Texas Senate Bill SB959

Texas 2019 - 86th Regular

Caption

Relating to health benefit coverage for certain fertility preservation services under certain health benefit plans.

Impact

The enactment of SB959 will have significant implications for state laws regarding health benefit coverage. It modifies existing regulations in the Texas Insurance Code to explicitly include fertility preservation services as a necessary benefit for individuals undergoing treatments that may impair fertility. This legislative change aims to provide stronger protections and support for patients, promoting a better standard of care and addressing the needs of couples or individuals who wish to preserve their fertility in the face of medical challenges. It will also influence the operation of health insurance providers in Texas, compelling them to update their coverage policies to comply with the new requirements.

Summary

Senate Bill 959 focuses on mandating health benefit plans to provide coverage for certain fertility preservation services. The bill applies to a wide range of health benefit plans, including those from insurance companies, health maintenance organizations, and other authorized entities operating within the state of Texas. It aims to ensure that individuals facing medically necessary treatments that could lead to impaired fertility, such as chemotherapy or radiation, have access to fertility preservation services as a covered benefit under their health plans. The coverage is to align with established medical practices and guidelines set by recognized professional organizations.

Contention

While SB959 has the potential to positively affect many individuals requiring fertility preservation, there may be points of contention surrounding its implementation. Concerns could arise regarding the cost implications for insurance providers and whether the additional coverage mandates could lead to higher premiums for consumers. Additionally, debates may surface around the definitions and standards of medical necessity, particularly which treatments qualify for fertility preservation services. Stakeholders in the healthcare and insurance sectors may express differing views on the balance between providing necessary health benefits and managing economic feasibility.