87R6441 MEW-D
By: Morrison H.B. No. 3423
A BILL TO BE ENTITLED
AN ACT
relating to coverage for supplemental ultrasound imaging to screen
for breast cancer under certain health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Chapter 1356, Insurance Code, is
amended to read as follows:
CHAPTER 1356. MAMMOGRAPHY AND OTHER BREAST IMAGING
SECTION 2. Chapter 1356, Insurance Code, is amended by
adding Section 1356.006 to read as follows:
Sec. 1356.006. SUPPLEMENTAL COVERAGE REQUIRED. (a) An
issuer of a health benefit plan that provides coverage under
Section 1356.005 must provide coverage for supplemental two- or
three-dimensional breast ultrasound imaging as part of an annual
screening covered under the plan if a licensed health care
professional treating the enrollee or screening the enrollee for
breast cancer finds that the enrollee has dense breast tissue, as
defined by the Breast Imaging Reporting and Database System (Fifth
Edition) established by the American College of Radiology.
(b) Coverage required by this section:
(1) may not be less favorable than coverage for other
radiological examinations under the plan; and
(2) must be subject to the same dollar limits,
deductibles, and coinsurance factors as coverage for other
radiological examinations under the plan.
SECTION 3. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 4. This Act applies only to a health benefit plan
that is delivered, issued for delivery, or renewed on or after
January 1, 2022. A health benefit plan that is 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 5. This Act takes effect September 1, 2021.