Bill Text: TX HB3144 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to coverage for certain services relating to postpartum depression under certain health benefit plans and the medical assistance and CHIP perinatal programs.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-03-29 - Referred to Human Services [HB3144 Detail]
Download: Texas-2017-HB3144-Introduced.html
85R9412 LED-D | ||
By: Thompson of Harris | H.B. No. 3144 |
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relating to coverage for certain services relating to postpartum | ||
depression under certain health benefit plans and the medical | ||
assistance and CHIP perinatal programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 62, Health and Safety Code, is amended by | ||
adding Subchapter E to read as follows: | ||
SUBCHAPTER E. CHIP PERINATAL PROGRAM | ||
Sec. 62.201. DEFINITION. In this subchapter, "postpartum | ||
depression" means a disorder with postpartum onset that is | ||
categorized as a mood disorder by the American Psychiatric | ||
Association in the Diagnostic and Statistical Manual of Mental | ||
Disorders, 5th Edition (DSM-5), or a subsequent edition adopted by | ||
rule by the executive commissioner. | ||
Sec. 62.202. COVERAGE FOR CERTAIN SERVICES REQUIRED. (a) | ||
The covered services under the CHIP perinatal program must include, | ||
for each woman who gives birth to a child who is enrolled in the CHIP | ||
perinatal program before birth, screening and treatment for | ||
postpartum depression for the 12-month period after the date the | ||
woman gives birth to the child. | ||
(b) The coverage for postpartum depression provided under | ||
Subsection (a): | ||
(1) must provide mental health services to a woman | ||
regardless of whether the woman has been found to be a danger to | ||
herself or others; and | ||
(2) may not place an arbitrary or artificial limit on | ||
the amount of services that may be provided. | ||
(c) The executive commissioner shall adopt rules necessary | ||
to implement this section. | ||
SECTION 2. Subchapter B, Chapter 32, Human Resources Code, | ||
is amended by adding Section 32.0249 to read as follows: | ||
Sec. 32.0249. SERVICES RELATED TO POSTPARTUM DEPRESSION. | ||
(a) For purposes of this section, "postpartum depression" means a | ||
disorder with postpartum onset that is categorized as a mood | ||
disorder by the American Psychiatric Association in the Diagnostic | ||
and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), or | ||
a subsequent edition adopted by rule by the executive commissioner. | ||
(b) The commission shall provide to a woman who receives | ||
medical assistance benefits during a pregnancy screening and | ||
treatment for postpartum depression for the 12-month period after | ||
the date the woman gives birth. | ||
(c) The commission shall provide mental health services to a | ||
woman under Subsection (b) regardless of whether the woman has been | ||
found to be a danger to herself or others. | ||
(d) The commission may not place an arbitrary or artificial | ||
limit on the amount of services that may be provided under | ||
Subsection (b). | ||
(e) The executive commissioner shall adopt rules necessary | ||
to implement this section. | ||
SECTION 3. Chapter 1366, Insurance Code, is amended by | ||
adding Subchapter C to read as follows: | ||
SUBCHAPTER C. COVERAGE FOR POSTPARTUM DEPRESSION TREATMENT | ||
Sec. 1366.101. DEFINITION. In this subchapter, "postpartum | ||
depression" means a disorder with postpartum onset that is | ||
categorized as a mood disorder by the American Psychiatric | ||
Association in the Diagnostic and Statistical Manual of Mental | ||
Disorders, 5th Edition (DSM-5), or a subsequent edition adopted by | ||
rule by the commissioner. | ||
Sec. 1366.102. APPLICABILITY OF SUBCHAPTER. (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 fraternal benefit society operating under | ||
Chapter 885; | ||
(4) a stipulated premium insurance company operating | ||
under Chapter 884; | ||
(5) a health maintenance organization operating under | ||
Chapter 843; | ||
(6) a multiple employer welfare arrangement that holds | ||
a certificate of authority under Chapter 846; or | ||
(7) an approved nonprofit health corporation that | ||
holds a certificate of authority under Chapter 844. | ||
(b) Notwithstanding any provision in Chapter 1551, 1575, | ||
1579, or 1601 or any other law, this subchapter 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. | ||
(c) This subchapter does not apply to a qualified health | ||
plan if a determination is made under 45 C.F.R. Section 155.170 | ||
that: | ||
(1) this chapter requires the plan to offer benefits | ||
in addition to the essential health benefits required under 42 | ||
U.S.C. Section 18022(b); and | ||
(2) this state is required to defray the cost of the | ||
benefits mandated under this chapter. | ||
Sec. 1366.103. COVERAGE FOR CERTAIN SERVICES REQUIRED. (a) | ||
A health benefit plan that provides maternity benefits must provide | ||
to a woman who gives birth to a child coverage for screening and | ||
treatment for postpartum depression for the 12-month period after | ||
the date the woman gives birth to the child. | ||
(b) The coverage for postpartum depression provided under | ||
Subsection (a): | ||
(1) must provide mental health services to a woman | ||
regardless of whether the woman has been found to be a danger to | ||
herself or others; and | ||
(2) may not place an arbitrary or artificial limit on | ||
the amount of services that may be provided. | ||
SECTION 4. As soon as practicable after the effective date | ||
of this Act, the executive commissioner of the Health and Human | ||
Services Commission shall develop and seek a waiver or other | ||
appropriate authorization from the Centers for Medicare and | ||
Medicaid Services to extend the number of postpartum visits a woman | ||
may receive under the CHIP perinatal program in order to implement | ||
Section 62.202, Health and Safety Code, as added by this Act. | ||
SECTION 5. If before implementing any provision of this Act | ||
a state agency determines that an additional waiver or additional | ||
authorization from a federal agency is necessary for implementation | ||
of that provision, the agency affected by the provision shall | ||
request the waiver or authorization and may delay implementing that | ||
provision until the waiver or authorization is granted. | ||
SECTION 6. Subchapter C, Chapter 1366, Insurance Code, as | ||
added 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 7. This Act takes effect September 1, 2017. |