83R10411 KFF-F
By: Deuell S.B. No. 1764
A BILL TO BE ENTITLED
AN ACT
relating to the provision of a cranial molding orthosis under the
medical assistance and child health plan programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter D, Chapter 62, Health and Safety
Code, is amended by adding Section 62.1511 to read as follows:
Sec. 62.1511. CHILD HEALTH PLAN COVERAGE FOR CRANIAL
MOLDING ORTHOSIS. (a) Subject to the requirements of this section,
the child health plan must provide a cranial molding orthosis as a
covered benefit for a child health plan enrollee who is at least 3
months of age but younger than 18 months of age.
(b) To qualify for coverage as a child health plan benefit,
a cranial molding orthosis must be:
(1) medically necessary, as established by
demonstrating that the child health plan enrollee has a cranial
vault asymmetry index of at least 6.25 or a cephalic index that is
at least two standard deviations above or below the age-adjusted
mean for the enrollee; and
(2) used as part of:
(A) a nonsurgical treatment program if the
enrollee is diagnosed with plagiocephaly, brachycephaly, or
scaphocephaly; or
(B) a surgical treatment program if the cranial
remolding orthosis is for postsurgical use to address additional
cranial deformities, including craniosynostosis.
SECTION 2. Section 32.024, Human Resources Code, is amended
by adding Subsection (kk) to read as follows:
(kk) Subject to the requirements of this subsection, the
department shall provide medical assistance for a cranial molding
orthosis for a child who is at least 3 months of age but younger than
18 months of age. The cranial molding orthosis must be:
(1) medically necessary, as established by
demonstrating that the recipient has a cranial vault asymmetry
index of at least 6.25 or a cephalic index that is at least two
standard deviations above or below the age-adjusted mean for the
recipient; and
(2) used as part of:
(A) a nonsurgical treatment program if the
recipient is diagnosed with plagiocephaly, brachycephaly, or
scaphocephaly; or
(B) a surgical treatment program if the cranial
remolding orthosis is for postsurgical use to address additional
cranial deformities, including craniosynostosis.
SECTION 3. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 4. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2013.