Texas 2023 - 88th Regular

Texas Senate Bill SB2176 Compare Versions

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11 88R7283 JES-D
22 By: LaMantia S.B. No. 2176
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55 A BILL TO BE ENTITLED
66 AN ACT
77 relating to health benefit plan coverage for treatment of autism.
88 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
99 SECTION 1. Section 1355.001(3), Insurance Code, is amended
1010 to read as follows:
1111 (3) "Autism spectrum disorder" means:
1212 (A) a neurobiological disorder or developmental
1313 disability that significantly affects verbal communication,
1414 nonverbal communication, and social interaction and that meets the
1515 diagnostic criteria for autism spectrum disorder specified by the
1616 Diagnostic and Statistical Manual of Mental Disorders, 5th edition,
1717 or a later edition; or
1818 (B) a diagnosis made using a previous edition of
1919 the Diagnostic and Statistical Manual of Mental Disorders of
2020 [includes] autism, Asperger's syndrome, or Pervasive Developmental
2121 Disorder--Not Otherwise Specified.
2222 SECTION 2. Sections 1355.015(a-1) and (c-1), Insurance
2323 Code, are amended to read as follows:
2424 (a-1) At a minimum, a health benefit plan must provide
2525 coverage for treatment of autism spectrum disorder as provided by
2626 this section to an enrollee who is diagnosed with autism spectrum
2727 disorder from the date of diagnosis[, only if the diagnosis was in
2828 place prior to the child's 10th birthday].
2929 (c-1) The health benefit plan may [is] not require [required
3030 to provide coverage under Subsection (b) for benefits for] an
3131 enrollee to be evaluated for autism spectrum disorder more than
3232 once every 10 years [of age or older for applied behavior analysis
3333 in an amount that exceeds $36,000 per year].
3434 SECTION 3. The changes in law made by this Act apply only to
3535 a health benefit plan delivered, issued for delivery, or renewed on
3636 or after January 1, 2024. A health benefit plan delivered, issued
3737 for delivery, or renewed before January 1, 2024, is governed by the
3838 law as it existed immediately before the effective date of this Act,
3939 and that law is continued in effect for that purpose.
4040 SECTION 4. This Act takes effect September 1, 2023.