86R12011 JES-F
By: J. Johnson of Dallas H.B. No. 2408
A BILL TO BE ENTITLED
AN ACT
relating to preauthorization by certain health benefit plan issuers
of certain benefits.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1356.005, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section may not require preauthorization of a screening
described by Subsection (a).
SECTION 2. Section 1357.004, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section may not require preauthorization of a
reconstruction, surgery, prostheses, or treatment described by
Subsection (a).
SECTION 3. Section 1357.054, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section may not require preauthorization for inpatient
care described by Subsection (a).
SECTION 4. Section 1358.054, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section may not require a qualified enrollee to obtain
preauthorization for diabetes equipment, diabetes supplies, or
self-management training described by Subsection (a).
SECTION 5. Section 1361.003, Insurance Code, is amended to
read as follows:
Sec. 1361.003. COVERAGE REQUIRED. (a) A group health
benefit plan must provide to a qualified enrollee coverage for
medically accepted bone mass measurement to detect low bone mass
and to determine the enrollee's risk of osteoporosis and fractures
associated with osteoporosis.
(b) A group health benefit plan issuer that provides
coverage under this section may not require a qualified enrollee to
obtain preauthorization for a bone mass measurement described by
Subsection (a).
SECTION 6. Section 1362.003, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section to an enrolled male may not require
preauthorization of a diagnostic examination described by
Subsection (a).
SECTION 7. Section 1363.003, Insurance Code, is amended by
adding Subsection (c) to read as follows:
(c) A health benefit plan issuer that provides coverage
under this section may not require preauthorization of a screening
examination described by Subsection (a).
SECTION 8. This Act applies only to a health benefit plan
that is delivered, issued for delivery, or renewed on or after
January 1, 2020.
SECTION 9. This Act takes effect September 1, 2019.