Texas 2009 - 81st Regular

Texas House Bill HB3793 Compare Versions

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

Old	New	Differences
1	1	81R10200 PMO-D
2	2	By: Morrison H.B. No. 3793
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to establishing a health and wellness initiative program
8	8	to reduce health plan costs for certain public employees.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter E, Chapter 1551, Insurance Code, is
11	11	amended by adding Section 1551.226 to read as follows:
12	12	Sec. 1551.226. ESTABLISHMENT OF HEALTH AND WELLNESS
13	13	INITIATIVE PROGRAM. (a) In this section:
14	14	(1) "Critical illness" means an illness designated by
15	15	the board of trustees as a critical illness, including:
16	16	(A) a major cancer, Alzheimer's disease,
17	17	multiple sclerosis, HIV/AIDS contracted during a blood transfusion
18	18	or operation, or Parkinson's disease;
19	19	(B) an organ failure or organ transplant;
20	20	(C) the loss of independent existence; and
21	21	(D) any terminal illness.
22	22	(2) "Initiative program" means the health and wellness
23	23	initiative program established under this section.
24	24	(b) The board of trustees by rule shall design and establish
25	25	a health and wellness initiative program. The initiative program
26	26	must:
27	27	(1) include:
28	28	(A) an early detection incentive for individuals
29	29	covered by the group benefits program who participate in the
30	30	initiative program;
31	31	(B) a no-smoking campaign; and
32	32	(C) a plan designed to match an individual to a
33	33	clinical trial;
34	34	(2) encourage an individual who participates in the
35	35	initiative program to:
36	36	(A) obtain a second opinion from a physician or
37	37	other health care provider about:
38	38	(i) a diagnosis of cancer or other critical
39	39	illness; or
40	40	(ii) treatment options; or
41	41	(B) visit a certified National Cancer Institute;
42	42	(3) from available funds, provide a $100 wellness
43	43	benefit to an employee for undergoing eligible screening tests as
44	44	designated by the board of trustees; and
45	45	(4) be available to individuals covered by the group
46	46	benefits program regardless of the individual's health history.
47	47	(c) The board of trustees shall establish an Internet
48	48	website for the initiative program. The board of trustees may
49	49	develop a list of eligible resources and support services, which
50	50	may be posted on the website, for individuals diagnosed with cancer
51	51	or other critical illness.
52	52	(d) The eligible resources and support services designated
53	53	under Subsection (c) may provide to individuals diagnosed with
54	54	cancer or another critical illness and those individuals' friends
55	55	and families:
56	56	(1) information about health-related topics,
57	57	including:
58	58	(A) obtaining a positive prognosis after a
59	59	diagnosis;
60	60	(B) living a healthy lifestyle; and
61	61	(C) reducing the risk of illness;
62	62	(2) one-on-one support;
63	63	(3) counseling and referrals to other resources; and
64	64	(4) information regarding financial and insurance
65	65	concerns.
66	66	(e) The board of trustees shall periodically update the list
67	67	established under Subsection (c).
68	68	SECTION 2. Subchapter D, Chapter 1575, Insurance Code, is
69	69	amended by adding Section 1575.172 to read as follows:
70	70	Sec. 1575.172. ESTABLISHMENT OF HEALTH AND WELLNESS
71	71	INITIATIVE PROGRAM. (a) In this section:
72	72	(1) "Critical illness" means an illness designated by
73	73	the board of trustees as a critical illness, including:
74	74	(A) a major cancer, Alzheimer's disease,
75	75	multiple sclerosis, HIV/AIDS contracted during a blood transfusion
76	76	or operation, or Parkinson's disease;
77	77	(B) an organ failure or organ transplant;
78	78	(C) the loss of independent existence; and
79	79	(D) any terminal illness.
80	80	(2) "Initiative program" means the health and wellness
81	81	initiative program established under this section.
82	82	(b) The trustee by rule shall design and establish a health
83	83	and wellness initiative program. The initiative program must:
84	84	(1) include:
85	85	(A) an early detection incentive for individuals
86	86	covered by the group program who participate in the initiative
87	87	program;
88	88	(B) a no-smoking campaign; and
89	89	(C) a plan designed to match an individual to a
90	90	clinical trial;
91	91	(2) encourage an individual who participates in the
92	92	initiative program to:
93	93	(A) obtain a second opinion from a physician or
94	94	other health care provider about:
95	95	(i) a diagnosis of cancer or other critical
96	96	illness; or
97	97	(ii) treatment options; or
98	98	(B) visit a certified National Cancer Institute;
99	99	(3) from available funds, provide a $100 wellness
100	100	benefit to a retiree for undergoing eligible screening tests as
101	101	designated by the trustee; and
102	102	(4) be available to individuals covered by the group
103	103	program regardless of the individual's health history.
104	104	(c) The trustee shall establish an Internet website for the
105	105	initiative program. The trustee may develop a list of eligible
106	106	resources and support services, which may be posted on the website,
107	107	for individuals diagnosed with cancer or other critical illness.
108	108	(d) The eligible resources and support services designated
109	109	under Subsection (c) may provide to individuals diagnosed with
110	110	cancer or another critical illness and those individuals' friends
111	111	and families:
112	112	(1) information about health-related topics,
113	113	including:
114	114	(A) obtaining a positive prognosis after a
115	115	diagnosis;
116	116	(B) living a healthy lifestyle; and
117	117	(C) reducing the risk of illness;
118	118	(2) one-on-one support;
119	119	(3) counseling and referrals to other resources; and
120	120	(4) information regarding financial and insurance
121	121	concerns.
122	122	(e) The trustee shall periodically update the list
123	123	established under Subsection (c).
124	124	SECTION 3. Subchapter C, Chapter 1579, Insurance Code, is
125	125	amended by adding Section 1579.110 to read as follows:
