Texas 2009 - 81st Regular

Texas House Bill HB1121 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R4451 TJS-D
2	2	By: Bolton H.B. No. 1121
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to group health benefit plan coverage for certain mental
8	8	illnesses.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1355.003, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 1355.003. EXCEPTION. [(a)] This subchapter does not
13	13	apply to coverage under:
14	14	(1) a blanket accident and health insurance policy, as
15	15	described by Chapter 1251;
16	16	(2) a short-term travel policy;
17	17	(3) an accident-only policy;
18	18	(4) a limited or specified-disease policy that does
19	19	not provide benefits for mental health care or similar services;
20	20	(5) [except as provided by Subsection (b), a plan
21	21	offered under Chapter 1551 or Chapter 1601;
22	22	[(6)] a plan offered in accordance with Section
23	23	1355.151; or
24	24	(6) [(7)] a Medicare supplement benefit plan, as
25	25	defined by Section 1652.002.
26	26	[(b) For the purposes of a plan described by Subsection
27	27	(a)(5), "serious mental illness" has the meaning assigned by
28	28	Section 1355.001.]
29	29	SECTION 2. Section 1355.004, Insurance Code, is amended to
30	30	read as follows:
31	31	Sec. 1355.004. REQUIRED COVERAGE FOR SERIOUS MENTAL
32	32	ILLNESS; COVERAGE PARITY. (a) A group health benefit plan:
33	33	(1) must provide coverage, based on medical necessity,
34	34	for the diagnosis and treatment of a serious mental illness under
35	35	terms at least as favorable as those provided for the diagnosis and
36	36	treatment of medical and surgical conditions, and in no case [not]
37	37	less than the following treatments [of serious mental illness] in
38	38	each calendar year:
39	39	(A) 45 days of inpatient treatment; and
40	40	(B) 60 visits for outpatient treatment,
41	41	including group and individual outpatient treatment;
42	42	(2) may not include a lifetime limitation on the
43	43	number of days of inpatient treatment or the number of visits for
44	44	outpatient treatment covered under the plan; [and]
45	45	(3) must include the same amount limitations,
46	46	deductibles, copayments, and coinsurance factors for serious
47	47	mental illness as the plan includes for physical illness; and
48	48	(4) may not impose treatment limitations or financial
49	49	requirements on the provision of benefits under this subchapter for
50	50	a serious mental illness if identical limitations or requirements
51	51	are not imposed on coverage of benefits for other medical
52	52	conditions.
53	53	(b) A group health benefit plan issuer:
54	54	(1) may not count an outpatient visit for medication
55	55	management against the number of outpatient visits required to be
56	56	covered under Subsection (a)(1)(B); and
57	57	(2) must provide coverage for an outpatient visit
58	58	described by Subsection (a)(1)(B) under the same terms as the
59	59	coverage the issuer provides for an outpatient visit for the
60	60	treatment of physical illness.
61	61	SECTION 3. The change in law made by this Act applies only
62	62	to a group health benefit plan delivered, issued for delivery, or
63	63	renewed on or after January 1, 2010. A group health benefit plan
64	64	delivered, issued for delivery, or renewed before January 1, 2010,
65	65	is governed by the law as it existed immediately before the
66	66	effective date of this Act, and that law is continued in effect for
67	67	that purpose.
68	68	SECTION 4. This Act takes effect September 1, 2009.