| 1 | 1 | | 87R9354 MWC-D |
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| 2 | 2 | | By: Johnson of Dallas H.B. No. 2984 |
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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 health benefit plan coverage for treatment of autism. |
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| 8 | 8 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 9 | 9 | | SECTION 1. Section 1355.015, Insurance Code, is amended by |
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| 10 | 10 | | amending Subsections (a-1) and (c-1) and adding Subsection (c-2) to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | (a-1) At a minimum, a health benefit plan must provide |
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| 13 | 13 | | coverage for treatment of autism spectrum disorder as provided by |
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| 14 | 14 | | this section to an enrollee who is diagnosed with autism spectrum |
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| 15 | 15 | | disorder from the date of diagnosis, only if the diagnosis was in |
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| 16 | 16 | | place prior to the enrollee's 22nd [child's 10th] birthday. |
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| 17 | 17 | | (c-1) The health benefit plan may [is] not require [required |
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| 18 | 18 | | to provide coverage under Subsection (b) for benefits for] an |
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| 19 | 19 | | enrollee to be evaluated for autism spectrum disorder more than |
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| 20 | 20 | | once every 10 years [of age or older for applied behavior analysis |
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| 21 | 21 | | in an amount that exceeds $36,000 per year]. |
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| 22 | 22 | | (c-2) The health benefit plan may not prohibit or place a |
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| 23 | 23 | | limitation on a health care practitioner described by Subsection |
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| 24 | 24 | | (b)(1) from performing an evaluation requested by the plan's |
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| 25 | 25 | | issuer. |
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| 26 | 26 | | SECTION 2. The change in law made by this Act applies only |
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| 27 | 27 | | to a health benefit plan delivered, issued for delivery, or renewed |
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| 28 | 28 | | on or after January 1, 2022. A health benefit plan delivered, |
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| 29 | 29 | | issued for delivery, or renewed before January 1, 2022, is governed |
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| 30 | 30 | | by the law as it existed immediately before the effective date of |
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| 31 | 31 | | this Act, and that law is continued in effect for that purpose. |
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| 32 | 32 | | SECTION 3. This Act takes effect September 1, 2021. |
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