State Codes and Statutes
Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1455-telemedicine-and-telehealth
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE F. PHYSICIANS AND HEALTH CARE PROVIDERS
CHAPTER 1455. TELEMEDICINE AND TELEHEALTH
Sec. 1455.001. DEFINITIONS. In this chapter:
(1) "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 physician in providing telemedicine
medical services that are delegated and supervised by the
physician; or
(C) a licensed or certified health professional acting within
the scope of the license or certification who does not perform a
telemedicine medical service.
(2) "Physician" means a person licensed to practice medicine in
this state under Subtitle B, Title 3, Occupations Code.
(3) "Telehealth service" and "telemedicine medical service" have
the meanings assigned by Section 57.042, Utilities Code.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.002. APPLICABILITY OF CHAPTER. This chapter applies
only to a health benefit plan that:
(1) provides benefits for medical or surgical expenses incurred
as a result of a health condition, accident, or sickness,
including:
(A) an individual, group, blanket, or franchise insurance policy
or insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage that is offered by:
(i) an insurance company;
(ii) a group hospital service corporation operating under
Chapter 842;
(iii) a fraternal benefit society operating under Chapter 885;
(iv) a stipulated premium company operating under Chapter 884;
or
(v) a health maintenance organization operating under Chapter
843; and
(B) to the extent permitted by the Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health
benefit plan that is offered by:
(i) a multiple employer welfare arrangement as defined by
Section 3 of that Act; or
(ii) another analogous benefit arrangement; or
(2) is offered by an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.003. EXCEPTION. This chapter does not apply to:
(1) a plan that provides coverage:
(A) only for a specified disease;
(B) only for accidental death or dismemberment;
(C) for wages or payments in lieu of wages for a period during
which an employee is absent from work because of sickness or
injury; or
(D) as a supplement to a liability insurance policy;
(2) a small employer health benefit plan written under Chapter
1501;
(3) a Medicare supplemental policy as defined by Section
1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(4) a workers' compensation insurance policy;
(5) medical payment insurance coverage provided under a motor
vehicle insurance policy; or
(6) a long-term care insurance policy, including a nursing home
fixed indemnity policy, unless the commissioner determines that
the policy provides benefit coverage so comprehensive that the
policy is a health benefit plan as described by Section 1455.002.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES AND
TELEHEALTH SERVICES. (a) A health benefit plan may not exclude
a telemedicine medical service or a telehealth service from
coverage under the plan solely because the service is not
provided through a face-to-face consultation.
(b) A health benefit plan may require a deductible, a copayment,
or coinsurance for a telemedicine medical 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 a comparable medical service provided
through a face-to-face consultation.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.005. RULES. Subject to Section 111.004, Occupations
Code, the commissioner may adopt rules necessary to implement
this chapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Amended by:
Acts 2005, 79th Leg., Ch.
728, Sec. 23.002(10), eff. September 1, 2005.
State Codes and Statutes
Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1455-telemedicine-and-telehealth
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE F. PHYSICIANS AND HEALTH CARE PROVIDERS
CHAPTER 1455. TELEMEDICINE AND TELEHEALTH
Sec. 1455.001. DEFINITIONS. In this chapter:
(1) "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 physician in providing telemedicine
medical services that are delegated and supervised by the
physician; or
(C) a licensed or certified health professional acting within
the scope of the license or certification who does not perform a
telemedicine medical service.
(2) "Physician" means a person licensed to practice medicine in
this state under Subtitle B, Title 3, Occupations Code.
(3) "Telehealth service" and "telemedicine medical service" have
the meanings assigned by Section 57.042, Utilities Code.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.002. APPLICABILITY OF CHAPTER. This chapter applies
only to a health benefit plan that:
(1) provides benefits for medical or surgical expenses incurred
as a result of a health condition, accident, or sickness,
including:
(A) an individual, group, blanket, or franchise insurance policy
or insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage that is offered by:
(i) an insurance company;
(ii) a group hospital service corporation operating under
Chapter 842;
(iii) a fraternal benefit society operating under Chapter 885;
(iv) a stipulated premium company operating under Chapter 884;
or
(v) a health maintenance organization operating under Chapter
843; and
(B) to the extent permitted by the Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health
benefit plan that is offered by:
(i) a multiple employer welfare arrangement as defined by
Section 3 of that Act; or
(ii) another analogous benefit arrangement; or
(2) is offered by an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.003. EXCEPTION. This chapter does not apply to:
(1) a plan that provides coverage:
(A) only for a specified disease;
(B) only for accidental death or dismemberment;
(C) for wages or payments in lieu of wages for a period during
which an employee is absent from work because of sickness or
injury; or
(D) as a supplement to a liability insurance policy;
(2) a small employer health benefit plan written under Chapter
1501;
(3) a Medicare supplemental policy as defined by Section
1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(4) a workers' compensation insurance policy;
(5) medical payment insurance coverage provided under a motor
vehicle insurance policy; or
(6) a long-term care insurance policy, including a nursing home
fixed indemnity policy, unless the commissioner determines that
the policy provides benefit coverage so comprehensive that the
policy is a health benefit plan as described by Section 1455.002.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES AND
TELEHEALTH SERVICES. (a) A health benefit plan may not exclude
a telemedicine medical service or a telehealth service from
coverage under the plan solely because the service is not
provided through a face-to-face consultation.
