Texas Statutes (Last Updated: January 4, 2014) |
INSURANCE CODE |
Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
Subtitle H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL EMPLOYEES |
Chapter 1551. TEXAS EMPLOYEES GROUP BENEFITS ACT |
Subchapter E. GROUP COVERAGES |
Sec. 1551.219. DISEASE MANAGEMENT SERVICES
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(a) In this section, "disease management services" means services to assist an individual manage a disease or other chronic health condition, such as heart disease, diabetes, respiratory illness, end-stage renal disease, HIV infection, or AIDS, and with respect to which the board of trustees identifies populations requiring disease management.
(b) A group health benefit plan offered under the group benefits program must provide disease management services or coverage for disease management services in the manner required by the board of trustees, including:
(1) patient self-management education;
(2) provider education;
(3) evidence-based models and minimum standards of care;
(4) standardized protocols and participation criteria; and
(5) physician-directed or physician-supervised care.