Texas 2021 - 87th Regular

Texas House Bill HB293 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~87R15990~~ JES-F
	1	+	87R223 JES-F
2	2		By: Collier H.B. No. 293
3		-	Substitute the following for H.B. No. 293:
4		-	By: Oliverson C.S.H.B. No. 293
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	40		cooperative under Subchapter B of that chapter; and
43	41		(2) a standard health benefit plan issued under
44	42		Chapter 1507.
45		-	Sec. 1366.102. EXCEPTIONS. ~~(a)~~ This subchapter does not
46		-	~~apply~~ to:
	43	+	Sec. 1366.102. EXCEPTIONS. This subchapter does not apply
	44	+	to:
47	45		(1) a plan that provides coverage:
48	46		(A) for wages or payments in lieu of wages for a
49	47		period during which an employee is absent from work because of
50	48		sickness or injury;
51	49		(B) as a supplement to a liability insurance
52	50		policy;
53	51		(C) for credit insurance;
54	52		(D) only for dental or vision care;
55	53		(E) only for hospital expenses; or
56	54		(F) only for indemnity for hospital confinement;
57	55		(2) a Medicare supplemental policy as defined by
58	56		Section 1882(g)(1), Social Security Act (42 U.S.C. Section
59	57		1395ss(g)(1));
60	58		(3) a workers' compensation insurance policy;
61	59		(4) medical payment insurance coverage provided under
62	60		a motor vehicle insurance policy;
63	61		(5) a long-term care policy, including a nursing home
64	62		fixed indemnity policy, unless the commissioner determines that the
65	63		policy provides benefit coverage so comprehensive that the policy
66	64		is a health benefit plan as described by Section 1366.101;
67	65		(6) Medicaid managed care programs operated under
68	66		Chapter 533, Government Code;
69	67		(7) Medicaid programs operated under Chapter 32, Human
70	68		Resources Code; or
71	69		(8) the state child health plan operated under Chapter
72	70		62 or 63, Health and Safety Code.
73		-	(b) This subchapter does not apply to a qualified health
74		-	plan, as defined by 45 C.F.R. Section 155.20, if a determination is
75		-	made under 45 C.F.R. Section 155.170 that:
76		-	(1) this subchapter requires the qualified health plan
77		-	to offer benefits in addition to the essential health benefits
78		-	required under 42 U.S.C. Section 18022(b); and
79		-	(2) this state must make payments to defray the cost of
80		-	the additional benefits mandated by this subchapter.
81		-	(c) If a determination described by Subsection (b) is made
82		-	as to a qualified health plan, this subchapter does not apply to a
83		-	non-qualified health plan if the non-qualified health plan is
84		-	offered in the same market as the qualified health plan.
85	71		Sec. 1366.103. REQUIRED COVERAGE. (a) Subject to
86	72		Subsection (b), a health benefit plan must provide coverage for
87	73		fertility preservation services to a covered person who will
88	74		receive a medically necessary treatment, including surgery,
89	75		chemotherapy, and radiation, that the American Society of Clinical
90	76		Oncology or the American Society for Reproductive Medicine has
91	77		established may directly or indirectly cause impaired fertility.
92	78		(b) The fertility preservation services described by
93	79		Subsection (a) must be standard procedures to preserve fertility
94	80		consistent with established medical practices or professional
95	81		guidelines published by the American Society of Clinical Oncology
96	82		or the American Society for Reproductive Medicine.
97	83		SECTION 2. This Act applies only to a health benefit plan
98	84		that is delivered, issued for delivery, or renewed on or after
99	85		January 1, 2022.
100	86		SECTION 3. This Act takes effect September 1, 2021.