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
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  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.
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