharing medical | ||
information, provided that the recipient has a primary care | ||
physician or provider and the recipient or, if appropriate, the | ||
recipient's parent or legal guardian, consents to the notice. | ||
(h) The commission shall develop, document, and implement a | ||
monitoring process to ensure that a Medicaid managed care | ||
organization ensures that the use of telemedicine medical services, | ||
teledentistry dental services, or telehealth services promotes and | ||
supports patient-centered medical homes and care coordination in | ||
accordance with Subsection (g)(3). The process must include | ||
monitoring of the rate at which a telemedicine medical service, | ||
teledentistry dental service, or telehealth service provider gives | ||
notice in accordance with Subsection (g)(3)(B). | ||
(i) The executive commissioner by rule shall ensure that a | ||
federally-qualified [ |
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by 42 U.S.C. Section 1396d(l)(2)(B) may be reimbursed for the | ||
originating site facility fee or the distant site practitioner fee | ||
or both, as appropriate, for a covered telemedicine medical | ||
service, teledentistry dental service, or telehealth service | ||
delivered by a health care provider to a Medicaid recipient. The | ||
commission is required to implement this subsection only if the | ||
legislature appropriates money specifically for that purpose. If | ||
the legislature does not appropriate money specifically for that | ||
purpose, the commission may, but is not required to, implement this | ||
subsection using other money available to the commission for that | ||
purpose. | ||
(j) In complying with state and federal requirements to | ||
provide access to medically necessary services under the Medicaid | ||
managed care program, a Medicaid managed care organization | ||
determining whether reimbursement for a telemedicine medical | ||
service, teledentistry dental service, or telehealth service is | ||
appropriate shall continue to consider other factors, including | ||
whether reimbursement is cost-effective and whether the provision | ||
of the service is clinically effective. | ||
SECTION 19. The heading to Section 531.02162, Government | ||
Code, is amended to read as follows: | ||
Sec. 531.02162. MEDICAID SERVICES PROVIDED THROUGH | ||
TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY DENTAL SERVICES, AND | ||
TELEHEALTH SERVICES TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS. | ||
SECTION 20. Sections 531.02162(b) and (c), Government Code, | ||
are amended to read as follows: | ||
(b) The executive commissioner by rule shall establish | ||
policies that permit reimbursement under Medicaid and the child | ||
health plan program for services provided through telemedicine | ||
medical services, teledentistry dental services, and telehealth | ||
services to children with special health care needs. | ||
(c) The policies required under this section must: | ||
(1) be designed to: | ||
(A) prevent unnecessary travel and encourage | ||
efficient use of telemedicine medical services, teledentistry | ||
dental services, and telehealth services for children with special | ||
health care needs in all suitable circumstances; and | ||
(B) ensure in a cost-effective manner the | ||
availability to a child with special health care needs of services | ||
appropriately performed using telemedicine medical services, | ||
teledentistry dental services, and telehealth services that are | ||
comparable to the same types of services available to that child | ||
without the use of telemedicine medical services, teledentistry | ||
dental services, and telehealth services; and | ||
(2) provide for reimbursement of multiple providers of | ||
different services who participate in a single session of | ||
telemedicine medical services, teledentistry dental services, | ||
[ |
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[ |
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commission determines that reimbursing each provider for the | ||
session is cost-effective in comparison to the costs that would be | ||
involved in obtaining the services from providers without the use | ||
of telemedicine medical services, teledentistry dental services, | ||
and telehealth services, including the costs of transportation and | ||
lodging and other direct costs. | ||
SECTION 21. Subchapter B, Chapter 531, Government Code, is | ||
amended by adding Section 531.02172 to read as follows: | ||
Sec. 531.02172. REIMBURSEMENT FOR TELEDENTISTRY DENTAL | ||
SERVICES. (a) The commission by rule shall require each health and | ||
human services agency that administers a part of the Medicaid | ||
program to provide Medicaid reimbursement for teledentistry dental | ||
services provided by a dentist licensed to practice dentistry in | ||
this state. | ||
(b) The commission shall require reimbursement for a | ||
teledentistry dental service at the same rate as the Medicaid | ||
program reimburses for the same in-person dental service. A | ||
request for reimbursement may not be denied solely because an | ||
in-person dental service between a dentist and a patient did not | ||
