Bill Text: TX SB792 | 2019-2020 | 86th Legislature | Comm Sub
Bill Title: Relating to the practice of dentistry and the provision of teledentistry dental services.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Introduced - Dead) 2019-05-16 - Co-author authorized [SB792 Detail]
Download: Texas-2019-SB792-Comm_Sub.html
By: Perry, Flores | S.B. No. 792 | |
(In the Senate - Filed February 12, 2019; March 1, 2019, | ||
read first time and referred to Committee on Health & Human | ||
Services; April 26, 2019, reported adversely, with favorable | ||
Committee Substitute by the following vote: Yeas 9, Nays 0; | ||
April 26, 2019, sent to printer.) | ||
COMMITTEE SUBSTITUTE FOR S.B. No. 792 | By: Perry |
|
||
|
||
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 [ |
||
"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 [ |
||
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) establish that a dentist may delegate to and | ||
supervise through a teledentistry dental service not more than two | ||
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, Occupations Code, is amended by | ||
amending Subsections (a) and (b) and adding Subsection (d) 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 | ||
[ |
||
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 | ||
[ |
||
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. | ||
(b) A practitioner who provides telemedicine medical | ||
services or teledentistry dental services to a patient as described | ||
in Subsection (a)(3) shall: | ||
(1) provide the patient with guidance on appropriate | ||
follow-up care; and | ||
(2) subject to Subsection (d), if the patient consents | ||
and the patient has a primary care physician or a regular dentist, | ||
provide to the patient's primary care physician or regular dentist, | ||
as appropriate, within 72 hours after the practitioner provides the | ||
services to the patient, a clinical [ |
||
report containing an explanation of: | ||
(A) the treatment provided by the practitioner to | ||
the patient; and | ||
(B) as authorized by the law under which the | ||
practitioner is licensed, certified, or otherwise permitted to | ||
provide the service, the practitioner's evaluation, analysis, or | ||
diagnosis[ |
||
(d) A practitioner who provides teledentistry dental | ||
services to a patient as described in Subsection (a)(3): | ||
(1) on the date the practitioner first provides the | ||
teledentistry dental services, shall inform the patient of the | ||
limitation provided by Subdivision (2); and | ||
(2) may only provide teledentistry dental services | ||
with respect to the patient for 12 months unless: | ||
(A) a dentist performs an in-person tactile and | ||
visual examination of the hard and soft tissues of the patient's | ||
oral cavity; and | ||
(B) the practitioner receives notice of the | ||
examination described by Paragraph (A). | ||
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). 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. CERTAIN PRESCRIPTIONS PROHIBITED. (a) In | ||
this section, "controlled substance" and "prescribe" have the | ||
meanings assigned by Section 481.002, Health and Safety Code. | ||
(b) A dentist may not prescribe a controlled substance to a | ||
patient as a teledentistry dental service. | ||
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 | ||
[ |
||
with the requirements for establishing such a relationship in | ||
accordance with Section 111.005. | ||
SECTION 17. Section 531.001, Government Code, is amended by | ||
adding Subdivision (6-a) to read as follows: | ||
(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. | ||
(b) In developing the system, the executive commissioner by | ||
rule shall: | ||
(1) review programs and pilot projects in other states | ||
to determine the most effective method for reimbursement; | ||
(2) establish billing codes and a fee schedule for | ||
services; | ||
(3) consult with the Department of State Health | ||
Services to establish procedures to: | ||
(A) identify clinical evidence supporting | ||
delivery of health care services using a telecommunications system; | ||
and | ||
(B) annually review health care services, | ||
considering new clinical findings, to determine whether | ||
reimbursement for particular services should be denied or | ||
authorized; | ||
(4) establish a separate provider identifier for | ||
telemedicine medical services providers, teledentistry dental | ||
services providers, telehealth services providers, and home | ||
telemonitoring services providers; and | ||
(5) establish a separate modifier for telemedicine | ||
medical services, teledentistry dental services, telehealth | ||
services, and home telemonitoring services eligible for | ||
reimbursement. | ||
(c) The commission shall encourage health care providers | ||
and health care facilities to participate as telemedicine medical | ||
