88R4039 KKR-F
By: Wu H.B. No. 526
A BILL TO BE ENTITLED
AN ACT
relating to HIV and AIDS tests and to health benefit plan coverage
of HIV and AIDS tests.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Subchapter D, Chapter 85, Health
and Safety Code, is amended to read as follows:
SUBCHAPTER D. HIV TESTING, TESTING PROGRAMS, AND COUNSELING
SECTION 2. Subchapter D, Chapter 85, Health and Safety
Code, is amended by adding Section 85.0815 to read as follows:
Sec. 85.0815. OPT-OUT HIV TESTING IN CERTAIN ROUTINE
MEDICAL SCREENINGS. (a) A health care provider who takes a sample
of an individual's blood as part of a medical screening may submit
the sample for an HIV diagnostic test, regardless of whether an HIV
test is part of a primary diagnosis, unless the individual opts out
of the HIV test.
(b) Before taking a sample of an individual's blood as part
of a medical screening, a health care provider must obtain the
individual's written consent for an HIV diagnostic test or verbally
inform the individual that an HIV diagnostic test will be performed
unless the individual opts out of the HIV test.
(c) A health care provider who submits an individual's blood
for an HIV diagnostic test shall provide to each individual who
receives a positive test result information on available HIV health
services and referrals to community support programs.
(d) The executive commissioner shall adopt rules to
implement this section. In adopting rules, the executive
commissioner must consider the most recent recommendations of the
Centers for Disease Control and Prevention for HIV testing of
adults and adolescents.
SECTION 3. Section 32.024, Human Resources Code, is amended
by adding Subsection (ee) to read as follows:
(ee) The executive commissioner shall adopt rules to
require the commission to provide an HIV test in accordance with
Section 85.0815, Health and Safety Code, to an individual who
receives medical assistance.
SECTION 4. Chapter 1364, Insurance Code, is amended by
adding Subchapter D to read as follows:
SUBCHAPTER D. COVERAGE OF CERTAIN TESTING REQUIRED
Sec. 1364.151. DEFINITIONS. In this subchapter, "AIDS" and
"HIV" have the meanings assigned by Section 81.101, Health and
Safety Code.
Sec. 1364.152. APPLICABILITY OF SUBCHAPTER. (a) This
subchapter applies only to a health benefit plan, including a large
or small employer health benefit plan written under Chapter 1501,
that provides benefits for medical or surgical expenses incurred as
a result of a health condition, accident, or sickness, including an
individual, group, blanket, or franchise insurance policy or
insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage or similar coverage
document that is offered by:
(1) an insurance company;
(2) a group hospital service corporation operating
under Chapter 842;
(3) a health maintenance organization operating under
Chapter 843;
(4) an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844;
(5) a multiple employer welfare arrangement that holds
a certificate of authority under Chapter 846;
(6) a stipulated premium company operating under
Chapter 884;
(7) a fraternal benefit society operating under
Chapter 885;
(8) a Lloyd's plan operating under Chapter 941; or
(9) a reciprocal exchange operating under Chapter 942.
(b) Notwithstanding any provision in Chapter 1551, 1575,
1579, or 1601 or any other law, this subchapter applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579;
and
(4) basic coverage under Chapter 1601.
Sec. 1364.153. COVERAGE OF CERTAIN TESTING REQUIRED. A
health benefit plan issuer may not exclude or deny coverage for the
performance of medical tests or procedures to determine HIV
infection, antibodies to HIV, or infection with any other probable
causative agent of AIDS, regardless of whether the test or medical
procedure is related to the primary diagnosis of the health
condition, accident, or sickness for which the enrollee seeks
medical or surgical treatment.
Sec. 1364.154. RULES. The commissioner may adopt rules
necessary to implement this subchapter.
SECTION 5. The heading to Section 1507.004, Insurance Code,
is amended to read as follows:
Sec. 1507.004. STANDARD HEALTH BENEFIT PLANS AUTHORIZED;
MINIMUM REQUIREMENTS [REQUIREMENT].
SECTION 6. Section 1507.004, Insurance Code, is amended by
adding Subsections (c), (d), and (e) to read as follows:
(c) Any standard health benefit plan must include coverage
for tests or procedures to determine HIV infection, antibodies to
HIV, or infection with any other probable causative agent of AIDS as
required by Subchapter D, Chapter 1364.
(d) Subsection (c) does not apply to a qualified health plan
defined by 45 C.F.R. Section 155.20 if a determination is made under
45 C.F.R. Section 155.170 that:
(1) Subsection (c) requires the plan to offer benefits
in addition to the essential health benefits required under 42
U.S.C. Section 18022(b); and
(2) this state must make payments to defray the cost of
the additional benefits mandated by Subsection (c).
(e) If a determination described by Subsection (d) is made
as to a qualified health plan, Subsection (c) does not apply to a
non-qualified health plan offered in the same market as the
qualified health plan.
SECTION 7. Section 1507.054, Insurance Code, is amended to
read as follows:
Sec. 1507.054. STANDARD HEALTH BENEFIT PLANS AUTHORIZED;
MINIMUM REQUIREMENTS. (a) A health maintenance organization
authorized to issue an evidence of coverage in this state may offer
one or more standard health benefit plans.
(b) Any standard health benefit plan must include coverage
for tests or procedures to determine HIV infection, antibodies to
HIV, or infection with any other probable causative agent of AIDS as
required by Subchapter D, Chapter 1364.
(c) Subsection (b) does not apply to a qualified health plan
defined by 45 C.F.R. Section 155.20 if a determination is made under
45 C.F.R. Section 155.170 that:
(1) Subsection (b) requires the plan to offer benefits
in addition to the essential health benefits required under 42
U.S.C. Section 18022(b); and
(2) this state must make payments to defray the cost of
the additional benefits mandated by Subsection (b).
(d) If a determination described by Subsection (c) is made
as to a qualified health plan, Subsection (b) does not apply to a
non-qualified health plan offered in the same market as the
qualified health plan.
SECTION 8. If before implementing the change in law made by
Section 32.024(ee), Human Resources Code, as added by this Act, a
state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that change in
law, the agency affected by the change in law shall request the
waiver or authorization and may delay implementing that change in
law until the waiver or authorization is granted.
SECTION 9. Subchapter D, Chapter 1364, Insurance Code, as
added by this Act, and Sections 1507.004 and 1507.054, Insurance
Code, as amended by this Act, apply only to a health benefit plan
that is delivered, issued for delivery, or renewed on or after
January 1, 2024. A health benefit plan that is delivered, issued
for delivery, or renewed before January 1, 2024, is covered by the
law in effect at the time the health benefit plan was delivered,
issued for delivery, or renewed, and that law is continued in effect
for that purpose.
SECTION 10. (a) The executive commissioner of the Health
and Human Services Commission shall adopt the rules required by
Section 85.0815, Health and Safety Code, as added by this Act, and
Section 32.024(ee), Human Resources Code, as added by this Act, not
later than January 1, 2024.
(b) Notwithstanding Section 85.0815, Health and Safety
Code, as added by this Act, a health care provider is not required
to comply with that section until January 1, 2024.
SECTION 11. This Act takes effect September 1, 2023.