occur. The commission may not limit a dentist's choice of platform | ||
for providing a teledentistry dental service by requiring that the | ||
dentist use a particular platform to receive reimbursement for the | ||
service. | ||
(c) The State Board of Dental Examiners, in consultation | ||
with the commission and the commission's office of inspector | ||
general, as appropriate, may adopt rules as necessary to: | ||
(1) ensure that appropriate care, including quality of | ||
care, is provided to patients who receive teledentistry dental | ||
services; and | ||
(2) prevent abuse and fraud through the use of | ||
teledentistry dental services, including rules relating to filing | ||
claims and the records required to be maintained in connection with | ||
teledentistry dental services. | ||
SECTION 22. The heading to Section 62.157, Health and | ||
Safety Code, is amended to read as follows: | ||
Sec. 62.157. TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY | ||
DENTAL SERVICES, AND TELEHEALTH SERVICES FOR CHILDREN WITH SPECIAL | ||
HEALTH CARE NEEDS. | ||
SECTION 23. Sections 62.157(a) and (b), Health and Safety | ||
Code, are amended to read as follows: | ||
(a) In providing covered benefits to a child with special | ||
health care needs, a health plan provider must permit benefits to be | ||
provided through telemedicine medical services, teledentistry | ||
dental services, and telehealth services in accordance with | ||
policies developed by the commission. | ||
(b) The policies must provide for: | ||
(1) the availability of covered benefits | ||
appropriately provided through telemedicine medical services, | ||
teledentistry dental services, and telehealth services that are | ||
comparable to the same types of covered benefits provided without | ||
the use of telemedicine medical services, teledentistry dental | ||
services, and telehealth services; and | ||
(2) the availability of covered benefits for different | ||
services performed by multiple health care providers during a | ||
single [ |
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session of telemedicine medical services, teledentistry dental | ||
services, telehealth services, or any combination of those | ||
services, if the executive commissioner determines that delivery of | ||
the covered benefits in that manner is cost-effective in comparison | ||
to the costs that would be involved in obtaining the services from | ||
providers without the use of telemedicine medical services, | ||
teledentistry dental services, and telehealth services, including | ||
the costs of transportation and lodging and other direct costs. | ||
SECTION 24. Section 62.1571, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 62.1571. TELEMEDICINE MEDICAL SERVICES AND | ||
TELEDENTISTRY DENTAL SERVICES. (a) In providing covered benefits | ||
to a child, a health plan provider must permit benefits to be | ||
provided through telemedicine medical services and teledentistry | ||
dental services in accordance with policies developed by the | ||
commission. | ||
(b) The policies must provide for: | ||
(1) the availability of covered benefits | ||
appropriately provided through telemedicine medical services and | ||
teledentistry dental services that are comparable to the same types | ||
of covered benefits provided without the use of telemedicine | ||
medical services and teledentistry dental services; and | ||
(2) the availability of covered benefits for different | ||
services performed by multiple health care providers during a | ||
single session of telemedicine medical services, teledentistry | ||
dental services, or both services, if the executive commissioner | ||
determines that delivery of the covered benefits in that manner is | ||
cost-effective in comparison to the costs that would be involved in | ||
obtaining the services from providers without the use of | ||
telemedicine medical services or teledentistry dental services, | ||
including the costs of transportation and lodging and other direct | ||
costs. | ||
(c) [ |
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and "telemedicine medical service" have [ |
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[ |
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SECTION 25. The heading to Chapter 1455, Insurance Code, is | ||
amended to read as follows: | ||
CHAPTER 1455. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH | ||
SECTION 26. Section 1455.001, Insurance Code, is amended by | ||
amending Subdivisions (1) and (3) and adding Subdivision (1-a) to | ||
read as follows: | ||
(1) "Dentist" means a person licensed to practice | ||
dentistry in this state under Subtitle D, Title 3, Occupations | ||
Code. | ||
(1-a) "Health professional" means: | ||
(A) a physician; | ||
(B) an individual who is: | ||
(i) licensed or certified in this state to | ||
perform health care services; and | ||
(ii) authorized to assist: | ||
(a) a physician in providing | ||
telemedicine medical services that are delegated and supervised by | ||
the physician; or | ||
(b) a dentist in providing | ||
teledentistry dental services that are delegated and supervised by | ||
