Bill Text: TX HB3276 | 2013-2014 | 83rd Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the coverage by certain health benefit plans for the screening and treatment of autism spectrum disorder.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [HB3276 Detail]
Download: Texas-2013-HB3276-Comm_Sub.html
Bill Title: Relating to the coverage by certain health benefit plans for the screening and treatment of autism spectrum disorder.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [HB3276 Detail]
Download: Texas-2013-HB3276-Comm_Sub.html
By: Simmons, et al. (Senate Sponsor - Deuell) | H.B. No. 3276 | |
(In the Senate - Received from the House May 10, 2013; | ||
May 10, 2013, read first time and referred to Committee on State | ||
Affairs; May 20, 2013, reported favorably by the following vote: | ||
Yeas 5, Nays 1; May 20, 2013, sent to printer.) |
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relating to the coverage by certain health benefit plans for the | ||
screening and treatment of autism spectrum disorder. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1355.015, Insurance Code, is amended by | ||
amending Subsections (a) and (b) and adding Subsections (a-1) and | ||
(f) to read as follows: | ||
(a) At a minimum, a health benefit plan must provide | ||
coverage for screening a child for autism spectrum disorder at the | ||
ages of 18 and 24 months. | ||
(a-1) At a minimum, a health benefit plan must provide | ||
coverage for treatment of autism spectrum disorder as provided by | ||
this section to an enrollee who is diagnosed with autism spectrum | ||
disorder from the date of diagnosis until the enrollee completes | ||
nine years of age. If an enrollee who is being treated for autism | ||
spectrum disorder becomes 10 years of age or older and continues to | ||
need treatment, this subsection does not preclude coverage of | ||
treatment and services described by Subsection (b). | ||
(b) The health benefit plan must provide coverage under this | ||
section to the enrollee for all generally recognized services | ||
prescribed in relation to autism spectrum disorder by the | ||
enrollee's primary care physician in the treatment plan recommended | ||
by that physician. An individual providing treatment prescribed | ||
under this subsection must be: | ||
(1) a health care practitioner: | ||
(A) [ |
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registered by an appropriate agency of this state; | ||
(B) [ |
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recognized and accepted by an appropriate agency of the United | ||
States; or | ||
(C) [ |
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the TRICARE military health system; or | ||
(2) an individual acting under the supervision of a | ||
health care practitioner described by Subdivision (1). | ||
(f) Subsection (a) does not apply to a qualified health plan | ||
defined by 45 C.F.R. Section 155.20 if a determination is made under | ||
45 C.F.R. Section 155.170 that: | ||
(1) this subchapter requires the qualified health plan | ||
to offer benefits in addition to the essential health benefits | ||
required under 42 U.S.C. Section 18022(b); and | ||
(2) this state must make payments to defray the cost of | ||
the additional benefits mandated by this subchapter. | ||
SECTION 2. Section 1355.015, Insurance Code, as amended by | ||
this Act, applies only to a health benefit plan delivered, issued | ||
for delivery, or renewed on or after January 1, 2014. A health | ||
benefit plan delivered, issued for delivery, or renewed before | ||
January 1, 2014, is governed by the law in effect immediately before | ||
the effective date of this Act, and that law is continued in effect | ||
for that purpose. | ||
SECTION 3. This Act takes effect September 1, 2013. | ||
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