126	126	Sec. 1579.110. ESTABLISHMENT OF HEALTH AND WELLNESS
127	127	INITIATIVE PROGRAM. (a) In this section:
128	128	(1) "Critical illness" means an illness designated by
129	129	the board of trustees as a critical illness, including:
130	130	(A) a major cancer, Alzheimer's disease,
131	131	multiple sclerosis, HIV/AIDS contracted during a blood transfusion
132	132	or operation, or Parkinson's disease;
133	133	(B) an organ failure or organ transplant;
134	134	(C) the loss of independent existence; and
135	135	(D) any terminal illness.
136	136	(2) "Initiative program" means the health and wellness
137	137	initiative program established under this section.
138	138	(b) The trustee by rule shall design and establish a health
139	139	and wellness initiative program. The initiative program must:
140	140	(1) include:
141	141	(A) an early detection incentive for individuals
142	142	covered by the uniform group coverage program who participate in
143	143	the initiative program;
144	144	(B) a no-smoking campaign; and
145	145	(C) a plan designed to match an individual to a
146	146	clinical trial;
147	147	(2) encourage an individual who participates in the
148	148	initiative program to:
149	149	(A) obtain a second opinion from a physician or
150	150	other health care provider about:
151	151	(i) a diagnosis of cancer or other critical
152	152	illness; or
153	153	(ii) treatment options; or
154	154	(B) visit a certified National Cancer Institute;
155	155	(3) from available funds, provide a $100 wellness
156	156	benefit to an employee for undergoing eligible screening tests as
157	157	designated by the trustee; and
158	158	(4) be available to individuals covered by the uniform
159	159	group coverage program regardless of the individual's health
160	160	history.
161	161	(c) The trustee shall establish an Internet website for the
162	162	initiative program. The trustee may develop a list of eligible
163	163	resources and support services, which may be posted on the website,
164	164	for individuals diagnosed with cancer or other critical illness.
165	165	(d) The eligible resources and support services designated
166	166	under Subsection (c) may provide to individuals diagnosed with
167	167	cancer or another critical illness and those individuals' friends
168	168	and families:
169	169	(1) information about health-related topics,
170	170	including:
171	171	(A) obtaining a positive prognosis after a
172	172	diagnosis;
173	173	(B) living a healthy lifestyle; and
174	174	(C) reducing the risk of illness;
175	175	(2) one-on-one support;
176	176	(3) counseling and referrals to other resources; and
177	177	(4) information regarding financial and insurance
178	178	concerns.
179	179	(e) The trustee shall periodically update the list
180	180	established under Subsection (c).
181	181	SECTION 4. Subchapter C, Chapter 1601, Insurance Code, is
182	182	amended by adding Section 1601.112 to read as follows:
183	183	Sec. 1601.112. ESTABLISHMENT OF HEALTH AND WELLNESS
184	184	INITIATIVE PROGRAM. (a) In this section:
185	185	(1) "Critical illness" means an illness designated by
186	186	the board of trustees as a critical illness, including:
187	187	(A) a major cancer, Alzheimer's disease,
188	188	multiple sclerosis, HIV/AIDS contracted during a blood transfusion
189	189	or operation, or Parkinson's disease;
190	190	(B) an organ failure or organ transplant;
191	191	(C) the loss of independent existence; and
192	192	(D) any terminal illness.
193	193	(2) "Initiative program" means the health and wellness
194	194	initiative program established under this section.
195	195	(b) Each system by rule shall design and establish a health
196	196	and wellness initiative program. The initiative program must:
197	197	(1) include:
198	198	(A) an early detection incentive for individuals
199	199	covered by a uniform program who participate in the initiative
200	200	program;
201	201	(B) a no-smoking campaign; and
202	202	(C) a plan designed to match an individual to a
203	203	clinical trial;
204	204	(2) encourage an individual who participates in the
205	205	initiative program to:
206	206	(A) obtain a second opinion from a physician or
207	207	other health care provider about:
208	208	(i) a diagnosis of cancer or other critical
209	209	illness; or
210	210	(ii) treatment options; or
211	211	(B) visit a certified National Cancer Institute;
212	212	(3) from available funds, provide a $100 wellness
213	213	benefit to an employee for undergoing eligible screening tests as
214	214	designated by the system; and
215	215	(4) be available to individuals covered by a uniform
216	216	program regardless of the individual's health history.
217	217	(c) Each system shall establish an Internet website for the
218	218	initiative program. The system may develop a list of eligible
219	219	resources and support services, which may be posted on the website,
220	220	for individuals diagnosed with cancer or other critical illness.
221	221	(d) The eligible resources and support services designated
222	222	under Subsection (c) may provide to individuals diagnosed with
223	223	cancer or another critical illness and those individuals' friends
224	224	and families:
225	225	(1) information about health-related topics,
226	226	including:
227	227	(A) obtaining a positive prognosis after a
228	228	diagnosis;
229	229	(B) living a healthy lifestyle; and
230	230	(C) reducing the risk of illness;
231	231	(2) one-on-one support;
232	232	(3) counseling and referrals to other resources; and
233	233	(4) information regarding financial and insurance
234	234	concerns.
235	235	(e) Each system shall periodically update the list
236	236	established under Subsection (c).
237	237	SECTION 5. The changes in law made by this Act apply only to
238	238	health benefit plans provided under Chapters 1551, 1575, 1579, and
239	239	1601, Insurance Code, beginning with the 2009-2010 plan year. A
240	240	plan year before 2009-2010 is governed by the law as it existed
241	241	immediately before September 1, 2009, and that law is continued in
242	242	effect for that purpose.
243	243	SECTION 6. This Act takes effect September 1, 2009.