H.B. No. 451
AN ACT
relating to health benefit plan coverage for autism spectrum
disorder.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1355.002, Insurance Code, is amended to
read as follows:
Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This
subchapter applies only to a group health benefit plan that
provides benefits for medical or surgical expenses incurred as a
result of a health condition, accident, or sickness, including:
(1) a group insurance policy, group insurance
agreement, group hospital service contract, or group evidence of
coverage that is offered by:
(A) an insurance company;
(B) a group hospital service corporation
operating under Chapter 842;
(C) a fraternal benefit society operating under
Chapter 885;
(D) a stipulated premium company operating under
Chapter 884; or
(E) a health maintenance organization operating
under Chapter 843; and
(2) to the extent permitted by the Employee Retirement
Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan
offered under:
(A) a multiple employer welfare arrangement as
defined by Section 3 of that Act; or
(B) another analogous benefit arrangement.
(b) Notwithstanding any provision in Chapter 1575 or 1579 or
any other law, Section 1355.015 applies to:
(1) a basic plan under Chapter 1575; and
(2) a primary care coverage plan under Chapter 1579.
SECTION 2. Section 1355.015(a), Insurance Code, is amended
to read as follows:
(a) At a minimum, a health benefit plan must provide
coverage as provided by this section to an enrollee [older than two
years of age and younger than six years of age] who is diagnosed
with autism spectrum disorder from the date of diagnosis until the
enrollee completes nine years of age. If an enrollee who is being
treated for autism spectrum disorder becomes 10 [six] years of age
or older and continues to need treatment, this subsection does not
preclude coverage of treatment and services described by Subsection
(b).
SECTION 3. This Act applies only to a health benefit plan
delivered, issued for delivery, or renewed on or after January 1,
2010. A health benefit plan delivered, issued for delivery, or
renewed before January 1, 2010, is governed by the law as it existed
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2009.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 451 was passed by the House on May 15,
2009, by the following vote: Yeas 144, Nays 0, 1 present, not
voting; that the House refused to concur in Senate amendments to
H.B. No. 451 on May 29, 2009, and requested the appointment of a
conference committee to consider the differences between the two
houses; and that the House adopted the conference committee report
on H.B. No. 451 on May 31, 2009, by the following vote: Yeas 122,
Nays 20, 1 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 451 was passed by the Senate, with
amendments, on May 25, 2009, by the following vote: Yeas 30, Nays
1; at the request of the House, the Senate appointed a conference
committee to consider the differences between the two houses; and
that the Senate adopted the conference committee report on H.B. No.
451 on May 31, 2009, by the following vote: Yeas 30, Nays 1.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor