Texas Statutes
Subchapter E. Group Coverages
Section 1551.219. Disease Management Services

Sec. 1551.219. DISEASE MANAGEMENT SERVICES. (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.
Added by Acts 2003, 78th Leg., ch. 589, Sec. 3, eff. June 20, 2003.

Structure Texas Statutes

Texas Statutes

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

Section 1551.201. Establishment

Section 1551.2011. Employee Awareness and Education

Section 1551.202. Authority to Define Basic Coverages

Section 1551.203. Authority to Define Optional Coverages

Section 1551.204. Authority to Define Voluntary Coverages

Section 1551.205. Limitations

Section 1551.206. Cafeteria Plan

Section 1551.207. Premium Conversion Benefit Portion of Cafeteria Plan

Section 1551.208. Determination to Self-Fund

Section 1551.209. Coverage Exempt From Insurance Law

Section 1551.210. Actuarial Advice for Self-Funded Coverage

Section 1551.211. Contingency Reserve Fund for Self-Funded Coverage

Section 1551.212. Firms to Administer Self-Funded Coverage

Section 1551.213. Bids for Purchased Coverage

Section 1551.214. Selection of Bids for Purchased Coverage

Section 1551.215. Accounting by Carrier Providing Purchased Coverage

Section 1551.216. Special Contingency Reserve

Section 1551.217. Use of Employee's Salary in Computation of Premium or Coverage

Section 1551.218. Prior Authorization for Certain Drugs

Section 1551.2181. Exemption From Preauthorization Requirements for Physicians and Health Care Providers Providing Certain Health Care Services

Section 1551.219. Disease Management Services

Section 1551.220. Beneficiary Causing Death of Participant or Beneficiary of Participant

Section 1551.222. Incentive Payments

Section 1551.224. Mail Order Requirement for Prescription Drug Coverage Prohibited

Section 1551.225. Bariatric Surgery Coverage

Section 1551.226. Tobacco Cessation Coverage

Section 1551.227. Tricare Military Health System Supplemental Plan

Section 1551.228. Emergency Care Payments

Section 1551.229. Out-of-Network Facility-Based Provider Payments

Section 1551.230. Out-of-Network Diagnostic Imaging Provider or Laboratory Service Provider Payments