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You are here: Home . bulletins . 1998 . b-0016-8
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COMMISSIONER'S BULLETIN # B-0016-98

February 19, 1998


To: All Insurers Licensed to Write Accident and Health Insurance and Health Maintenance Organizations (HMOs) and Multiple Employer Welfare Arrangements as defined by Section 3, Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1002) (MEWA)


Re: Legislation Enacted - 75th Legislative Session, HB 2033 (Article 21.53F, Texas Insurance Code) relating to coverage for services provided through telemedicine under certain health benefit plans

NOTE:THIS BULLETIN SHOULD BE FORWARDED TO THE APPROPRIATE STAFF IN CHARGE OF DATA COLLECTING AND REPORTING)

The Texas Department of Insurance periodically sends out a data call survey form to collect information from health benefit plans. The purpose of this bulletin is to notify you of certain additional information concerning telemedicine that should be maintained for purposes of reporting to the Texas Department of Insurance on this survey form. This additional data will be used to monitor the utilization, accessibility and availability of health care services related to telemedicine. Each insurer, HMO, and MEWA subject to Texas Insurance Code, Article 21.53F, concerning Telemedicine, shall maintain records regarding the utilization of telemedicine services. Data which should be collected and maintained for each calendar year beginning no later than May 1, 1998, should include the following:

  • the total dollar amount of telemedicine claims/medical expenses paid;
  • the total number of telemedicine encounters;
  • the total dollar amount of claims/medical expenses paid to each provider/physician by physician/provider number and zip code where the patient receives care; and,
  • the total number of telemedicine encounters by physician/provider number and zip code where the patient receives care.

For purposes of future reporting, data should be collected in a manner that will allow you to report only on individuals covered under policies and evidences of coverage issued in Texas and on Texas certificate holders covered under a group health benefit plan issued outside the State of Texas.

You are responsible for implementing changes to comply with the new statute including collecting and reporting the specified data as required. A data form will be provided by the Texas Department of Insurance at a later date for reporting purposes.

If you have any questions concerning this bulletin, please contact Dianne Longley, Insurance Director, Life/Health Group, (512) 305-7298 at the Texas Department of Insurance.



____________________________

ELTON BOMER

COMMISSIONER OF INSURANCE



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