85R4955 MEW-D
By: Farrar H.B. No. 2603
A BILL TO BE ENTITLED
AN ACT
relating to coverage for serious mental illness under certain group
health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1355.001, Insurance Code, is amended by
amending Subdivision (1) and adding Subdivision (5) to read as
follows:
(1) "Serious mental illness" means the following
psychiatric illnesses as defined by the American Psychiatric
Association in the Diagnostic and Statistical Manual of Mental
Disorders (DSM), fifth edition, or a later edition adopted by the
commissioner:
(A) bipolar disorders (hypomanic, manic,
depressive, and mixed);
(B) depression in childhood and adolescence;
(C) major depressive disorders (single episode
or recurrent);
(D) obsessive-compulsive disorders;
(E) paranoid and other psychotic disorders;
(F) posttraumatic stress disorder;
(G) schizo-affective disorders (bipolar or
depressive); and
(H) [(G)] schizophrenia.
(5) "Posttraumatic stress disorder" means a disorder
that:
(A) meets the diagnostic criteria for
posttraumatic stress disorder specified by the American
Psychiatric Association in the Diagnostic and Statistical Manual of
Mental Disorders, fifth edition, or a later edition adopted by the
commissioner; and
(B) results in an impairment of a person's
functioning in the person's community, employment, family, school,
or social group.
SECTION 2. The heading to Section 1355.003, Insurance Code,
is amended to read as follows:
Sec. 1355.003. EXCEPTIONS [EXCEPTION].
SECTION 3. Section 1355.003, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) This subchapter, or the applicable portion of this
subchapter, does not apply to a qualified health plan to the extent
that a determination is made under 45 C.F.R. Section 155.170 that:
(1) this subchapter or a portion of this subchapter
requires the plan to offer benefits in addition to the essential
health benefits required under 42 U.S.C. Section 18022(b); and
(2) this state is required to defray the cost of the
benefits mandated under this subchapter or a portion of this
subchapter.
SECTION 4. The change in law made by this Act applies only
to a group health benefit plan that is delivered, issued for
delivery, or renewed on or after January 1, 2018. A group health
benefit plan that is delivered, issued for delivery, or renewed
before January 1, 2018, 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 5. This Act takes effect September 1, 2017.