81R10200 PMO-D
By: Morrison H.B. No. 3793
A BILL TO BE ENTITLED
AN ACT
relating to establishing a health and wellness initiative program
to reduce health plan costs for certain public employees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter E, Chapter 1551, Insurance Code, is
amended by adding Section 1551.226 to read as follows:
Sec. 1551.226. ESTABLISHMENT OF HEALTH AND WELLNESS
INITIATIVE PROGRAM. (a) In this section:
(1) "Critical illness" means an illness designated by
the board of trustees as a critical illness, including:
(A) a major cancer, Alzheimer's disease,
multiple sclerosis, HIV/AIDS contracted during a blood transfusion
or operation, or Parkinson's disease;
(B) an organ failure or organ transplant;
(C) the loss of independent existence; and
(D) any terminal illness.
(2) "Initiative program" means the health and wellness
initiative program established under this section.
(b) The board of trustees by rule shall design and establish
a health and wellness initiative program. The initiative program
must:
(1) include:
(A) an early detection incentive for individuals
covered by the group benefits program who participate in the
initiative program;
(B) a no-smoking campaign; and
(C) a plan designed to match an individual to a
clinical trial;
(2) encourage an individual who participates in the
initiative program to:
(A) obtain a second opinion from a physician or
other health care provider about:
(i) a diagnosis of cancer or other critical
illness; or
(ii) treatment options; or
(B) visit a certified National Cancer Institute;
(3) from available funds, provide a $100 wellness
benefit to an employee for undergoing eligible screening tests as
designated by the board of trustees; and
(4) be available to individuals covered by the group
benefits program regardless of the individual's health history.
(c) The board of trustees shall establish an Internet
website for the initiative program. The board of trustees may
develop a list of eligible resources and support services, which
may be posted on the website, for individuals diagnosed with cancer
or other critical illness.
(d) The eligible resources and support services designated
under Subsection (c) may provide to individuals diagnosed with
cancer or another critical illness and those individuals' friends
and families:
(1) information about health-related topics,
including:
(A) obtaining a positive prognosis after a
diagnosis;
(B) living a healthy lifestyle; and
(C) reducing the risk of illness;
(2) one-on-one support;
(3) counseling and referrals to other resources; and
(4) information regarding financial and insurance
concerns.
(e) The board of trustees shall periodically update the list
established under Subsection (c).
SECTION 2. Subchapter D, Chapter 1575, Insurance Code, is
amended by adding Section 1575.172 to read as follows:
Sec. 1575.172. ESTABLISHMENT OF HEALTH AND WELLNESS
INITIATIVE PROGRAM. (a) In this section:
(1) "Critical illness" means an illness designated by
the board of trustees as a critical illness, including:
(A) a major cancer, Alzheimer's disease,
multiple sclerosis, HIV/AIDS contracted during a blood transfusion
or operation, or Parkinson's disease;
(B) an organ failure or organ transplant;
(C) the loss of independent existence; and
(D) any terminal illness.
(2) "Initiative program" means the health and wellness
initiative program established under this section.
(b) The trustee by rule shall design and establish a health
and wellness initiative program. The initiative program must:
(1) include:
(A) an early detection incentive for individuals
covered by the group program who participate in the initiative
program;
(B) a no-smoking campaign; and
(C) a plan designed to match an individual to a
clinical trial;
(2) encourage an individual who participates in the
initiative program to:
(A) obtain a second opinion from a physician or
other health care provider about:
(i) a diagnosis of cancer or other critical
illness; or
(ii) treatment options; or
(B) visit a certified National Cancer Institute;
(3) from available funds, provide a $100 wellness
benefit to a retiree for undergoing eligible screening tests as
designated by the trustee; and
(4) be available to individuals covered by the group
program regardless of the individual's health history.
(c) The trustee shall establish an Internet website for the
initiative program. The trustee may develop a list of eligible
resources and support services, which may be posted on the website,
for individuals diagnosed with cancer or other critical illness.
(d) The eligible resources and support services designated
under Subsection (c) may provide to individuals diagnosed with
cancer or another critical illness and those individuals' friends
and families:
(1) information about health-related topics,
including:
(A) obtaining a positive prognosis after a
diagnosis;
(B) living a healthy lifestyle; and
(C) reducing the risk of illness;
(2) one-on-one support;
(3) counseling and referrals to other resources; and
(4) information regarding financial and insurance
concerns.
(e) The trustee shall periodically update the list
established under Subsection (c).
