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