Texas 2021 - 87th Regular

Texas House Bill HB410 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R997 JES-F
2	2	By: Johnson of Dallas H.B. No. 410
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to preauthorization of certain benefits by certain health
8	8	benefit plan issuers.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1356.005, Insurance Code, is amended by
11	11	adding Subsection (c) to read as follows:
12	12	(c) A health benefit plan issuer that provides coverage
13	13	under this section may not require preauthorization for a mammogram
14	14	described by Subsection (a) or (a-1). This subsection may not be
15	15	construed to authorize a physician or other health care provider to
16	16	provide the medical care or health care described by this section if
17	17	providing the care is outside of the scope of the individual's
18	18	applicable license.
19	19	SECTION 2. Section 1357.004, Insurance Code, is amended by
20	20	adding Subsection (c) to read as follows:
21	21	(c) A health benefit plan issuer that provides coverage
22	22	under this section may not require preauthorization for a
23	23	reconstruction, surgery, prostheses, or treatment described by
24	24	Subsection (a). This subsection may not be construed to authorize a
25	25	physician or other health care provider to provide the medical care
26	26	or health care described by this section if providing the care is
27	27	outside of the scope of the individual's applicable license.
28	28	SECTION 3. Section 1357.054, Insurance Code, is amended by
29	29	adding Subsection (c) to read as follows:
30	30	(c) A health benefit plan issuer that provides coverage
31	31	under this section may not require preauthorization for inpatient
32	32	care described by Subsection (a). This subsection may not be
33	33	construed to authorize a physician or other health care provider to
34	34	provide the medical care or health care described by this section if
35	35	providing the care is outside of the scope of the individual's
36	36	applicable license.
37	37	SECTION 4. Section 1358.054, Insurance Code, is amended by
38	38	adding Subsection (c) to read as follows:
39	39	(c) A health benefit plan issuer that provides coverage
40	40	under this section may not require preauthorization for the
41	41	provision to a qualified enrollee of diabetes equipment, diabetes
42	42	supplies, or self-management training described by Subsection (a).
43	43	This subsection may not be construed to authorize a physician or
44	44	other health care provider to provide the medical care or health
45	45	care described by this section if providing the care is outside of
46	46	the scope of the individual's applicable license.
47	47	SECTION 5. Section 1361.003, Insurance Code, is amended to
48	48	read as follows:
49	49	Sec. 1361.003. COVERAGE REQUIRED. (a) A group health
50	50	benefit plan must provide to a qualified enrollee coverage for
51	51	medically accepted bone mass measurement to detect low bone mass
52	52	and to determine the enrollee's risk of osteoporosis and fractures
53	53	associated with osteoporosis.
54	54	(b) A group health benefit plan issuer that provides
55	55	coverage under this section may not require preauthorization for
56	56	the provision to a qualified enrollee of a bone mass measurement
57	57	described by Subsection (a). This subsection may not be construed
58	58	to authorize a physician or other health care provider to provide
59	59	the medical care or health care described by this section if
60	60	providing the care is outside of the scope of the individual's
61	61	applicable license.
62	62	SECTION 6. Section 1362.003, Insurance Code, is amended by
63	63	adding Subsection (c) to read as follows:
64	64	(c) A health benefit plan issuer that provides coverage
65	65	under this section to an enrolled male may not require
66	66	preauthorization for a diagnostic examination described by
67	67	Subsection (a). This subsection may not be construed to authorize a
68	68	physician or other health care provider to provide the medical care
69	69	or health care described by this section if providing the care is
70	70	outside of the scope of the individual's applicable license.
71	71	SECTION 7. Section 1363.003, Insurance Code, is amended by
72	72	adding Subsection (c) to read as follows:
73	73	(c) A health benefit plan issuer that provides coverage
74	74	under this section may not require preauthorization for a screening
75	75	examination described by Subsection (a). This subsection may not
76	76	be construed to authorize a physician or other health care provider
77	77	to provide the medical care or health care described by this section
78	78	if providing the care is outside of the scope of the individual's
79	79	applicable license.
80	80	SECTION 8. This Act applies only to a health benefit plan
81	81	that is delivered, issued for delivery, or renewed on or after
82	82	January 1, 2022.
83	83	SECTION 9. This Act takes effect September 1, 2021.