Bill Text: TX HB1161 | 2017-2018 | 85th Legislature | Comm Sub
Bill Title: Relating to health benefit plan coverage of prescription contraceptive drugs.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-05-06 - Committee report sent to Calendars [HB1161 Detail]
Download: Texas-2017-HB1161-Comm_Sub.html
85R25826 MEW-D | |||
By: Davis of Harris, Howard | H.B. No. 1161 | ||
Substitute the following for H.B. No. 1161: | |||
By: Phillips | C.S.H.B. No. 1161 |
|
||
|
||
relating to health benefit plan coverage of prescription | ||
contraceptive drugs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1369.102, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1369.102. APPLICABILITY OF SUBCHAPTER. Except as | ||
otherwise provided by this subchapter, this [ |
||
applies only to a health benefit plan, including a small employer | ||
health benefit plan written under Chapter 1501, 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 fraternal benefit society operating under | ||
Chapter 885; | ||
(4) a stipulated premium company operating under | ||
Chapter 884; | ||
(5) a reciprocal exchange operating under Chapter 942; | ||
(6) a health maintenance organization operating under | ||
Chapter 843; | ||
(7) a multiple employer welfare arrangement that holds | ||
a certificate of authority under Chapter 846; or | ||
(8) an approved nonprofit health corporation that | ||
holds a certificate of authority under Chapter 844. | ||
SECTION 2. Subchapter C, Chapter 1369, Insurance Code, is | ||
amended by adding Section 1369.1031 to read as follows: | ||
Sec. 1369.1031. CERTAIN COVERAGE REQUIRED. (a) This | ||
section applies to a health benefit plan described by Section | ||
1369.102. | ||
(b) This section applies to group health coverage made | ||
available by a school district in accordance with Section 22.004, | ||
Education Code. | ||
(c) Notwithstanding any provision in Chapter 1551, 1575, | ||
1579, or 1601 or any other law, this section applies to: | ||
(1) a basic coverage plan under Chapter 1551; | ||
(2) a basic plan under Chapter 1575; | ||
(3) a primary care coverage plan under Chapter 1579; | ||
and | ||
(4) basic coverage under Chapter 1601. | ||
(d) Notwithstanding Sections 1507.004 and 1507.053, or any | ||
other law, this section applies to a consumer choice of benefits | ||
plan issued under Chapter 1507. | ||
(e) To the extent allowed by federal law, the child health | ||
plan program operated under Chapter 62, Health and Safety Code, the | ||
health benefits plan for children operated under Chapter 63, Health | ||
and Safety Code, the state Medicaid program, and a managed care | ||
organization that contracts with the Health and Human Services | ||
Commission to provide health care services to recipients through a | ||
managed care plan shall provide the coverage required under this | ||
section to a recipient. | ||
(f) A health benefit plan that provides benefits for a | ||
prescription contraceptive drug must provide for an enrollee to | ||
obtain up to: | ||
(1) a 3-month supply of the covered prescription | ||
contraceptive drug at one time the first time the enrollee obtains | ||
the drug; and | ||
(2) a 12-month supply of the covered prescription | ||
contraceptive drug at one time each subsequent time the enrollee | ||
obtains the same drug, regardless of whether the enrollee was | ||
enrolled in the health benefit plan the first time the enrollee | ||
obtained the drug. | ||
(g) An enrollee may obtain only one 12-month supply of a | ||
covered prescription contraceptive drug during each 12-month | ||
period. | ||
SECTION 3. The change in law made by this Act applies only | ||
to a health benefit plan that is delivered, issued for delivery, or | ||
renewed on or after January 1, 2018. A health benefit plan that is | ||
delivered, issued for delivery, or renewed before January 1, 2018, | ||
is governed by the law as it existed immediately before the | ||
effective date of this Act, and that law is continued in effect for | ||
that purpose. | ||
SECTION 4. This Act takes effect September 1, 2017. |