Texas 2025 - 89th Regular

Texas Senate Bill SB636 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	89R3644 MEW-D
1	2		By: Johnson S.B. No. 636
2		-	(In the Senate - Filed December 18, 2024; February 3, 2025,
3		-	read first time and referred to Committee on Health & Human
4		-	Services; April 14, 2025, reported adversely, with favorable
5		-	Committee Substitute by the following vote: Yeas 7, Nays 2;
6		-	April 14, 2025, sent to printer.)
7		-	Click here to see the committee vote
8		-	COMMITTEE SUBSTITUTE FOR S.B. No. 636 By: Hancock
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12	6
13	7		A BILL TO BE ENTITLED
14	8		AN ACT
15	9		relating to coverage for mental health conditions and substance use
16	10		disorders under certain governmental health benefit plans.
17	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
18	12		SECTION 1. Section 1355.002(b), Insurance Code, is amended
19	13		to read as follows:
20	14		(b) Except as otherwise provided by this subchapter, but
21	15		notwithstanding [Notwithstanding any provision in Chapter 1575 or
22	16		1579 or] any other law, this subchapter [Section 1355.015] applies
23	17		to:
24	18		(1) a basic coverage plan under Chapter 1551;
25	19		(2) a basic plan under Chapter 1575; [and]
26	20		(3) [(2)] a primary care coverage plan under Chapter
27	21		1579; and
28	22		(4) a plan providing basic coverage under Chapter
29	23		1601.
30	24		SECTION 2. Section 1355.003(a), Insurance Code, is amended
31	25		to read as follows:
32	26		(a) This subchapter does not apply to coverage under:
33	27		(1) a blanket accident and health insurance policy, as
34	28		described by Chapter 1251;
35	29		(2) a short-term travel policy;
36	30		(3) an accident-only policy;
37	31		(4) a limited or specified-disease policy that does
38	32		not provide benefits for mental health care or similar services;
39	33		(5) [except as provided by Subsection (b), a plan
40	34		offered under Chapter 1551 or Chapter 1601;
41	35		[(6)] a plan offered in accordance with Section
42	36		1355.151; or
43	37		(6) [(7)] a Medicare supplement benefit plan, as
44	38		defined by Section 1652.002.
45	39		SECTION 3. Section 1355.015(e), Insurance Code, is amended
46	40		to read as follows:
47	41		(e) Notwithstanding any other law, this section does not
48	42		apply to:
49	43		(1) a standard health benefit plan provided under
50	44		Chapter 1507;
51	45		(2) a basic coverage plan under Chapter 1551; or
52	46		(3) a plan providing basic coverage under Chapter
53	47		1601.
54	48		SECTION 4. Section 1355.252, Insurance Code, is amended by
55	49		adding Subsection (d) to read as follows:
56	50		(d) Notwithstanding any other law, this subchapter applies
57	51		to:
58	52		(1) a basic coverage plan under Chapter 1551;
59	53		(2) a basic plan under Chapter 1575;
60	54		(3) a primary care coverage plan under Chapter 1579;
61	55		and
62	56		(4) a plan providing basic coverage under Chapter
63	57		1601.
64	58		SECTION 5. Section 1355.255, Insurance Code, is amended to
65	59		read as follows:
66	60		Sec. 1355.255. COMPLIANCE. (a) Except as provided by
67	61		Subsection (b), the [The] commissioner shall enforce compliance
68	62		with Section 1355.254 by evaluating the benefits and coverage
69	63		offered by a health benefit plan for quantitative and
70	64		nonquantitative treatment limitations in the following categories:
71	65		(1) in-network and out-of-network inpatient care;
72	66		(2) in-network and out-of-network outpatient care;
73	67		(3) emergency care; and
74	68		(4) prescription drugs.
75	69		(b) With respect to a plan described by Section 1355.252(d),
76	70		the applicable trustee, board of trustees, or system shall enforce
77	71		compliance with Section 1355.254 by evaluating the benefits and
78	72		coverage offered by a health benefit plan for quantitative and
79	73		nonquantitative treatment limitations in the following categories:
80	74		(1) in-network and out-of-network inpatient care;
81	75		(2) in-network and out-of-network outpatient care;
82	76		(3) emergency care; and
83	77		(4) prescription drugs.
84		-	SECTION 6. Section 1551.205, Insurance Code, is amended to
85		-	read as follows:
86		-	Sec. 1551.205. LIMITATIONS. The board of trustees may not
87		-	contract for or provide a coverage plan that:
88		-	(1) excludes or limits coverage or services for
89		-	acquired immune deficiency syndrome, as defined by the Centers for
90		-	Disease Control and Prevention of the United States Public Health
91		-	Service, or human immunodeficiency virus infection; or
92		-	(2) [provides coverage for serious mental illness that
93		-	is less extensive than the coverage provided for any physical
94		-	illness; or
95		-	[(3)] may provide coverage for prescription drugs to
96		-	assist in stopping smoking at a lower benefit level than is provided
97		-	for other prescription drugs.
98		-	SECTION 7. Section 1355.003(b), Insurance Code, is
	78	+	SECTION 6. Section 1355.003(b), Insurance Code, is
99	79		repealed.
100		-	SECTION 8. The changes in law made by this Act apply only to
	80	+	SECTION 7. The changes in law made by this Act apply only to
101	81		a plan year that commences on or after January 1, 2026. A plan year
102	82		that commenced before January 1, 2026, is governed by the law as it
103	83		existed immediately before the effective date of this Act, and that
104	84		law is continued in effect for that purpose.
105		-	SECTION 9. This Act takes effect September 1, 2025.
106		-	* * * * *
	85	+	SECTION 8. This Act takes effect September 1, 2025.