By: Watson, Davis, Lucio S.B. No. 1484
(In the Senate - Filed March 7, 2013; March 18, 2013, read
first time and referred to Committee on State Affairs;
April 24, 2013, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 5, Nays 4; April 24, 2013,
sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1484 By: Lucio
A BILL TO BE ENTITLED
AN ACT
relating to health benefit plan coverage for enrollees diagnosed
with autism spectrum disorder.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1355.015, Insurance Code, is amended by
amending Subsection (a) and adding Subsection (f) to read as
follows:
(a) At a minimum, a health benefit plan must provide
coverage as provided by this section to an enrollee 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 years of age or
older and continues to need treatment, this subsection does not
preclude coverage of treatment and services described by Subsection
(b)].
(f) To the extent that this section would otherwise require
this state to make a payment under 42 U.S.C. Section
18031(d)(3)(B)(ii), a qualified health plan, as defined by 45
C.F.R. Section 155.20, is not required to provide a benefit under
this section that exceeds the specified essential health benefits
required under 42 U.S.C. Section 18022(b).
SECTION 2. The heading to Section 1355.015, Insurance Code,
is amended to read as follows:
Sec. 1355.015. REQUIRED COVERAGE FOR CERTAIN ENROLLEES
[CHILDREN].
SECTION 3. (a) Subsection (a), Section 1355.015,
Insurance Code, as amended by this Act, applies only to a health
benefit plan that is delivered, issued for delivery, or renewed on
or after the effective date of this Act. A health benefit plan that
is delivered, issued for delivery, or renewed before the effective
date of this Act is covered by the law in effect at the time the
health benefit plan is delivered, issued for delivery, or renewed,
and that law is continued in effect for that purpose.
(b) Subsection (f), Section 1355.015, Insurance Code, as
added by this Act, applies only to a health benefit plan that is
delivered, issued for delivery, or renewed on or after January 1,
2014. A health benefit plan that is delivered, issued for delivery,
or renewed before January 1, 2014, is covered by the law in effect
at the time the health benefit plan is delivered, issued for
delivery, or renewed, and that law is continued in effect for that
purpose.
SECTION 4. This Act takes effect September 1, 2013.
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