1 | 1 | | H.B. No. 451 |
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2 | 2 | | |
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3 | 3 | | |
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4 | 4 | | AN ACT |
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5 | 5 | | relating to health benefit plan coverage for autism spectrum |
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6 | 6 | | disorder. |
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7 | 7 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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8 | 8 | | SECTION 1. Section 1355.002, Insurance Code, is amended to |
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9 | 9 | | read as follows: |
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10 | 10 | | Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This |
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11 | 11 | | subchapter applies only to a group health benefit plan that |
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12 | 12 | | provides benefits for medical or surgical expenses incurred as a |
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13 | 13 | | result of a health condition, accident, or sickness, including: |
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14 | 14 | | (1) a group insurance policy, group insurance |
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15 | 15 | | agreement, group hospital service contract, or group evidence of |
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16 | 16 | | coverage that is offered by: |
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17 | 17 | | (A) an insurance company; |
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18 | 18 | | (B) a group hospital service corporation |
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19 | 19 | | operating under Chapter 842; |
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20 | 20 | | (C) a fraternal benefit society operating under |
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21 | 21 | | Chapter 885; |
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22 | 22 | | (D) a stipulated premium company operating under |
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23 | 23 | | Chapter 884; or |
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24 | 24 | | (E) a health maintenance organization operating |
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25 | 25 | | under Chapter 843; and |
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26 | 26 | | (2) to the extent permitted by the Employee Retirement |
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27 | 27 | | Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan |
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28 | 28 | | offered under: |
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29 | 29 | | (A) a multiple employer welfare arrangement as |
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30 | 30 | | defined by Section 3 of that Act; or |
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31 | 31 | | (B) another analogous benefit arrangement. |
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32 | 32 | | (b) Notwithstanding any provision in Chapter 1575 or 1579 or |
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33 | 33 | | any other law, Section 1355.015 applies to: |
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34 | 34 | | (1) a basic plan under Chapter 1575; and |
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35 | 35 | | (2) a primary care coverage plan under Chapter 1579. |
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36 | 36 | | SECTION 2. Section 1355.015(a), Insurance Code, is amended |
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37 | 37 | | to read as follows: |
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38 | 38 | | (a) At a minimum, a health benefit plan must provide |
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39 | 39 | | coverage as provided by this section to an enrollee [older than two |
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40 | 40 | | years of age and younger than six years of age] who is diagnosed |
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41 | 41 | | with autism spectrum disorder from the date of diagnosis until the |
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42 | 42 | | enrollee completes nine years of age. If an enrollee who is being |
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43 | 43 | | treated for autism spectrum disorder becomes 10 [six] years of age |
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44 | 44 | | or older and continues to need treatment, this subsection does not |
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45 | 45 | | preclude coverage of treatment and services described by Subsection |
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46 | 46 | | (b). |
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47 | 47 | | SECTION 3. This Act applies only to a health benefit plan |
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48 | 48 | | delivered, issued for delivery, or renewed on or after January 1, |
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49 | 49 | | 2010. A health benefit plan delivered, issued for delivery, or |
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50 | 50 | | renewed before January 1, 2010, is governed by the law as it existed |
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51 | 51 | | immediately before the effective date of this Act, and that law is |
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52 | 52 | | continued in effect for that purpose. |
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53 | 53 | | SECTION 4. This Act takes effect September 1, 2009. |
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54 | 54 | | ______________________________ ______________________________ |
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55 | 55 | | President of the Senate Speaker of the House |
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56 | 56 | | I certify that H.B. No. 451 was passed by the House on May 15, |
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57 | 57 | | 2009, by the following vote: Yeas 144, Nays 0, 1 present, not |
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58 | 58 | | voting; that the House refused to concur in Senate amendments to |
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59 | 59 | | H.B. No. 451 on May 29, 2009, and requested the appointment of a |
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60 | 60 | | conference committee to consider the differences between the two |
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61 | 61 | | houses; and that the House adopted the conference committee report |
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62 | 62 | | on H.B. No. 451 on May 31, 2009, by the following vote: Yeas 122, |
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63 | 63 | | Nays 20, 1 present, not voting. |
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64 | 64 | | ______________________________ |
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65 | 65 | | Chief Clerk of the House |
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66 | 66 | | I certify that H.B. No. 451 was passed by the Senate, with |
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67 | 67 | | amendments, on May 25, 2009, by the following vote: Yeas 30, Nays |
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68 | 68 | | 1; at the request of the House, the Senate appointed a conference |
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69 | 69 | | committee to consider the differences between the two houses; and |
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70 | 70 | | that the Senate adopted the conference committee report on H.B. No. |
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71 | 71 | | 451 on May 31, 2009, by the following vote: Yeas 30, Nays 1. |
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72 | 72 | | ______________________________ |
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73 | 73 | | Secretary of the Senate |
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74 | 74 | | APPROVED: __________________ |
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75 | 75 | | Date |
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76 | 76 | | __________________ |
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77 | 77 | | Governor |
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