Texas 2023 - 88th Regular

Texas House Bill HB118 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R22801 CJD-D
2	2	By: Cortez, et al. H.B. No. 118
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to health benefit plan coverage for certain tests to
8	8	detect prostate cancer.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1362.001, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 1362.001. APPLICABILITY OF CHAPTER. (a) This chapter
13	13	applies only to a health benefit plan that[:
14	14	[(1)] provides benefits for medical or surgical
15	15	expenses incurred as a result of a health condition, accident, or
16	16	sickness, including[:
17	17	[(A)] an individual, group, blanket, or
18	18	franchise insurance policy or insurance agreement, a group hospital
19	19	service contract, or an individual or group evidence of coverage
20	20	that is offered by:
21	21	(1) [(i)] an insurance company;
22	22	(2) [(ii)] a group hospital service corporation
23	23	operating under Chapter 842;
24	24	(3) [(iii)] a fraternal benefit society operating
25	25	under Chapter 885;
26	26	(4) [(iv)] a stipulated premium company operating
27	27	under Chapter 884; [or]
28	28	(5) [(v)] a health maintenance organization operating
29	29	under Chapter 843;
30	30	(6) an approved nonprofit health corporation that
31	31	holds a certificate of authority under Chapter 844;
32	32	(7) a multiple employer welfare arrangement that holds
33	33	a certificate of authority under Chapter 846;
34	34	(8) a Lloyd's plan operating under Chapter 941; or
35	35	(9) an exchange operating under Chapter 942.
36	36	(b) Notwithstanding any other law, this chapter applies to
37	37	[and
38	38	[(B) to the extent permitted by the Employee
39	39	Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
40	40	seq.), a health benefit plan that is offered by:
41	41	[(i) a multiple employer welfare
42	42	arrangement as defined by Section 3 of that Act; or
43	43	[(ii) another analogous benefit
44	44	arrangement;
45	45	[(2) is offered by]:
46	46	(1) a small employer health benefit plan subject to
47	47	Chapter 1501, including coverage provided through a health group
48	48	cooperative under Subchapter B of that chapter;
49	49	(2) a standard health benefit plan issued under
50	50	Chapter 1507;
51	51	(3) a basic coverage plan under Chapter 1551;
52	52	(4) a basic plan under Chapter 1575;
53	53	(5) a primary care coverage plan under Chapter 1579;
54	54	(6) a plan providing basic coverage under Chapter
55	55	1601;
56	56	(7) group health coverage made available by a school
57	57	district in accordance with Section 22.004, Education Code;
58	58	(8) the state Medicaid program, including the Medicaid
59	59	managed care program operated under Chapter 533, Government Code;
60	60	(9) the child health plan program under Chapter 62,
61	61	Health and Safety Code;
62	62	(10) a regional or local health care program operated
63	63	under Section 75.104, Health and Safety Code;
64	64	(11) a self-funded health benefit plan sponsored by a
65	65	professional employer organization under Chapter 91, Labor Code;
66	66	and
67	67	(12) a health benefit plan offered by [(A) an approved
68	68	nonprofit health corporation that holds a certificate of authority
69	69	under Chapter 844; or
70	70	[(B)] an entity not authorized under this code or
71	71	another insurance law of this state that contracts directly for
72	72	health care services on a risk-sharing basis, including a
73	73	capitation basis[; or
74	74	[(3) provides health and accident coverage through a
75	75	risk pool created under Chapter 172, Local Government Code,
76	76	notwithstanding Section 172.014, Local Government Code, or any
77	77	other law].
78	78	SECTION 2. Section 1362.002, Insurance Code, is amended to
79	79	read as follows:
80	80	Sec. 1362.002. EXCEPTION. This chapter does not apply to:
81	81	(1) a health benefit plan that provides coverage:
82	82	(A) only for a specified disease or for another
83	83	limited benefit;
84	84	(B) only for accidental death or dismemberment;
85	85	(C) for wages or payments in lieu of wages for a
86	86	period during which an employee is absent from work because of
87	87	sickness or injury;
88	88	(D) as a supplement to a liability insurance
89	89	policy; or
90	90	(E) only for indemnity for hospital confinement;
91	91	(2) [a small employer health benefit plan written
92	92	under Chapter 1501;
93	93	[(3)] a Medicare supplemental policy as defined by
94	94	Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
95	95	(3) [(4)] a workers' compensation insurance policy;
96	96	(4) [(5)] medical payment insurance coverage provided
97	97	under a motor vehicle insurance policy; or
98	98	(5) [(6)] a long-term care insurance policy,
99	99	including a nursing home fixed indemnity policy, unless the
100	100	commissioner determines that the policy provides benefit coverage
101	101	so comprehensive that the policy is a health benefit plan as
102	102	described by Section 1362.001.
103	103	SECTION 3. Section 1362.003, Insurance Code, is amended by
104	104	adding Subsection (c) to read as follows:
105	105	(c) A health benefit plan that provides coverage under this
106	106	section may not charge any premium, copayment, coinsurance,
107	107	deductible, or any other form of cost sharing for a covered benefit
108	108	described by this section.
109	109	SECTION 4. Section 1575.159, Insurance Code, is repealed.
110	110	SECTION 5. If before implementing any provision of this Act
111	111	a state agency determines that a waiver or authorization from a
112	112	federal agency is necessary for implementation of that provision,
113	113	the agency affected by the provision shall request the waiver or
114	114	authorization and may delay implementing that provision until the
115	115	waiver or authorization is granted.
116	116	SECTION 6. The changes in law made by this Act apply only to
117	117	a health benefit plan delivered, issued for delivery, or renewed on
118	118	or after January 1, 2024. A health benefit plan delivered, issued
119	119	for delivery, or renewed before January 1, 2024, is governed by the
120	120	law as it existed immediately before the effective date of this Act,
121	121	and that law is continued in effect for that purpose.
122	122	SECTION 7. This Act takes effect September 1, 2023.