82R115 AJA-F
By: Zerwas H.B. No. 1644
A BILL TO BE ENTITLED
AN ACT
relating to health benefit plan coverage for certain tests for the
early detection of cardiovascular disease in certain children.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Section 1376.003, Insurance Code,
is amended to read as follows:
Sec. 1376.003. MINIMUM COVERAGE REQUIRED: CERTAIN ADULTS.
SECTION 2. Chapter 1376, Insurance Code, is amended by
adding Section 1376.004 to read as follows:
Sec. 1376.004. MINIMUM COVERAGE REQUIRED: CERTAIN
CHILDREN. (a) A health benefit plan that provides coverage for
screening medical procedures must provide the minimum coverage
required by this section to each covered individual who is older
than 10 years of age and younger than 18 years of age and who:
(1) is a student at a middle school in Texas; or
(2) has not been diagnosed with heart disease and has
not undergone an electrocardiogram or echocardiogram within the
past two years.
(b) The minimum coverage required to be provided under this
section is coverage of up to $150 for the following series of
examinations once every five years, performed by a physician and a
laboratory certified by a national organization recognized by the
commissioner by rule for the purposes of this section, and intended
to detect asymptomatic underlying congenital cardiovascular
conditions that are associated with sudden cardiac arrest in
children, including abnormal structure or function of the heart,
the arteries, or the electrical pathways in the heart:
(1) history documenting personal or family history
associated with sudden cardiac arrest;
(2) focused cardiovascular physical examination for
clues to underlying conditions associated with sudden cardiac
arrest, such as abnormal murmurs and body habitus;
(3) electrocardiogram measuring cardiac electrical
activity and for the detection of those conditions associated with
sudden cardiac arrest; and
(4) limited five-minute echocardiography to detect
those structural cardiovascular conditions associated with sudden
cardiac arrest in children.
SECTION 3. The change in law made by this Act applies only
to a health benefit plan delivered, issued for delivery, or renewed
on or after January 1, 2012. A health benefit plan delivered,
issued for delivery, or renewed before January 1, 2012, is governed
by the law in effect 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, 2011.