Texas 2025 - 89th Regular

Texas House Bill HB1045 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R3557 RDR-D
2	2	By: Turner H.B. No. 1045
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to health benefit plan coverage of treatment for chemical
10	10	dependency.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 1368.001(2), Insurance Code, is amended
13	13	to read as follows:
14	14	(2) "Chemical dependency treatment center" means a
15	15	facility that provides a program for the treatment of chemical
16	16	dependency under a written treatment plan approved and monitored by
17	17	a physician and that is:
18	18	(A) affiliated with a hospital under a
19	19	contractual agreement with an established system for patient
20	20	referral;
21	21	(B) accredited as a chemical dependency
22	22	treatment center by the Joint Commission on Accreditation of
23	23	Healthcare Organizations;
24	24	(C) licensed as a chemical dependency treatment
25	25	program by the Health and Human Services [Texas] Commission [on
26	26	Alcohol and Drug Abuse]; or
27	27	(D) licensed, certified, or approved as a
28	28	chemical dependency treatment program or center by another state
29	29	agency.
30	30	SECTION 2. Sections 1368.002, 1368.003, and 1368.004,
31	31	Insurance Code, are amended to read as follows:
32	32	Sec. 1368.002. APPLICABILITY OF CHAPTER. (a) This chapter
33	33	applies only to a [group] health benefit plan that provides
34	34	hospital and medical coverage or services on an expense incurred,
35	35	service, or prepaid basis, including an individual or a group
36	36	insurance policy or contract or self-funded or self-insured plan or
37	37	arrangement that is offered in this state by:
38	38	(1) an insurer;
39	39	(2) a group hospital service corporation operating
40	40	under Chapter 842;
41	41	(3) a health maintenance organization operating under
42	42	Chapter 843; or
43	43	(4) an employer, trustee, or other self-funded or
44	44	self-insured plan or arrangement.
45	45	(b) Notwithstanding any other law, this chapter applies to:
46	46	(1) a basic coverage plan under Chapter 1551;
47	47	(2) a basic plan under Chapter 1575;
48	48	(3) a primary care coverage plan under Chapter 1579;
49	49	or
50	50	(4) a plan providing basic coverage under Chapter
51	51	1601.
52	52	Sec. 1368.003. EXCEPTION. This chapter does not apply to:
53	53	(1) [an employer, trustee, or other self-funded or
54	54	self-insured plan or arrangement with 250 or fewer employees or
55	55	members;
56	56	[(2) an individual insurance policy;
57	57	[(3) an individual evidence of coverage issued by a
58	58	health maintenance organization;
59	59	[(4)] a health insurance policy that provides only:
60	60	(A) cash indemnity for hospital or other
61	61	confinement benefits;
62	62	(B) supplemental or limited benefit coverage;
63	63	(C) coverage for specified diseases or
64	64	accidents;
65	65	(D) disability income coverage; or
66	66	(E) any combination of those benefits or
67	67	coverages;
68	68	(2) [(5)] a blanket insurance policy;
69	69	(3) [(6)] a short-term travel insurance policy;
70	70	(4) [(7)] an accident-only insurance policy;
71	71	(5) [(8)] a limited or specified disease insurance
72	72	policy;
73	73	(6) [(9)] an individual conversion insurance policy
74	74	or contract;
75	75	(7) [(10)] a policy or contract designed for issuance
76	76	to a person eligible for Medicare coverage or other similar
77	77	coverage under a state or federal government plan; or
78	78	(8) [(11)] an evidence of coverage provided by a
79	79	health maintenance organization if the plan holder is the subject
80	80	of a collective bargaining agreement that was in effect on January
81	81	1, 1982, and that has not expired since that date.
82	82	Sec. 1368.004. COVERAGE REQUIRED. (a) A [group] health
83	83	benefit plan shall provide coverage for the necessary care and
84	84	treatment of chemical dependency.
85	85	(b) Coverage required under this section may be provided:
86	86	(1) directly by the [group] health benefit plan
87	87	issuer; or
88	88	(2) by another entity, including a single service
89	89	health maintenance organization, under contract with the [group]
90	90	health benefit plan issuer.
91	91	SECTION 3. Section 1368.005(a), Insurance Code, is amended
92	92	to read as follows:
93	93	(a) Coverage [Except as provided by Subsection (b),
94	94	coverage] required under this chapter[:
95	95	[(1)] may not be less favorable than coverage provided
96	96	for physical illness generally under the plan[; and
97	97	[(2) shall be subject to the same durational limits,
98	98	dollar limits, deductibles, and coinsurance factors that apply to
99	99	coverage provided for physical illness generally under the plan].
100	100	SECTION 4. The heading to Section 1368.006, Insurance Code,
101	101	is amended to read as follows:
102	102	Sec. 1368.006. LIFETIME LIMITATION ON COVERAGE PROHIBITED.
103	103	SECTION 5. Section 1368.006(b), Insurance Code, is amended
104	104	to read as follows:
105	105	(b) Coverage [Notwithstanding Section 1368.005, coverage]
106	106	required under this chapter may not be subject [is limited] to a
107	107	lifetime maximum [of three separate treatment series for each
108	108	covered individual].
109	109	SECTION 6. Sections 1368.007(a) and (b), Insurance Code,
110	110	are amended to read as follows:
111	111	(a) Coverage provided under this chapter for necessary care
112	112	and treatment in a chemical dependency treatment center must be
113	113	provided at an appropriate level of [as if the] care [and treatment
114	114	were provided in a hospital].
115	115	(b) The commissioner [department] by rule shall adopt
116	116	standards formulated and approved by the commissioner [department]
117	117	and the executive commissioner of the Health and Human Services
118	118	Commission [Texas Commission on Alcohol and Drug Abuse] for use by
119	119	insurers, other third-party reimbursement sources, and chemical
120	120	dependency treatment centers.
121	121	SECTION 7. Sections 1368.005(b) and 1368.006(a), Insurance
122	122	Code, are repealed.
123	123	SECTION 8. The changes in law made by this Act apply only to
124	124	a health benefit plan that is delivered, issued for delivery, or
125	125	renewed on or after January 1, 2026. A health benefit plan
126	126	delivered, issued for delivery, or renewed before January 1, 2026,
127	127	is governed by the law as it existed immediately before the
128	128	effective date of this Act, and that law is continued in effect for
129	129	that purpose.
130	130	SECTION 9. This Act takes effect September 1, 2025.