| 1 | 1 | | 89R9634 SCR-D |
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| 2 | 2 | | By: Hull H.B. No. 2580 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to a study on health benefit plan coverage for certain |
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| 10 | 10 | | treatments of traumatic brain injuries. |
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| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 12 | 12 | | SECTION 1. (a) In this Act: |
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| 13 | 13 | | (1) "Department" means the Texas Department of |
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| 14 | 14 | | Insurance. |
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| 15 | 15 | | (2) "Traumatic brain injury" means an acquired injury |
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| 16 | 16 | | to the brain, including brain injuries caused by anoxia due to near |
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| 17 | 17 | | drowning. The term does not include brain dysfunction caused by |
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| 18 | 18 | | congenital or degenerative disorders or birth trauma. |
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| 19 | 19 | | (3) "Traumatic brain injury treatment" means |
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| 20 | 20 | | cognitive rehabilitation therapy, cognitive communication therapy, |
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| 21 | 21 | | neurocognitive therapy and rehabilitation, neurobehavioral, |
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| 22 | 22 | | neurophysiological, neuropsychological, and psychophysiological |
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| 23 | 23 | | testing and treatment, neurofeedback therapy, and remediation |
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| 24 | 24 | | required for and related to treatment of a traumatic brain injury. |
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| 25 | 25 | | (b) The department, in consultation with the Texas |
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| 26 | 26 | | Traumatic Brain Injury Advisory Council, shall conduct a study on |
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| 27 | 27 | | the effect of Chapter 1352, Insurance Code, on the coverage of |
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| 28 | 28 | | traumatic brain injury treatment by health benefit plans offered in |
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| 29 | 29 | | this state. |
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| 30 | 30 | | (c) In conducting the study, the department shall: |
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| 31 | 31 | | (1) review the number, types, and outcome of claims |
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| 32 | 32 | | made in this state for treatment of traumatic brain injuries; |
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| 33 | 33 | | (2) review the coverage offered for traumatic brain |
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| 34 | 34 | | injury treatment by health benefit plans in this state; |
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| 35 | 35 | | (3) determine the effect, if any, of substance abuse, |
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| 36 | 36 | | including opioid abuse and addiction, on traumatic brain injury |
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| 37 | 37 | | coverage and treatment in this state; and |
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| 38 | 38 | | (4) analyze the effect of any exclusions or exceptions |
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| 39 | 39 | | in health benefit plan coverage of traumatic brain injury |
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| 40 | 40 | | treatment, including exclusions for injuries caused by self-harm or |
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| 41 | 41 | | substance abuse. |
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| 42 | 42 | | (d) In conducting the study, the department may request from |
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| 43 | 43 | | a health benefit plan issuer and a health benefit plan issuer shall |
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| 44 | 44 | | provide deidentified and aggregated information on claims for |
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| 45 | 45 | | traumatic brain injuries. |
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| 46 | 46 | | (e) Not later than December 1, 2026, the department shall |
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| 47 | 47 | | submit to the governor, the lieutenant governor, the speaker of the |
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| 48 | 48 | | house of representatives, and the chair of the standing committee |
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| 49 | 49 | | of each house of the legislature with primary jurisdiction over the |
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| 50 | 50 | | department a written report that includes: |
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| 51 | 51 | | (1) the findings of the study conducted under this |
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| 52 | 52 | | section; and |
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| 53 | 53 | | (2) any recommendations for legislative or other |
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| 54 | 54 | | action related to coverage and treatment of traumatic brain |
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| 55 | 55 | | injuries. |
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| 56 | 56 | | (f) This Act expires September 1, 2027. |
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| 57 | 57 | | SECTION 2. This Act takes effect September 1, 2025. |
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