| 1 | 1 | | 86R12011 JES-F |
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| 2 | 2 | | By: Menéndez S.B. No. 1741 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to preauthorization by certain health benefit plan issuers |
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| 8 | 8 | | of certain benefits. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 1356.005, Insurance Code, is amended by |
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| 11 | 11 | | adding Subsection (c) to read as follows: |
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| 12 | 12 | | (c) A health benefit plan issuer that provides coverage |
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| 13 | 13 | | under this section may not require preauthorization of a screening |
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| 14 | 14 | | described by Subsection (a). |
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| 15 | 15 | | SECTION 2. Section 1357.004, Insurance Code, is amended by |
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| 16 | 16 | | adding Subsection (c) to read as follows: |
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| 17 | 17 | | (c) A health benefit plan issuer that provides coverage |
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| 18 | 18 | | under this section may not require preauthorization of a |
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| 19 | 19 | | reconstruction, surgery, prostheses, or treatment described by |
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| 20 | 20 | | Subsection (a). |
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| 21 | 21 | | SECTION 3. Section 1357.054, Insurance Code, is amended by |
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| 22 | 22 | | adding Subsection (c) to read as follows: |
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| 23 | 23 | | (c) A health benefit plan issuer that provides coverage |
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| 24 | 24 | | under this section may not require preauthorization for inpatient |
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| 25 | 25 | | care described by Subsection (a). |
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| 26 | 26 | | SECTION 4. Section 1358.054, Insurance Code, is amended by |
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| 27 | 27 | | adding Subsection (c) to read as follows: |
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| 28 | 28 | | (c) A health benefit plan issuer that provides coverage |
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| 29 | 29 | | under this section may not require a qualified enrollee to obtain |
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| 30 | 30 | | preauthorization for diabetes equipment, diabetes supplies, or |
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| 31 | 31 | | self-management training described by Subsection (a). |
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| 32 | 32 | | SECTION 5. Section 1361.003, Insurance Code, is amended to |
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| 33 | 33 | | read as follows: |
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| 34 | 34 | | Sec. 1361.003. COVERAGE REQUIRED. (a) A group health |
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| 35 | 35 | | benefit plan must provide to a qualified enrollee coverage for |
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| 36 | 36 | | medically accepted bone mass measurement to detect low bone mass |
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| 37 | 37 | | and to determine the enrollee's risk of osteoporosis and fractures |
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| 38 | 38 | | associated with osteoporosis. |
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| 39 | 39 | | (b) A group health benefit plan issuer that provides |
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| 40 | 40 | | coverage under this section may not require a qualified enrollee to |
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| 41 | 41 | | obtain preauthorization for a bone mass measurement described by |
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| 42 | 42 | | Subsection (a). |
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| 43 | 43 | | SECTION 6. Section 1362.003, Insurance Code, is amended by |
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| 44 | 44 | | adding Subsection (c) to read as follows: |
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| 45 | 45 | | (c) A health benefit plan issuer that provides coverage |
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| 46 | 46 | | under this section to an enrolled male may not require |
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| 47 | 47 | | preauthorization of a diagnostic examination described by |
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| 48 | 48 | | Subsection (a). |
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| 49 | 49 | | SECTION 7. Section 1363.003, Insurance Code, is amended by |
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| 50 | 50 | | adding Subsection (c) to read as follows: |
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| 51 | 51 | | (c) A health benefit plan issuer that provides coverage |
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| 52 | 52 | | under this section may not require preauthorization of a screening |
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| 53 | 53 | | examination described by Subsection (a). |
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| 54 | 54 | | SECTION 8. This Act applies only to a health benefit plan |
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| 55 | 55 | | that is delivered, issued for delivery, or renewed on or after |
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| 56 | 56 | | January 1, 2020. |
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| 57 | 57 | | SECTION 9. This Act takes effect September 1, 2019. |
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