Texas 2023 - 88th Regular

Texas Senate Bill SB2247 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R12429 RDS-F
2	2	By: Johnson S.B. No. 2247
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to limitations on health benefit plan cost-sharing
8	8	requirements for preventive services.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle E, Title 8, Insurance Code, is amended
11	11	by adding Chapter 1380 to read as follows:
12	12	CHAPTER 1380. CERTAIN COST-SHARING FOR PREVENTIVE SERVICES
13	13	PROHIBITED
14	14	Sec. 1380.001. APPLICABILITY OF CHAPTER. (a) This chapter
15	15	applies only to a health benefit plan that provides benefits for
16	16	medical or surgical expenses incurred as a result of a health
17	17	condition, accident, or sickness, including an individual, group,
18	18	blanket, or franchise insurance policy or insurance agreement, a
19	19	group hospital service contract, or an individual or group evidence
20	20	of coverage or similar coverage document that is issued by:
21	21	(1) an insurance company;
22	22	(2) a group hospital service corporation operating
23	23	under Chapter 842;
24	24	(3) a health maintenance organization operating under
25	25	Chapter 843;
26	26	(4) an approved nonprofit health corporation that
27	27	holds a certificate of authority under Chapter 844;
28	28	(5) a multiple employer welfare arrangement that holds
29	29	a certificate of authority under Chapter 846;
30	30	(6) a stipulated premium company operating under
31	31	Chapter 884;
32	32	(7) a fraternal benefit society operating under
33	33	Chapter 885;
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	(1) a small employer health benefit plan subject to
38	38	Chapter 1501, including coverage provided through a health group
39	39	cooperative under Subchapter B of that chapter;
40	40	(2) a standard health benefit plan issued under
41	41	Chapter 1507;
42	42	(3) a basic coverage plan under Chapter 1551;
43	43	(4) a basic plan under Chapter 1575;
44	44	(5) a primary care coverage plan under Chapter 1579;
45	45	(6) a plan providing basic coverage under Chapter
46	46	1601;
47	47	(7) health benefits provided by or through a church
48	48	benefits board under Subchapter I, Chapter 22, Business
49	49	Organizations Code;
50	50	(8) group health coverage made available by a school
51	51	district in accordance with Section 22.004, Education Code;
52	52	(9) the state Medicaid program, including the Medicaid
53	53	managed care program operated under Chapter 533, Government Code;
54	54	(10) the child health plan program under Chapter 62,
55	55	Health and Safety Code;
56	56	(11) a regional or local health care program operated
57	57	under Section 75.104, Health and Safety Code;
58	58	(12) a self-funded health benefit plan sponsored by a
59	59	professional employer organization under Chapter 91, Labor Code;
60	60	(13) county employee group health benefits provided
61	61	under Chapter 157, Local Government Code; and
62	62	(14) health and accident coverage provided by a risk
63	63	pool created under Chapter 172, Local Government Code.
64	64	(c) This chapter applies to coverage under a group health
65	65	benefit plan provided to a resident of this state regardless of
66	66	whether the group policy, agreement, or contract is delivered,
67	67	issued for delivery, or renewed in this state.
68	68	Sec. 1380.002. EXCEPTION. This chapter does not apply to an
69	69	individual health benefit plan issued on or before March 23, 2010,
70	70	that has not had any significant changes since that date that reduce
71	71	benefits or increase costs to the individual.
72	72	Sec. 1380.003. CERTAIN COST-SHARING PROVISIONS FOR
73	73	PREVENTIVE SERVICES PROHIBITED. A health benefit plan issuer may
74	74	not impose a deductible, copayment, coinsurance, or other
75	75	cost-sharing provision applicable to benefits for:
76	76	(1) a preventive item or service that has in effect a
77	77	rating of "A" or "B" in the most recent recommendations of the
78	78	United States Preventive Services Task Force;
79	79	(2) an immunization recommended for routine use in the
80	80	most recent immunization schedules published by the United States
81	81	Centers for Disease Control and Prevention of the United States
82	82	Public Health Service; or
83	83	(3) preventive care and screenings supported by the
84	84	most recent comprehensive guidelines adopted by the United States
85	85	Health Resources and Services Administration, including additional
86	86	preventive care and screenings for women not described in
87	87	Subdivision (1).
88	88	Sec. 1380.004. RULES. (a) Subject to Subsection (b), the
89	89	commissioner may adopt rules as necessary to implement this
90	90	chapter.
91	91	(b) Rules adopted by the commissioner to implement this
92	92	chapter must be consistent with the Patient Protection and
93	93	Affordable Care Act (Pub. L. No. 111-148), as that Act existed on
94	94	January 1, 2017.
95	95	SECTION 2. If before implementing any provision of this Act
96	96	a state agency determines that a waiver or authorization from a
97	97	federal agency is necessary for implementation of that provision,
98	98	the agency affected by the provision shall request the waiver or
99	99	authorization and may delay implementing that provision until the
100	100	waiver or authorization is granted.
101	101	SECTION 3. The change in law made by this Act applies only
102	102	to a health benefit plan that is delivered, issued for delivery, or
103	103	renewed on or after January 1, 2024. A health benefit plan that is
104	104	delivered, issued for delivery, or renewed before January 1, 2024,
105	105	is governed by the law as it existed immediately before the
106	106	effective date of this Act, and that law is continued in effect for
107	107	that purpose.
108	108	SECTION 4. This Act takes effect September 1, 2023.