Texas 2025 - 89th Regular

Texas Senate Bill SB1142 Compare Versions

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

Old	New	Differences
1	1	89R419 CJD-F
2	2	By: Miles S.B. No. 1142
3	3
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to preauthorization of certain benefits by certain health
10	10	benefit plan issuers.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 1356.005, Insurance Code, is amended by
13	13	adding Subsection (c) to read as follows:
14	14	(c) A health benefit plan issuer that provides coverage
15	15	under this section may not require preauthorization for a screening
16	16	mammogram or diagnostic imaging described by Subsection (a) or
17	17	(a-1). This subsection may not be construed to authorize a
18	18	physician or other health care provider to provide the medical care
19	19	or health care described by this section if providing the care is
20	20	outside of the scope of the individual's applicable license or
21	21	other authorization issued under Title 3, Occupations Code.
22	22	SECTION 2. Section 1357.004, Insurance Code, is amended by
23	23	adding Subsection (c) to read as follows:
24	24	(c) A health benefit plan issuer that provides coverage
25	25	under this section may not require preauthorization for a
26	26	reconstruction, surgery, prostheses, or treatment described by
27	27	Subsection (a). This subsection may not be construed to authorize a
28	28	physician or other health care provider to provide the medical care
29	29	or health care described by this section if providing the care is
30	30	outside of the scope of the individual's applicable license or
31	31	other authorization issued under Title 3, Occupations Code.
32	32	SECTION 3. Section 1357.054, Insurance Code, is amended by
33	33	adding Subsection (c) to read as follows:
34	34	(c) A health benefit plan issuer that provides coverage
35	35	under this section may not require preauthorization for inpatient
36	36	care described by Subsection (a). This subsection may not be
37	37	construed to authorize a physician or other health care provider to
38	38	provide the medical care or health care described by this section if
39	39	providing the care is outside of the scope of the individual's
40	40	applicable license or other authorization issued under Title 3,
41	41	Occupations Code.
42	42	SECTION 4. Section 1358.054, Insurance Code, is amended by
43	43	adding Subsection (c) to read as follows:
44	44	(c) A health benefit plan issuer that provides coverage
45	45	under this section may not require preauthorization for the
46	46	provision to a qualified enrollee of diabetes equipment, diabetes
47	47	supplies, or diabetes self-management training described by
48	48	Subsection (a). This subsection may not be construed to authorize a
49	49	physician or other health care provider to provide the medical care
50	50	or health care described by this section if providing the care is
51	51	outside of the scope of the individual's applicable license or
52	52	other authorization issued under Title 3, Occupations Code.
53	53	SECTION 5. Section 1361.003, Insurance Code, is amended to
54	54	read as follows:
55	55	Sec. 1361.003. COVERAGE REQUIRED. (a) A group health
56	56	benefit plan must provide to a qualified enrollee coverage for
57	57	medically accepted bone mass measurement to detect low bone mass
58	58	and to determine the enrollee's risk of osteoporosis and fractures
59	59	associated with osteoporosis.
60	60	(b) A group health benefit plan issuer that provides
61	61	coverage under this section may not require preauthorization for
62	62	the provision to a qualified enrollee of a bone mass measurement
63	63	described by Subsection (a). This subsection may not be construed
64	64	to authorize a physician or other health care provider to provide
65	65	the medical care or health care described by this section if
66	66	providing the care is outside of the scope of the individual's
67	67	applicable license or other authorization issued under Title 3,
68	68	Occupations Code.
69	69	SECTION 6. Section 1362.003, Insurance Code, is amended by
70	70	adding Subsection (c) to read as follows:
71	71	(c) A health benefit plan issuer that provides coverage
72	72	under this section to an enrolled male may not require
73	73	preauthorization for a diagnostic examination described by
74	74	Subsection (a). This subsection may not be construed to authorize a
75	75	physician or other health care provider to provide the medical care
76	76	or health care described by this section if providing the care is
77	77	outside of the scope of the individual's applicable license or
78	78	other authorization issued under Title 3, Occupations Code.
79	79	SECTION 7. Section 1363.003, Insurance Code, is amended by
80	80	adding Subsection (d) to read as follows:
81	81	(d) A health benefit plan issuer that provides coverage
82	82	under this section may not require preauthorization for a screening
83	83	examination described by Subsection (a). This subsection may not
84	84	be construed to authorize a physician or other health care provider
85	85	to provide the medical care or health care described by this section
86	86	if providing the care is outside of the scope of the individual's
87	87	applicable license or other authorization issued under Title 3,
88	88	Occupations Code.
89	89	SECTION 8. This Act applies only to a health benefit plan
90	90	that is delivered, issued for delivery, or renewed on or after
91	91	January 1, 2026.
92	92	SECTION 9. This Act takes effect September 1, 2025.