SECTION 3. Subchapter C, Chapter 1579, Insurance Code, is
amended by adding Section 1579.110 to read as follows:
Sec. 1579.110. ESTABLISHMENT OF HEALTH AND WELLNESS
INITIATIVE PROGRAM. (a) In this section:
(1) "Critical illness" means an illness designated by
the board of trustees as a critical illness, including:
(A) a major cancer, Alzheimer's disease,
multiple sclerosis, HIV/AIDS contracted during a blood transfusion
or operation, or Parkinson's disease;
(B) an organ failure or organ transplant;
(C) the loss of independent existence; and
(D) any terminal illness.
(2) "Initiative program" means the health and wellness
initiative program established under this section.
(b) The trustee by rule shall design and establish a health
and wellness initiative program. The initiative program must:
(1) include:
(A) an early detection incentive for individuals
covered by the uniform group coverage program who participate in
the initiative program;
(B) a no-smoking campaign; and
(C) a plan designed to match an individual to a
clinical trial;
(2) encourage an individual who participates in the
initiative program to:
(A) obtain a second opinion from a physician or
other health care provider about:
(i) a diagnosis of cancer or other critical
illness; or
(ii) treatment options; or
(B) visit a certified National Cancer Institute;
(3) from available funds, provide a $100 wellness
benefit to an employee for undergoing eligible screening tests as
designated by the trustee; and
(4) be available to individuals covered by the uniform
group coverage program regardless of the individual's health
history.
(c) The trustee shall establish an Internet website for the
initiative program. The trustee may develop a list of eligible
resources and support services, which may be posted on the website,
for individuals diagnosed with cancer or other critical illness.
(d) The eligible resources and support services designated
under Subsection (c) may provide to individuals diagnosed with
cancer or another critical illness and those individuals' friends
and families:
(1) information about health-related topics,
including:
(A) obtaining a positive prognosis after a
diagnosis;
(B) living a healthy lifestyle; and
(C) reducing the risk of illness;
(2) one-on-one support;
(3) counseling and referrals to other resources; and
(4) information regarding financial and insurance
concerns.
(e) The trustee shall periodically update the list
established under Subsection (c).
SECTION 4. Subchapter C, Chapter 1601, Insurance Code, is
amended by adding Section 1601.112 to read as follows:
Sec. 1601.112. ESTABLISHMENT OF HEALTH AND WELLNESS
INITIATIVE PROGRAM. (a) In this section:
(1) "Critical illness" means an illness designated by
the board of trustees as a critical illness, including:
(A) a major cancer, Alzheimer's disease,
multiple sclerosis, HIV/AIDS contracted during a blood transfusion
or operation, or Parkinson's disease;
(B) an organ failure or organ transplant;
(C) the loss of independent existence; and
(D) any terminal illness.
(2) "Initiative program" means the health and wellness
initiative program established under this section.
(b) Each system by rule shall design and establish a health
and wellness initiative program. The initiative program must:
(1) include:
(A) an early detection incentive for individuals
covered by a uniform program who participate in the initiative
program;
(B) a no-smoking campaign; and
(C) a plan designed to match an individual to a
clinical trial;
(2) encourage an individual who participates in the
initiative program to:
(A) obtain a second opinion from a physician or
other health care provider about:
(i) a diagnosis of cancer or other critical
illness; or
(ii) treatment options; or
(B) visit a certified National Cancer Institute;
(3) from available funds, provide a $100 wellness
benefit to an employee for undergoing eligible screening tests as
designated by the system; and
(4) be available to individuals covered by a uniform
program regardless of the individual's health history.
(c) Each system shall establish an Internet website for the
initiative program. The system may develop a list of eligible
resources and support services, which may be posted on the website,
for individuals diagnosed with cancer or other critical illness.
(d) The eligible resources and support services designated
under Subsection (c) may provide to individuals diagnosed with
cancer or another critical illness and those individuals' friends
and families:
(1) information about health-related topics,
including:
(A) obtaining a positive prognosis after a
diagnosis;
(B) living a healthy lifestyle; and
(C) reducing the risk of illness;
(2) one-on-one support;
(3) counseling and referrals to other resources; and
(4) information regarding financial and insurance
concerns.
(e) Each system shall periodically update the list
established under Subsection (c).
SECTION 5. The changes in law made by this Act apply only to
health benefit plans provided under Chapters 1551, 1575, 1579, and
1601, Insurance Code, beginning with the 2009-2010 plan year. A
plan year before 2009-2010 is governed by the law as it existed
immediately before September 1, 2009, and that law is continued in
effect for that purpose.
SECTION 6. This Act takes effect September 1, 2009.