| 1 | 1 | | 85R1704 MEW-D |
|---|
| 2 | 2 | | By: Anderson of McLennan, Howard, H.B. No. 831 |
|---|
| 3 | 3 | | Davis of Harris, Thompson of Harris, Vo |
|---|
| 4 | 4 | | |
|---|
| 5 | 5 | | |
|---|
| 6 | 6 | | A BILL TO BE ENTITLED |
|---|
| 7 | 7 | | AN ACT |
|---|
| 8 | 8 | | relating to coverage for treatment of craniofacial abnormalities |
|---|
| 9 | 9 | | under certain health benefit plans. |
|---|
| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 11 | 11 | | SECTION 1. Subchapter D, Chapter 1367, Insurance Code, is |
|---|
| 12 | 12 | | amended by adding Section 1367.1535 to read as follows: |
|---|
| 13 | 13 | | Sec. 1367.1535. COVERAGE FOR TREATMENT OF CRANIOFACIAL |
|---|
| 14 | 14 | | ABNORMALITIES. A health benefit plan described by Section 1367.153 |
|---|
| 15 | 15 | | that provides coverage for reconstructive surgery for craniofacial |
|---|
| 16 | 16 | | abnormalities, as defined in accordance with that section, must |
|---|
| 17 | 17 | | provide coverage for the treatment of the primary conditions |
|---|
| 18 | 18 | | constituting craniofacial abnormalities and secondary conditions |
|---|
| 19 | 19 | | related to or arising from craniofacial abnormalities, including: |
|---|
| 20 | 20 | | (1) oral and facial surgery, surgical management, and |
|---|
| 21 | 21 | | follow-up care; |
|---|
| 22 | 22 | | (2) prosthetic treatments, including obturators and |
|---|
| 23 | 23 | | speech and feeding appliances; |
|---|
| 24 | 24 | | (3) orthodontic treatment and management; |
|---|
| 25 | 25 | | (4) preventive and restorative dentistry to ensure |
|---|
| 26 | 26 | | good health and adequate dental structures for orthodontic |
|---|
| 27 | 27 | | treatment or prosthetic management or therapy; |
|---|
| 28 | 28 | | (5) speech-language pathology services, including |
|---|
| 29 | 29 | | evaluation and therapy; |
|---|
| 30 | 30 | | (6) audiological assessments and amplification |
|---|
| 31 | 31 | | devices; |
|---|
| 32 | 32 | | (7) otolaryngological treatment and management; |
|---|
| 33 | 33 | | (8) psychological assessment and counseling; and |
|---|
| 34 | 34 | | (9) genetic assessment counseling for the parents and |
|---|
| 35 | 35 | | child. |
|---|
| 36 | 36 | | SECTION 2. The change in law made by this Act applies only |
|---|
| 37 | 37 | | to a health benefit plan that is delivered, issued for delivery, or |
|---|
| 38 | 38 | | renewed on or after January 1, 2018. A plan delivered, issued for |
|---|
| 39 | 39 | | delivery, or renewed before January 1, 2018, is governed by the law |
|---|
| 40 | 40 | | as it existed immediately before the effective date of this Act, and |
|---|
| 41 | 41 | | that law is continued in effect for that purpose. |
|---|
| 42 | 42 | | SECTION 3. This Act takes effect September 1, 2017. |
|---|