Bill Text: TX HB109 | 2023-2024 | 88th Legislature | Enrolled
Bill Title: Relating to health benefit coverage for hearing aids for children and adults.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Passed) 2023-05-13 - Effective on 9/1/23 [HB109 Detail]
Download: Texas-2023-HB109-Enrolled.html
| H.B. No. 109 | ||
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| relating to health benefit coverage for hearing aids for children | ||
| and adults. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1365, Insurance Code, is amended by | ||
| designating Sections 1365.001 through 1365.004 as Subchapter A and | ||
| adding a subchapter heading to read as follows: | ||
| SUBCHAPTER A. GENERAL PROVISIONS | ||
| SECTION 2. Sections 1365.001 and 1365.002, Insurance Code, | ||
| are amended to read as follows: | ||
| Sec. 1365.001. APPLICABILITY OF SUBCHAPTER [ |
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| subchapter [ |
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| that provides hospital and medical coverage on an expense-incurred, | ||
| service, or prepaid basis, including a group policy, contract, or | ||
| plan that is offered in this state by: | ||
| (1) an insurer; | ||
| (2) a group hospital service corporation operating | ||
| under Chapter 842; or | ||
| (3) a health maintenance organization operating under | ||
| Chapter 843. | ||
| Sec. 1365.002. APPLICABILITY OF GENERAL PROVISIONS OF OTHER | ||
| LAW. The provisions of Chapter 1201, including provisions relating | ||
| to the applicability, purpose, and enforcement of that chapter, | ||
| construction of policies under that chapter, rulemaking under that | ||
| chapter, and definitions of terms applicable in that chapter, apply | ||
| to this subchapter [ |
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| SECTION 3. Chapter 1365, Insurance Code, is amended by | ||
| adding Subchapter B to read as follows: | ||
| SUBCHAPTER B. HEARING AID COVERAGE | ||
| Sec. 1365.051. APPLICABILITY. (a) This subchapter applies | ||
| only to a health benefit plan that provides benefits for medical or | ||
| surgical expenses incurred as a result of a health condition, | ||
| accident, or sickness, including an individual, group, blanket, or | ||
| franchise insurance policy or insurance agreement, a group hospital | ||
| service contract, or an individual or group evidence of coverage or | ||
| similar coverage document that is offered by: | ||
| (1) an insurance company; | ||
| (2) a group hospital service corporation operating | ||
| under Chapter 842; | ||
| (3) a health maintenance organization operating under | ||
| Chapter 843; | ||
| (4) an approved nonprofit health corporation that | ||
| holds a certificate of authority under Chapter 844; | ||
| (5) a multiple employer welfare arrangement that holds | ||
| a certificate of authority under Chapter 846; | ||
| (6) a stipulated premium company operating under | ||
| Chapter 884; | ||
| (7) a fraternal benefit society operating under | ||
| Chapter 885; | ||
| (8) a Lloyd's plan operating under Chapter 941; or | ||
| (9) an exchange operating under Chapter 942. | ||
| (b) This subchapter applies to coverage under a group health | ||
| benefit plan described by Subsection (a) provided to a resident of | ||
| this state, regardless of whether the group policy, agreement, or | ||
| contract is delivered, issued for delivery, or renewed within or | ||
| outside this state. | ||
| (c) Notwithstanding any other law, this subchapter applies | ||
| to: | ||
| (1) a small employer health benefit plan subject to | ||
| Chapter 1501, including coverage provided through a health group | ||
| cooperative under Subchapter B of that chapter; | ||
| (2) a standard health benefit plan issued under | ||
| Chapter 1507; | ||
| (3) a basic coverage plan under Chapter 1551; | ||
| (4) a basic plan under Chapter 1575; | ||
| (5) a primary care coverage plan under Chapter 1579; | ||
| (6) a plan providing basic coverage under Chapter | ||
| 1601; | ||
| (7) a regional or local health care program operated | ||
| under Section 75.104, Health and Safety Code; and | ||
| (8) a self-funded health benefit plan sponsored by a | ||
| professional employer organization under Chapter 91, Labor Code. | ||
| Sec. 1365.052. EXCEPTION. This subchapter does not apply | ||
| to: | ||
| (1) a plan that provides coverage: | ||
| (A) for wages or payments in lieu of wages for a | ||
| period during which an employee is absent from work because of | ||
| sickness or injury; or | ||
| (B) only for hospital expenses; or | ||
| (2) the state Medicaid program, including the Medicaid | ||
| managed care program operated under Chapter 533, Government Code. | ||
| Sec. 1365.053. CHOICE OF HEARING AID. (a) A health benefit | ||
| plan that provides coverage for hearing aids may not deny an | ||
| enrollee's claim for a hearing aid solely on the basis that the | ||
| price of the hearing aid is more than the benefit available under | ||
| the health benefit plan. | ||
| (b) Notwithstanding Section 1367.253(d), this section | ||
| applies to a health benefit plan subject to Subchapter F, Chapter | ||
| 1367. | ||
| (c) Nothing in this section requires a health benefit plan | ||
| to pay an enrollee's claim for a hearing aid in an amount that is | ||
| more than the benefit available under the health benefit plan. | ||
| SECTION 4. This Act applies only to a health benefit plan | ||
| that is delivered, issued for delivery, or renewed on or after | ||
| January 1, 2024. | ||
| SECTION 5. This Act takes effect September 1, 2023. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I certify that H.B. No. 109 was passed by the House on April | ||
| 20, 2023, by the following vote: Yeas 143, Nays 3, 2 present, not | ||
| voting. | ||
| ______________________________ | ||
| Chief Clerk of the House | ||
| I certify that H.B. No. 109 was passed by the Senate on April | ||
| 27, 2023, by the following vote: Yeas 30, Nays 1. | ||
| ______________________________ | ||
| Secretary of the Senate | ||
| APPROVED: _____________________ | ||
| Date | ||
| _____________________ | ||
| Governor | ||
