| 1 | 1 | | 87R6441 MEW-D |
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| 2 | 2 | | By: Morrison H.B. No. 3423 |
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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 coverage for supplemental ultrasound imaging to screen |
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| 8 | 8 | | for breast cancer under certain health benefit plans. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. The heading to Chapter 1356, Insurance Code, is |
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| 11 | 11 | | amended to read as follows: |
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| 12 | 12 | | CHAPTER 1356. MAMMOGRAPHY AND OTHER BREAST IMAGING |
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| 13 | 13 | | SECTION 2. Chapter 1356, Insurance Code, is amended by |
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| 14 | 14 | | adding Section 1356.006 to read as follows: |
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| 15 | 15 | | Sec. 1356.006. SUPPLEMENTAL COVERAGE REQUIRED. (a) An |
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| 16 | 16 | | issuer of a health benefit plan that provides coverage under |
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| 17 | 17 | | Section 1356.005 must provide coverage for supplemental two- or |
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| 18 | 18 | | three-dimensional breast ultrasound imaging as part of an annual |
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| 19 | 19 | | screening covered under the plan if a licensed health care |
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| 20 | 20 | | professional treating the enrollee or screening the enrollee for |
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| 21 | 21 | | breast cancer finds that the enrollee has dense breast tissue, as |
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| 22 | 22 | | defined by the Breast Imaging Reporting and Database System (Fifth |
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| 23 | 23 | | Edition) established by the American College of Radiology. |
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| 24 | 24 | | (b) Coverage required by this section: |
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| 25 | 25 | | (1) may not be less favorable than coverage for other |
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| 26 | 26 | | radiological examinations under the plan; and |
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| 27 | 27 | | (2) must be subject to the same dollar limits, |
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| 28 | 28 | | deductibles, and coinsurance factors as coverage for other |
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| 29 | 29 | | radiological examinations under the plan. |
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| 30 | 30 | | SECTION 3. If before implementing any provision of this Act |
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| 31 | 31 | | a state agency determines that a waiver or authorization from a |
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| 32 | 32 | | federal agency is necessary for implementation of that provision, |
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| 33 | 33 | | the agency affected by the provision shall request the waiver or |
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| 34 | 34 | | authorization and may delay implementing that provision until the |
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| 35 | 35 | | waiver or authorization is granted. |
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| 36 | 36 | | SECTION 4. This Act applies only to a health benefit plan |
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| 37 | 37 | | that is delivered, issued for delivery, or renewed on or after |
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| 38 | 38 | | January 1, 2022. A health benefit plan that is delivered, issued |
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| 39 | 39 | | for delivery, or renewed before January 1, 2022, is governed by the |
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| 40 | 40 | | law as it existed immediately before the effective date of this Act, |
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| 41 | 41 | | and that law is continued in effect for that purpose. |
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| 42 | 42 | | SECTION 5. This Act takes effect September 1, 2021. |
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