86R24953 SMT-F
By: Lucio III H.B. No. 1410
Substitute the following for H.B. No. 1410:
By: Lucio III C.S.H.B. No. 1410
A BILL TO BE ENTITLED
AN ACT
relating to payment for care provided by a chiropractor under
certain health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter I, Chapter 843, Insurance Code, is
amended by adding Section 843.3042 to read as follows:
Sec. 843.3042. CHIROPRACTIC SERVICES. (a) A health
maintenance organization offering a health care plan that covers a
service that is within the scope of the practice of chiropractic as
described by Section 201.002, Occupations Code, may not refuse to
provide reimbursement to an in-network chiropractor for the
performance of the covered service solely because the service is
provided by a chiropractor.
(b) This section does not require a health maintenance
organization to cover a particular health care service.
(c) This section does not affect the right of a health
maintenance organization to determine whether a health care service
is medically necessary.
SECTION 2. Subchapter B, Chapter 1301, Insurance Code, is
amended by adding Section 1301.0516 to read as follows:
Sec. 1301.0516. CHIROPRACTIC SERVICES. (a) An insurer
offering a preferred provider benefit plan, other than an exclusive
provider benefit plan, that covers a service that is within the
scope of the practice of chiropractic as described by Section
201.002, Occupations Code, may not refuse to provide reimbursement
for the performance of the covered service solely because the
service is provided by a chiropractor.
(b) An insurer offering an exclusive provider benefit plan
that covers a service that is within the scope of the practice of
chiropractic as described by Section 201.002, Occupations Code, may
not refuse to provide reimbursement to a chiropractor who is a
preferred provider for the performance of the covered service
solely because the service is provided by a chiropractor.
(c) This section does not require an insurer to cover a
particular medical or health care service.
(d) This section does not affect the right of an insurer to
determine whether a medical or health care service is medically
necessary.
SECTION 3. The change in law made by this Act applies only
to a health benefit plan that is delivered, issued for delivery, or
renewed on or after January 1, 2020. A health benefit plan that is
delivered, issued for delivery, or renewed before January 1, 2020,
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 4. This Act takes effect September 1, 2019.