the dentist; | ||
(C) a licensed or certified health professional | ||
acting within the scope of the license or certification who does not | ||
perform a telemedicine medical service or a teledentistry dental | ||
service; or | ||
(D) a dentist. | ||
(3) "Teledentistry dental service," "telehealth | ||
[ |
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the meanings assigned by Section 111.001, Occupations Code. | ||
SECTION 27. Section 1455.004, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES, | ||
TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES. (a) A | ||
health benefit plan: | ||
(1) must provide coverage for a covered health care | ||
service or procedure delivered by a preferred or contracted health | ||
professional to a covered patient as a telemedicine medical | ||
service, teledentistry dental service, or telehealth service on the | ||
same basis and to the same extent that the plan provides coverage | ||
for the service or procedure in an in-person setting; and | ||
(2) may not: | ||
(A) exclude from coverage a covered health care | ||
service or procedure delivered by a preferred or contracted health | ||
professional to a covered patient as a telemedicine medical | ||
service, a teledentistry dental service, or a telehealth service | ||
solely because the covered health care service or procedure is not | ||
provided through an in-person consultation; and | ||
(B) subject to Subsection (c), limit, deny, or | ||
reduce coverage for a covered health care service or procedure | ||
delivered as a telemedicine medical service, teledentistry dental | ||
service, or telehealth service based on the health professional's | ||
choice of platform for delivering the service or procedure. | ||
(b) A health benefit plan may require a deductible, a | ||
copayment, or coinsurance for a covered health care service or | ||
procedure delivered by a preferred or contracted health | ||
professional to a covered patient as a telemedicine medical | ||
service, a teledentistry dental service, or a telehealth service. | ||
The amount of the deductible, copayment, or coinsurance may not | ||
exceed the amount of the deductible, copayment, or coinsurance | ||
required for the covered health care service or procedure provided | ||
through an in-person consultation. | ||
(b-1) Subsection (b) does not authorize a health benefit | ||
plan to charge a separate deductible that applies only to a covered | ||
health care service or procedure delivered as a telemedicine | ||
medical service, teledentistry dental service, or telehealth | ||
service. | ||
(c) Notwithstanding Subsection (a), a health benefit plan | ||
is not required to provide coverage for a telemedicine medical | ||
service, a teledentistry dental service, or a telehealth service | ||
provided by only synchronous or asynchronous audio interaction, | ||
including: | ||
(1) an audio-only telephone consultation; | ||
(2) a text-only e-mail message; or | ||
(3) a facsimile transmission. | ||
(d) A health benefit plan may not impose an annual or | ||
lifetime maximum on coverage for covered health care services or | ||
procedures delivered as telemedicine medical services, | ||
teledentistry dental services, or telehealth services other than | ||
the annual or lifetime maximum, if any, that applies in the | ||
aggregate to all items and services and procedures covered under | ||
the plan. | ||
SECTION 28. Section 1455.006, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1455.006. TELEMEDICINE MEDICAL SERVICES, | ||
TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES STATEMENT. | ||
(a) Each issuer of a health benefit plan shall adopt and display in | ||
a conspicuous manner on the health benefit plan issuer's Internet | ||
website the issuer's policies and payment practices for | ||
telemedicine medical services, teledentistry dental services, and | ||
telehealth services. | ||
(b) This section does not require an issuer of a health | ||
benefit plan to display negotiated contract payment rates for | ||
health professionals who contract with the issuer to provide | ||
telemedicine medical services, teledentistry dental services, or | ||
telehealth services. | ||
SECTION 29. Not later than March 1, 2022: | ||
(1) the State Board of Dental Examiners and the Texas | ||
State Board of Pharmacy shall jointly adopt rules as required by | ||
Section 111.006(c), Occupations Code, as added by this Act; | ||
(2) the State Board of Dental Examiners shall adopt: | ||
(A) rules necessary to implement Chapter 111, | ||
Occupations Code, as amended by this Act; and | ||
(B) rules as required by Section 254.0035, | ||
Occupations Code, as added by this Act; and | ||
(3) the Health and Human Services Commission shall | ||
adopt rules as required by Section 531.02172, Government Code, as | ||
added by this Act. | ||
SECTION 30. If before implementing any provision of this | ||
Act a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 31. (a) Except as provided by Subsection (b) of | ||
this section, this Act takes effect September 1, 2021. | ||
(b) Sections 1455.004 and 1455.006, Insurance Code, as | ||
amended by this Act, take effect January 1, 2022. |