| Old | New | Differences | |
|---|---|---|---|
| 1 | - | 86R21993 JES-F | |
| 2 | - | By: J. Johnson of Dallas, et al. H.B. No. 2408 | |
| 3 | - | Substitute the following for H.B. No. 2408: | |
| 4 | - | By: Lucio III C.S.H.B. No. 2408 | |
| 1 | + | 86R12011 JES-F | |
| 2 | + | By: J. Johnson of Dallas H.B. No. 2408 | |
| 5 | 3 | ||
| 6 | 4 | ||
| 7 | 5 | A BILL TO BE ENTITLED | |
| 8 | 6 | AN ACT | |
| 9 | 7 | relating to preauthorization by certain health benefit plan issuers | |
| 10 | 8 | of certain benefits. | |
| 11 | 9 | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | |
| 12 | 10 | SECTION 1. Section 1356.005, Insurance Code, is amended by | |
| 13 | 11 | adding Subsection (c) to read as follows: | |
| 14 | 12 | (c) A health benefit plan issuer that provides coverage | |
| 15 | - | under this section may not require preauthorization for a screening | |
| 16 | - | described by Subsection (a). This subsection may not be construed | |
| 17 | - | to authorize a physician or other health care provider to provide | |
| 18 | - | the medical care or health care described by this section if | |
| 19 | - | providing the care is outside of the scope of the individual's | |
| 20 | - | applicable license. | |
| 13 | + | under this section may not require preauthorization of a screening | |
| 14 | + | described by Subsection (a). | |
| 21 | 15 | SECTION 2. Section 1357.004, Insurance Code, is amended by | |
| 22 | 16 | adding Subsection (c) to read as follows: | |
| 23 | 17 | (c) A health benefit plan issuer that provides coverage | |
| 24 | - | under this section may not require preauthorization | |
| 18 | + | under this section may not require preauthorization of a | |
| 25 | 19 | reconstruction, surgery, prostheses, or treatment described by | |
| 26 | - | Subsection (a). This subsection may not be construed to authorize a | |
| 27 | - | physician or other health care provider to provide the medical care | |
| 28 | - | or health care described by this section if providing the care is | |
| 29 | - | outside of the scope of the individual's applicable license. | |
| 20 | + | Subsection (a). | |
| 30 | 21 | SECTION 3. Section 1357.054, Insurance Code, is amended by | |
| 31 | 22 | adding Subsection (c) to read as follows: | |
| 32 | 23 | (c) A health benefit plan issuer that provides coverage | |
| 33 | 24 | under this section may not require preauthorization for inpatient | |
| 34 | - | care described by Subsection (a). This subsection may not be | |
| 35 | - | construed to authorize a physician or other health care provider to | |
| 36 | - | provide the medical care or health care described by this section if | |
| 37 | - | providing the care is outside of the scope of the individual's | |
| 38 | - | applicable license. | |
| 25 | + | care described by Subsection (a). | |
| 39 | 26 | SECTION 4. Section 1358.054, Insurance Code, is amended by | |
| 40 | 27 | adding Subsection (c) to read as follows: | |
| 41 | 28 | (c) A health benefit plan issuer that provides coverage | |
| 42 | - | under this section may not require preauthorization for the | |
| 43 | - | provision to a qualified enrollee of diabetes equipment, diabetes | |
| 44 | - | supplies, or self-management training described by Subsection (a). | |
| 45 | - | This subsection may not be construed to authorize a physician or | |
| 46 | - | other health care provider to provide the medical care or health | |
| 47 | - | care described by this section if providing the care is outside of | |
| 48 | - | the scope of the individual's applicable license. | |
| 29 | + | under this section may not require a qualified enrollee to obtain | |
| 30 | + | preauthorization for diabetes equipment, diabetes supplies, or | |
| 31 | + | self-management training described by Subsection (a). | |
| 49 | 32 | SECTION 5. Section 1361.003, Insurance Code, is amended to | |
| 50 | 33 | read as follows: | |
| 51 | 34 | Sec. 1361.003. COVERAGE REQUIRED. (a) A group health | |
| 52 | 35 | benefit plan must provide to a qualified enrollee coverage for | |
| 53 | 36 | medically accepted bone mass measurement to detect low bone mass | |
| 54 | 37 | and to determine the enrollee's risk of osteoporosis and fractures | |
| 55 | 38 | associated with osteoporosis. | |
| 56 | 39 | (b) A group health benefit plan issuer that provides | |
| 57 | - | coverage under this section may not require preauthorization for | |
| 58 | - | the provision to a qualified enrollee of a bone mass measurement | |
| 59 | - | described by Subsection (a). This subsection may not be construed | |
| 60 | - | to authorize a physician or other health care provider to provide | |
| 61 | - | the medical care or health care described by this section if | |
| 62 | - | providing the care is outside of the scope of the individual's | |
| 63 | - | applicable license. | |
| 40 | + | coverage under this section may not require a qualified enrollee to | |
| 41 | + | obtain preauthorization for a bone mass measurement described by | |
| 42 | + | Subsection (a). | |
| 64 | 43 | SECTION 6. Section 1362.003, Insurance Code, is amended by | |
| 65 | 44 | adding Subsection (c) to read as follows: | |
| 66 | 45 | (c) A health benefit plan issuer that provides coverage | |
| 67 | 46 | under this section to an enrolled male may not require | |
| 68 | - | preauthorization for a diagnostic examination described by | |
| 69 | - | Subsection (a). This subsection may not be construed to authorize a | |
| 70 | - | physician or other health care provider to provide the medical care | |
| 71 | - | or health care described by this section if providing the care is | |
| 72 | - | outside of the scope of the individual's applicable license. | |
| 47 | + | preauthorization of a diagnostic examination described by | |
| 48 | + | Subsection (a). | |
| 73 | 49 | SECTION 7. Section 1363.003, Insurance Code, is amended by | |
| 74 | 50 | adding Subsection (c) to read as follows: | |
| 75 | 51 | (c) A health benefit plan issuer that provides coverage | |
| 76 | - | under this section may not require preauthorization for a screening | |
| 77 | - | examination described by Subsection (a). This subsection may not | |
| 78 | - | be construed to authorize a physician or other health care provider | |
| 79 | - | to provide the medical care or health care described by this section | |
| 80 | - | if providing the care is outside of the scope of the individual's | |
| 81 | - | applicable license. | |
| 52 | + | under this section may not require preauthorization of a screening | |
| 53 | + | examination described by Subsection (a). | |
| 82 | 54 | SECTION 8. This Act applies only to a health benefit plan | |
| 83 | 55 | that is delivered, issued for delivery, or renewed on or after | |
| 84 | 56 | January 1, 2020. | |
| 85 | 57 | SECTION 9. This Act takes effect September 1, 2019. |