(b) A health benefit plan may require a deductible, a copayment,
or coinsurance for a telemedicine medical 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 a comparable medical service provided
through a face-to-face consultation.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.005. RULES. Subject to Section 111.004, Occupations
Code, the commissioner may adopt rules necessary to implement
this chapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Amended by:
Acts 2005, 79th Leg., Ch.
728, Sec. 23.002(10), eff. September 1, 2005.
State Codes and Statutes
Statutes >
Texas >
Insurance-code >
Title-8-health-insurance-and-other-health-coverages >
Chapter-1455-telemedicine-and-telehealth INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE F. PHYSICIANS AND HEALTH CARE PROVIDERS
CHAPTER 1455. TELEMEDICINE AND TELEHEALTH
Sec. 1455.001. DEFINITIONS. In this chapter:
(1) "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 physician in providing telemedicine
medical services that are delegated and supervised by the
physician; or
(C) a licensed or certified health professional acting within
the scope of the license or certification who does not perform a
telemedicine medical service.
(2) "Physician" means a person licensed to practice medicine in
this state under Subtitle B, Title 3, Occupations Code.
(3) "Telehealth service" and "telemedicine medical service" have
the meanings assigned by Section 57.042, Utilities Code.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.002. APPLICABILITY OF CHAPTER. This chapter applies
only to a health benefit plan that:
(1) provides benefits for medical or surgical expenses incurred
as a result of a health condition, accident, or sickness,
including:
(A) an individual, group, blanket, or franchise insurance policy
or insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage that is offered by:
(i) an insurance company;
(ii) a group hospital service corporation operating under
Chapter 842;
(iii) a fraternal benefit society operating under Chapter 885;
(iv) a stipulated premium company operating under Chapter 884;
or
(v) a health maintenance organization operating under Chapter
843; and
(B) to the extent permitted by the Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health
benefit plan that is offered by:
(i) a multiple employer welfare arrangement as defined by
Section 3 of that Act; or
(ii) another analogous benefit arrangement; or
(2) is offered by an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.003. EXCEPTION. This chapter does not apply to:
(1) a plan that provides coverage:
(A) only for a specified disease;
(B) only for accidental death or dismemberment;
(C) for wages or payments in lieu of wages for a period during
which an employee is absent from work because of sickness or
injury; or
(D) as a supplement to a liability insurance policy;
(2) a small employer health benefit plan written under Chapter
1501;
(3) a Medicare supplemental policy as defined by Section
1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(4) a workers' compensation insurance policy;
(5) medical payment insurance coverage provided under a motor
vehicle insurance policy; or
(6) a long-term care insurance policy, including a nursing home
fixed indemnity policy, unless the commissioner determines that
the policy provides benefit coverage so comprehensive that the
policy is a health benefit plan as described by Section 1455.002.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.004. COVERAGE FOR TELEMEDICINE MEDICAL SERVICES AND
TELEHEALTH SERVICES. (a) A health benefit plan may not exclude
a telemedicine medical service or a telehealth service from
coverage under the plan solely because the service is not
provided through a face-to-face consultation.
(b) A health benefit plan may require a deductible, a copayment,
or coinsurance for a telemedicine medical 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 a comparable medical service provided
through a face-to-face consultation.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1455.005. RULES. Subject to Section 111.004, Occupations
Code, the commissioner may adopt rules necessary to implement
this chapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Amended by:
Acts 2005, 79th Leg., Ch.
728, Sec. 23.002(10), eff. September 1, 2005.
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