Bill Text: TX HB2408 | 2019-2020 | 86th Legislature | Comm Sub
Bill Title: Relating to preauthorization by certain health benefit plan issuers of certain benefits.
Spectrum: Moderate Partisan Bill (Democrat 16-3)
Status: (Introduced - Dead) 2019-04-11 - Committee report sent to Calendars [HB2408 Detail]
Download: Texas-2019-HB2408-Comm_Sub.html
86R21993 JES-F | |||
By: J. Johnson of Dallas, et al. | H.B. No. 2408 | ||
Substitute the following for H.B. No. 2408: | |||
By: Lucio III | C.S.H.B. No. 2408 |
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relating to preauthorization by certain health benefit plan issuers | ||
of certain benefits. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1356.005, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section may not require preauthorization for a screening | ||
described by Subsection (a). This subsection may not be construed | ||
to authorize a physician or other health care provider to provide | ||
the medical care or health care described by this section if | ||
providing the care is outside of the scope of the individual's | ||
applicable license. | ||
SECTION 2. Section 1357.004, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section may not require preauthorization for a | ||
reconstruction, surgery, prostheses, or treatment described by | ||
Subsection (a). This subsection may not be construed to authorize a | ||
physician or other health care provider to provide the medical care | ||
or health care described by this section if providing the care is | ||
outside of the scope of the individual's applicable license. | ||
SECTION 3. Section 1357.054, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section may not require preauthorization for inpatient | ||
care described by Subsection (a). This subsection may not be | ||
construed to authorize a physician or other health care provider to | ||
provide the medical care or health care described by this section if | ||
providing the care is outside of the scope of the individual's | ||
applicable license. | ||
SECTION 4. Section 1358.054, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section may not require preauthorization for the | ||
provision to a qualified enrollee of diabetes equipment, diabetes | ||
supplies, or self-management training described by Subsection (a). | ||
This subsection may not be construed to authorize a physician or | ||
other health care provider to provide the medical care or health | ||
care described by this section if providing the care is outside of | ||
the scope of the individual's applicable license. | ||
SECTION 5. Section 1361.003, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1361.003. COVERAGE REQUIRED. (a) A group health | ||
benefit plan must provide to a qualified enrollee coverage for | ||
medically accepted bone mass measurement to detect low bone mass | ||
and to determine the enrollee's risk of osteoporosis and fractures | ||
associated with osteoporosis. | ||
(b) A group health benefit plan issuer that provides | ||
coverage under this section may not require preauthorization for | ||
the provision to a qualified enrollee of a bone mass measurement | ||
described by Subsection (a). This subsection may not be construed | ||
to authorize a physician or other health care provider to provide | ||
the medical care or health care described by this section if | ||
providing the care is outside of the scope of the individual's | ||
applicable license. | ||
SECTION 6. Section 1362.003, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section to an enrolled male may not require | ||
preauthorization for a diagnostic examination described by | ||
Subsection (a). This subsection may not be construed to authorize a | ||
physician or other health care provider to provide the medical care | ||
or health care described by this section if providing the care is | ||
outside of the scope of the individual's applicable license. | ||
SECTION 7. Section 1363.003, Insurance Code, is amended by | ||
adding Subsection (c) to read as follows: | ||
(c) A health benefit plan issuer that provides coverage | ||
under this section may not require preauthorization for a screening | ||
examination described by Subsection (a). This subsection may not | ||
be construed to authorize a physician or other health care provider | ||
to provide the medical care or health care described by this section | ||
if providing the care is outside of the scope of the individual's | ||
applicable license. | ||
SECTION 8. This Act applies only to a health benefit plan | ||
that is delivered, issued for delivery, or renewed on or after | ||
January 1, 2020. | ||
SECTION 9. This Act takes effect September 1, 2019. |