| 1 | 1 | | 81R5646 AJA-D |
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| 2 | 2 | | By: Farabee H.B. No. 868 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to health benefit plan coverage for certain mental |
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| 8 | 8 | | disorders. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 1355.001(1), Insurance Code, is amended |
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| 11 | 11 | | to read as follows: |
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| 12 | 12 | | (1) "Serious mental illness" means the following |
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| 13 | 13 | | psychiatric illnesses as defined by the American Psychiatric |
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| 14 | 14 | | Association in the Diagnostic and Statistical Manual (DSM): |
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| 15 | 15 | | (A) bipolar disorders (hypomanic, manic, |
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| 16 | 16 | | depressive, and mixed); |
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| 17 | 17 | | (B) depression in childhood and adolescence; |
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| 18 | 18 | | (C) major depressive disorders (single episode |
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| 19 | 19 | | or recurrent); |
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| 20 | 20 | | (D) obsessive-compulsive disorders; |
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| 21 | 21 | | (E) paranoid and other psychotic disorders; |
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| 22 | 22 | | (F) schizo-affective disorders (bipolar or |
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| 23 | 23 | | depressive); [and] |
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| 24 | 24 | | (G) schizophrenia; and |
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| 25 | 25 | | (H) anorexia nervosa and bulimia nervosa. |
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| 26 | 26 | | SECTION 2. Section 1355.007, Insurance Code, is amended to |
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| 27 | 27 | | read as follows: |
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| 28 | 28 | | Sec. 1355.007. SMALL EMPLOYER COVERAGE. (a) An issuer of |
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| 29 | 29 | | a group health benefit plan to a small employer must offer the |
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| 30 | 30 | | coverage described by Section 1355.004 to the employer but is not |
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| 31 | 31 | | required to provide the coverage if the employer rejects the |
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| 32 | 32 | | coverage. |
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| 33 | 33 | | (b) Regardless of whether a small employer accepts the |
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| 34 | 34 | | coverage required by Subsection (a), an issuer of a group health |
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| 35 | 35 | | benefit plan to a small employer must provide the coverage required |
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| 36 | 36 | | by Section 1355.004 for persons under the age of 19 years for the |
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| 37 | 37 | | following psychiatric illnesses as defined by the American |
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| 38 | 38 | | Psychiatric Association in the Diagnostic and Statistical Manual |
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| 39 | 39 | | (DSM): |
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| 40 | 40 | | (1) depression in childhood and adolescence; and |
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| 41 | 41 | | (2) anorexia nervosa and bulimia nervosa. |
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| 42 | 42 | | SECTION 3. (a) On or before September 1, 2014, the Sunset |
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| 43 | 43 | | Advisory Commission shall conduct a study to determine: |
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| 44 | 44 | | (1) to what extent the health benefit plan coverage |
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| 45 | 45 | | required by the change in law made by this Act to Chapter 1355, |
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| 46 | 46 | | Insurance Code, is being used by enrollees in health benefit plans |
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| 47 | 47 | | to which those articles apply; and |
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| 48 | 48 | | (2) the impact of the required coverage on the cost of |
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| 49 | 49 | | those health benefit plans. |
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| 50 | 50 | | (b) The Sunset Advisory Commission shall report its |
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| 51 | 51 | | findings under this section to the legislature on or before January |
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| 52 | 52 | | 1, 2015. |
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| 53 | 53 | | (c) The Texas Department of Insurance and any other state |
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| 54 | 54 | | agency shall cooperate with the Sunset Advisory Commission as |
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| 55 | 55 | | necessary to implement this section. |
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| 56 | 56 | | SECTION 4. This Act applies only to a health benefit plan |
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| 57 | 57 | | delivered, issued for delivery, or renewed on or after January 1, |
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| 58 | 58 | | 2010. A health benefit plan delivered, issued for delivery, or |
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| 59 | 59 | | renewed before January 1, 2010, is governed by the law as it existed |
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| 60 | 60 | | immediately before the effective date of this Act, and that law is |
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| 61 | 61 | | continued in effect for that purpose. |
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| 62 | 62 | | SECTION 5. This Act takes effect September 1, 2009. |
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