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Tex. Insurance Code § 1575.164

DISEASE MANAGEMENT SERVICES

Texas · Texas Insurance Code · Status: effective

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Tex. Insurance Code § 1575.164, DISEASE MANAGEMENT SERVICES, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/683054
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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 Teacher Retirement System of Texas identifies populations requiring disease management. (b) A health benefit plan provided under this chapter, other than a Medicare Advantage plan or a Medicare prescription drug plan, must provide disease management services or coverage for disease management services in the manner required by the Teacher Retirement System of Texas, 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.