service providers, teledentistry dental service providers, or | ||
telehealth service providers 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 when the service can | ||
reasonably be provided by a physician or a dentist through a | ||
face-to-face consultation with the patient in the community in | ||
which the patient resides or works. This subsection does not | ||
prohibit the authorization of the provision of any service to a | ||
patient through telemedicine medical services, teledentistry | ||
dental services, or telehealth services at the patient's request. | ||
(c-1) Subsection (c) does not prohibit the authorization of | ||
the provision of any service to a patient through teledentistry | ||
dental services if: | ||
(1) the patient requests the service; and | ||
(2) the provision of the service through teledentistry | ||
does not violate the standard of care applicable to the service. | ||
(c-2) The commission shall: | ||
(1) explore opportunities to increase STAR Health | ||
program providers' use of telemedicine medical services in | ||
medically underserved areas of this state; and | ||
(2) encourage STAR Health program providers to use | ||
telemedicine medical services as appropriate. | ||
(d) Subject to Sections 111.004 and [ |
||
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. | ||
(e) The commission may not reimburse a health care facility | ||
for telemedicine medical services, teledentistry dental services, | ||
or telehealth services provided to a Medicaid recipient unless the | ||
facility complies with the minimum standards adopted under Section | ||
531.02161. | ||
(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, and the cost of utilization of | ||
telemedicine medical services, teledentistry dental services, | ||
telehealth services, and home telemonitoring services to Medicaid. | ||
SECTION 19. The heading to Section 531.02161, Government | ||
Code, is amended to read as follows: | ||
Sec. 531.02161. TELEMEDICINE, TELEDENTISTRY, TELEHEALTH, | ||
AND HOME TELEMONITORING TECHNOLOGY STANDARDS. | ||
SECTION 20. Section 531.02161(b), Government Code, is | ||
amended to read as follows: | ||
(b) The executive commissioner by rule shall establish and | ||
adopt minimum standards for an operating system used in the | ||
provision of telemedicine medical services, teledentistry dental | ||
services, telehealth services, or home telemonitoring services by a | ||
health care facility participating in Medicaid, including | ||
standards for electronic transmission, software, and hardware. | ||
SECTION 21. 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 22. Section 531.02162, Government Code, is amended | ||
by amending Subsections (b) and (c) and adding Subsection (d) 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, | ||
[ |
||
[ |
||
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. | ||
(d) The policies established under Subsection (c)(1) may | ||
authorize the provision of a service as a teledentistry dental | ||
service only if the provision of the service through teledentistry | ||
does not violate the standard of care applicable to the service. | ||
SECTION 23. 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 a comparable 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. A service provided as a teledentistry dental service may | ||
only be reimbursed if provision of the service through | ||
teledentistry does not violate the standard of care applicable to | ||
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 24. 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 25. 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 [ |
||
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 26. 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) [ |
||
and "telemedicine medical service" have [ |
||
[ |
||
SECTION 27. The heading to Chapter 1455, Insurance Code, is | ||
amended to read as follows: | ||
CHAPTER 1455. TELEMEDICINE, TELEDENTISTRY, AND TELEHEALTH | ||
SECTION 28. 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 | ||
[ |
||
the meanings assigned by Section 111.001, Occupations Code. | ||
SECTION 29. 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 may not 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. | ||
(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. | ||
(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. | ||
SECTION 30. 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 31. Not later than March 1, 2020: | ||
(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 32. 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 33. (a) Except as provided by Subsection (b) of | ||
this section, this Act takes effect September 1, 2019. | ||
(b) Sections 1455.004 and 1455.006, Insurance Code, as | ||
amended by this Act, take effect January 1, 2020. | ||
* * * * * |