Texas 2019 - 86th Regular

Texas House Bill HB2682 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	86R26211 PMO-F
2		-	By: Collier, Lopez H.B. No. 2682
3		-	Substitute the following for H.B. No. 2682:
4		-	By: Lucio III C.S.H.B. No. 2682
	1	+	86R6879 PMO-F
	2	+	By: Collier H.B. No. 2682
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to health benefit coverage for certain fertility
10	8		preservation services under certain health benefit plans.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	10		SECTION 1. Chapter 1366, Insurance Code, is amended by
13	11		adding Subchapter C to read as follows:
14	12		SUBCHAPTER C. COVERAGE FOR CERTAIN FERTILITY PRESERVATION SERVICES
15	13		Sec. 1366.101. APPLICABILITY OF SUBCHAPTER. (a) This
16	14		subchapter applies only to a health benefit plan that provides
17	15		benefits for medical or surgical expenses incurred as a result of a
18	16		health condition, accident, or sickness, including an individual,
19	17		group, blanket, or franchise insurance policy or insurance
20	18		agreement, a group hospital service contract, or an individual or
21	19		group evidence of coverage or similar coverage document that is
22	20		issued in this state by:
23	21		(1) an insurance company;
24	22		(2) a group hospital service corporation operating
25	23		under Chapter 842;
26	24		(3) a health maintenance organization operating under
27	25		Chapter 843;
28	26		(4) an approved nonprofit health corporation that
29	27		holds a certificate of authority under Chapter 844;
30	28		(5) a multiple employer welfare arrangement that holds
31	29		a certificate of authority under Chapter 846;
32	30		(6) a stipulated premium company operating under
33	31		Chapter 884;
34	32		(7) a fraternal benefit society operating under
35	33		Chapter 885;
36	34		(8) a Lloyd's plan operating under Chapter 941; or
37	35		(9) an exchange operating under Chapter 942.
38	36		(b) Notwithstanding any other law, this subchapter applies
39	37		to:
40	38		(1) a small employer health benefit plan subject to
41	39		Chapter 1501, including coverage provided through a health group
42		-	cooperative under Subchapter B of that chapter; ~~and~~
	40	+	cooperative under Subchapter B of that chapter;
43	41		(2) a standard health benefit plan issued under
44		-	Chapter 1507.
	42	+	Chapter 1507;
	43	+	(3) a basic coverage plan under Chapter 1551;
	44	+	(4) a basic plan under Chapter 1575;
	45	+	(5) a primary care coverage plan under Chapter 1579;
	46	+	(6) a plan providing basic coverage under Chapter
	47	+	1601;
	48	+	(7) health benefits provided by or through a church
	49	+	benefits board under Subchapter I, Chapter 22, Business
	50	+	Organizations Code;
	51	+	(8) group health coverage made available by a school
	52	+	district in accordance with Section 22.004, Education Code;
	53	+	(9) the state Medicaid program, including the Medicaid
	54	+	managed care program operated under Chapter 533, Government Code;
	55	+	(10) the child health plan program under Chapter 62,
	56	+	Health and Safety Code;
	57	+	(11) a regional or local health care program operated
	58	+	under Section 75.104, Health and Safety Code;
	59	+	(12) a self-funded health benefit plan sponsored by a
	60	+	professional employer organization under Chapter 91, Labor Code;
	61	+	(13) county employee group health benefits provided
	62	+	under Chapter 157, Local Government Code; and
	63	+	(14) health and accident coverage provided by a risk
	64	+	pool created under Chapter 172, Local Government Code.
45	65		Sec. 1366.102. EXCEPTIONS. This subchapter does not apply
46	66		to:
47	67		(1) a plan that provides coverage:
48	68		(A) for wages or payments in lieu of wages for a
49	69		period during which an employee is absent from work because of
50	70		sickness or injury;
51	71		(B) as a supplement to a liability insurance
52	72		policy;
53	73		(C) for credit insurance;
54	74		(D) only for dental or vision care;
55	75		(E) only for hospital expenses; or
56	76		(F) only for indemnity for hospital confinement;
57	77		(2) a Medicare supplemental policy as defined by
58	78		Section 1882(g)(1), Social Security Act (42 U.S.C. Section
59	79		1395ss(g)(1));
60	80		(3) a workers' compensation insurance policy;
61	81		(4) medical payment insurance coverage provided under
62		-	a motor vehicle insurance policy;
	82	+	a motor vehicle insurance policy; or
63	83		(5) a long-term care policy, including a nursing home
64	84		fixed indemnity policy, unless the commissioner determines that the
65	85		policy provides benefit coverage so comprehensive that the policy
66		-	is a health benefit plan as described by Section 1366.101;
67		-	(6) Medicaid managed care programs operated under
68		-	Chapter 533, Government Code;
69		-	(7) Medicaid programs operated under Chapter 32, Human
70		-	Resources Code; or
71		-	(8) the state child health plan operated under Chapter
72		-	62 or 63, Health and Safety Code.
	86	+	is a health benefit plan as described by Section 1366.001.
73	87		Sec. 1366.103. REQUIRED COVERAGE. (a) Subject to
74	88		Subsection (b), a health benefit plan must provide coverage for
75	89		fertility preservation services to a covered person who will
76	90		receive a medically necessary treatment, including surgery,
77	91		chemotherapy, and radiation, that the American Society of Clinical
78	92		Oncology or the American Society for Reproductive Medicine has
79	93		established may directly or indirectly cause impaired fertility.
80	94		(b) The fertility preservation services described by
81	95		Subsection (a) must be standard procedures to preserve fertility
82	96		consistent with established medical practices or professional
83	97		guidelines published by the American Society of Clinical Oncology
84	98		or the American Society for Reproductive Medicine.
85	99		SECTION 2. This Act applies only to a health benefit plan
86	100		that is delivered, issued for delivery, or renewed on or after
87	101		January 1, 2020.
88	102		SECTION 3. This Act takes effect September 1, 2019.