86R4686 JES-F
By: Watson S.B. No. 344
A BILL TO BE ENTITLED
AN ACT
relating to the participation of campus-based mental health
professionals in certain health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 843.010, Insurance Code, is amended to
read as follows:
Sec. 843.010. APPLICABILITY OF CERTAIN PROVISIONS TO
GOVERNMENTAL HEALTH BENEFIT PLANS. (a) Sections 843.306(f) and
843.363(a)(4) do not apply to coverage under:
(1) the child health plan program under Chapter 62,
Health and Safety Code, or the health benefits plan for children
under Chapter 63, Health and Safety Code; or
(2) a Medicaid program, including a Medicaid managed
care program operated under Chapter 533, Government Code.
(b) Section 843.3046 applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579;
(4) a plan providing basic coverage under Chapter
1601;
(5) the Medicaid managed care program operated under
Chapter 533, Government Code; and
(6) the child health plan program under Chapter 62,
Health and Safety Code.
SECTION 2. Subchapter I, Chapter 843, Insurance Code, is
amended by adding Section 843.3046 to read as follows:
Sec. 843.3046. CAMPUS-BASED MENTAL HEALTH PROFESSIONALS.
(a) In this section:
(1) "Campus-based mental health professional" means a
licensed clinical social worker, professional counselor,
psychological associate, or psychologist who provides mental
health care services primarily or exclusively at a campus of a
school district or an open-enrollment charter school.
(2) "Open-enrollment charter school" means a school
that has been granted a charter under Subchapter D, Chapter 12,
Education Code.
(3) "School district" means a public school district
created under the laws of this state.
(b) If a health maintenance organization includes mental
health care services in the services covered by the health
maintenance organization's health care plan, the health
maintenance organization may not reject the initial application of
a campus-based mental health professional to contract with the
health maintenance organization to provide mental health care
services on behalf of the health maintenance organization based on
a determination that the health maintenance organization has
contracted with sufficient qualified mental health care providers
in the applicant's geographic area.
(c) A campus-based mental health professional who applies
to a health maintenance organization to contract with the health
maintenance organization to provide mental health care services on
behalf of the health maintenance organization is entitled to an
expedited decision on the application.
SECTION 3. Subchapter C, Chapter 848, Insurance Code, is
amended by adding Section 848.111 to read as follows:
Sec. 848.111. CAMPUS-BASED MENTAL HEALTH PROFESSIONALS.
(a) In this section:
(1) "Campus-based mental health professional" means a
licensed clinical social worker, professional counselor,
psychological associate, or psychologist who provides mental
health care services primarily or exclusively at a campus of a
school district or an open-enrollment charter school.
(2) "Open-enrollment charter school" means a school
that has been granted a charter under Subchapter D, Chapter 12,
Education Code.
(3) "School district" means a public school district
created under the laws of this state.
(b) If a health care collaborative includes mental health
care services in the services covered by the health care
collaborative's health care plan, the health care collaborative may
not reject the initial application of a campus-based mental health
professional to contract with the health care collaborative to
provide mental health care services as part of the health care
collaborative's delivery network based on a determination that the
health care collaborative has contracted with sufficient qualified
mental health care providers in the applicant's geographic area.
(c) A campus-based mental health professional who applies
to a health care collaborative for inclusion in the health care
collaborative's delivery network is entitled to an expedited
decision on the application.
SECTION 4. Subchapter B, Chapter 1301, Insurance Code, is
amended by adding Section 1301.0516 to read as follows:
Sec. 1301.0516. CERTAIN CAMPUS-BASED MENTAL HEALTH
SERVICES. (a) In this section:
(1) "Campus-based mental health professional" means a
licensed clinical social worker, professional counselor,
psychological associate, or psychologist who provides mental
health care services primarily or exclusively at a campus of a
school district or an open-enrollment charter school.
(2) "Open-enrollment charter school" means a school
that has been granted a charter under Subchapter D, Chapter 12,
Education Code.
(3) "School district" means a public school district
created under the laws of this state.
(b) Notwithstanding any other law, this section applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579;
and
(4) a plan providing basic coverage under Chapter
1601.
(c) If an insurer offers a preferred provider benefit plan
that includes mental health care services in the services covered
by the plan, the insurer may not reject the initial application of a
campus-based mental health professional to contract for
designation as a preferred provider under the plan based on a
determination that the insurer has contracted with sufficient
qualified mental health care providers in the applicant's
geographic area.
(d) A campus-based mental health professional who applies
to an insurer for designation as a preferred provider is entitled to
an expedited decision on the application.
SECTION 5. (a) Section 843.3046, Insurance Code, as added
by this Act, applies only to an application to contract with a
health maintenance organization submitted on or after the effective
date of this Act.
(b) Section 848.111, Insurance Code, as added by this Act,
applies only to an application to contract with a health care
collaborative submitted on or after the effective date of this Act.
(c) Section 1301.0516, Insurance Code, as added by this Act,
applies only to an application to contract with an insurer
submitted on or after the effective date of this Act.
SECTION 6. This Act takes effect September 1, 2019.