Texas 2023 - 88th Regular

Texas House Bill HB3566 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R12761 EAS-F
2	2	By: Bucy H.B. No. 3566
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to statewide standards for the provision of and health
8	8	benefit plan coverage of substance use and addiction treatment.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle I, Title 4, Government Code, is amended
11	11	by adding Chapter 542 to read as follows:
12	12	CHAPTER 542. SUBSTANCE USE AND ADDICTION TREATMENT
13	13	Sec. 542.001. STANDARDS FOR SUBSTANCE USE AND ADDICTION
14	14	TREATMENT. In carrying out the commission's duties under law in
15	15	relation to the provision of substance use and addiction treatment,
16	16	including the designation of appropriate levels of care, the
17	17	transfer or discharge of a patient, and the utilization management
18	18	review of care and treatment provided to individuals suffering from
19	19	a substance use, mental health, or co-occurring disorder, the
20	20	commission shall endeavor to use and encourage the use of the most
21	21	recently published standards on substance use and addiction
22	22	treatment by the American Society of Addiction Medicine, including
23	23	the use of those standards for determining the level of care and
24	24	authorizing payment commensurate with the level of care indicated
25	25	by a health benefit plan.
26	26	Sec. 542.002. MEMORANDUM OF UNDERSTANDING. To encourage
27	27	the use of standards described by Section 542.001 by other state
28	28	agencies and local governmental entities, the commission may adopt
29	29	a memorandum of understanding with those agencies and entities to
30	30	coordinate the use of and authorize the payment for services
31	31	delivered in accordance with those standards.
32	32	SECTION 2. Chapter 1355, Insurance Code, is amended by
33	33	adding Subchapter G to read as follows:
34	34	SUBCHAPTER G. CLASSIFICATION AND DETERMINATION OF COVERAGE FOR
35	35	MENTAL ILLNESS
36	36	Sec. 1355.301. APPLICABILITY OF SUBCHAPTER. (a) This
37	37	subchapter applies only to a health benefit plan that provides
38	38	benefits for medical or surgical expenses incurred as a result of a
39	39	health condition, accident, or sickness, including an individual,
40	40	group, blanket, or franchise insurance policy or insurance
41	41	agreement, a group hospital service contract, or an individual or
42	42	group evidence of coverage or similar coverage document that is
43	43	issued by:
44	44	(1) an insurance company;
45	45	(2) a group hospital service corporation operating
46	46	under Chapter 842;
47	47	(3) a health maintenance organization operating under
48	48	Chapter 843;
49	49	(4) an approved nonprofit health corporation that
50	50	holds a certificate of authority under Chapter 844;
51	51	(5) a multiple employer welfare arrangement that holds
52	52	a certificate of authority under Chapter 846;
53	53	(6) a stipulated premium company operating under
54	54	Chapter 884;
55	55	(7) a fraternal benefit society operating under
56	56	Chapter 885;
57	57	(8) a Lloyd's plan operating under Chapter 941; or
58	58	(9) an exchange operating under Chapter 942.
59	59	(b) Notwithstanding any other law, this subchapter applies
60	60	to:
61	61	(1) a small employer health benefit plan subject to
62	62	Chapter 1501, including coverage provided through a health group
63	63	cooperative under Subchapter B of that chapter;
64	64	(2) a standard health benefit plan issued under
65	65	Chapter 1507;
66	66	(3) a basic coverage plan under Chapter 1551;
67	67	(4) a basic plan under Chapter 1575;
68	68	(5) a primary care coverage plan under Chapter 1579;
69	69	(6) a plan providing basic coverage under Chapter
70	70	1601;
71	71	(7) nonprofit agricultural organization health
72	72	benefits offered by a nonprofit agricultural organization under
73	73	Chapter 1682;
74	74	(8) alternative health benefit coverage offered by a
75	75	subsidiary of the Texas Mutual Insurance Company under Subchapter
76	76	M, Chapter 2054;
77	77	(9) health benefits provided by or through a church
78	78	benefits board under Subchapter I, Chapter 22, Business
79	79	Organizations Code;
80	80	(10) group health coverage made available by a school
81	81	district in accordance with Section 22.004, Education Code;
82	82	(11) the state Medicaid program, including the
83	83	Medicaid managed care program operated under Chapter 533,
84	84	Government Code;
85	85	(12) the child health plan program under Chapter 62,
86	86	Health and Safety Code;
87	87	(13) a regional or local health care program operated
88	88	under Section 75.104, Health and Safety Code;
89	89	(14) a self-funded health benefit plan sponsored by a
90	90	professional employer organization under Chapter 91, Labor Code;
91	91	(15) county employee group health benefits provided
92	92	under Chapter 157, Local Government Code; and
93	93	(16) health and accident coverage provided by a risk
94	94	pool created under Chapter 172, Local Government Code.
95	95	Sec. 1355.302. REQUIRED USE OF MANUAL. A health benefit
96	96	plan that provides coverage for mental health or substance use
97	97	disorders must use the Diagnostic and Statistical Manual of Mental
98	98	Disorders, 5th edition, for purposes of classifying and determining
99	99	coverage for mental illness.
100	100	SECTION 3. If before implementing any provision of this Act
101	101	a state agency determines that a waiver or authorization from a
102	102	federal agency is necessary for implementation of that provision,
103	103	the agency affected by the provision shall request the waiver or
104	104	authorization and may delay implementing that provision until the
105	105	waiver or authorization is granted.
106	106	SECTION 4. Section 1355.302, Insurance Code, as added by
107	107	this Act, applies only to a health benefit plan that is delivered,
108	108	issued for delivery, or renewed on or after January 1, 2024.
109	109	SECTION 5. This Act takes effect September 1, 2023.