Bill Text: TX HB834 | 2011-2012 | 82nd Legislature | Introduced
Bill Title: Relating to supplemental breast cancer screening.
Spectrum: Slight Partisan Bill (Democrat 6-2)
Status: (Introduced - Dead) 2011-04-13 - Left pending in committee [HB834 Detail]
Download: Texas-2011-HB834-Introduced.html
82R1862 TRH-F | ||
By: Hernandez Luna | H.B. No. 834 |
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relating to supplemental breast cancer screening. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. This Act shall be known as Henda's Law. | ||
SECTION 2. Subchapter B, Chapter 86, Health and Safety | ||
Code, is amended by adding Section 86.013 to read as follows: | ||
Sec. 86.013. INFORMATION ON SUPPLEMENTAL BREAST CANCER | ||
SCREENING. (a) A physician consulting with a patient regarding the | ||
results of a mammography exam shall provide the patient with a copy | ||
of the patient's mammography report. | ||
(b) A mammography report provided to a patient under | ||
Subsection (a) must include information regarding breast density, | ||
based on the Breast Imaging Reporting and Database System | ||
established by the American College of Radiology. The report must | ||
include the following notice: | ||
"If your mammogram demonstrates that you have dense breast | ||
tissue, which could hide abnormalities, you might benefit from | ||
supplemental screening tests, which can include a breast MRI | ||
examination, a breast ultrasound screening, or other available | ||
screening methods, depending on your individual risk factors. | ||
"Dense breast tissue, in and of itself, is a relatively | ||
common condition. Therefore, this statement is not provided to | ||
cause undue concern, but rather to raise your awareness of the | ||
limitations of mammography testing and to promote discussion with | ||
your physician regarding the presence of other risk factors, in | ||
addition to dense breast tissue, that may warrant supplemental | ||
screening. | ||
"A report of your mammography results, which contains | ||
information about your breast density, has been sent to your | ||
physician's office, and you should contact your physician if you | ||
have any questions or concerns regarding this report." | ||
(c) This section does not create a cause of action under | ||
Chapter 74, Civil Practice and Remedies Code. | ||
SECTION 3. Section 1201.005, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1201.005. REFERENCES TO CHAPTER. In this chapter, a | ||
reference to this chapter includes a reference to: | ||
(1) Section 1202.052; | ||
(2) Section 1271.005(a), to the extent that the | ||
subsection relates to the applicability of Section 1201.105, and | ||
Sections 1271.005(d) and (e); | ||
(3) Chapter 1351; | ||
(4) Subchapters C and E, Chapter 1355; | ||
(5) Subchapter A, Chapter 1356; | ||
(6) Chapter 1365; | ||
(7) Subchapter A, Chapter 1367; and | ||
(8) Subchapters A, B, and G, Chapter 1451. | ||
SECTION 4. The heading to Chapter 1356, Insurance Code, is | ||
amended to read as follows: | ||
CHAPTER 1356. [ |
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SCREENING | ||
SECTION 5. Sections 1356.001 through 1356.005, Insurance | ||
Code, are designated as Subchapter A, Chapter 1356, Insurance Code, | ||
and a heading is added to Subchapter A to read as follows: | ||
SUBCHAPTER A. LOW-DOSE MAMMOGRAPHY | ||
SECTION 6. Section 1356.001, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1356.001. DEFINITION. In this subchapter [ |
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"low-dose mammography" means the x-ray examination of the breast | ||
using equipment dedicated specifically for mammography, including | ||
an x-ray tube, filter, compression device, screens, films, and | ||
cassettes, with an average radiation exposure delivery of less than | ||
one rad mid-breast, with two views for each breast. | ||
SECTION 7. Section 1356.002, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1356.002. APPLICABILITY OF SUBCHAPTER [ |
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subchapter [ |
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delivered, issued for delivery, or renewed in this state and that is | ||
an individual or group accident and health insurance policy, | ||
including a policy issued by a group hospital service corporation | ||
operating under Chapter 842. | ||
SECTION 8. Section 1356.003, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1356.003. 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 9. Section 1356.004, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1356.004. EXCEPTION. This subchapter [ |
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not apply to a plan that provides coverage only for a specified | ||
disease or for another limited benefit. | ||
SECTION 10. Chapter 1356, Insurance Code, is amended by | ||
adding Subchapter B to read as follows: | ||
SUBCHAPTER B. SUPPLEMENTAL BREAST CANCER SCREENING | ||
Sec. 1356.051. DEFINITION. In this subchapter, | ||
"supplemental breast cancer screening" means a method of screening | ||
designed to supplement mammography by detecting breast cancers that | ||
may not be visible using only mammography. The term may include: | ||
(1) a breast MRI examination; | ||
(2) a breast ultrasound screening; or | ||
(3) any other method determined by a physician, based | ||
on a patient's specific risk factors. | ||
Sec. 1356.052. 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 company operating under | ||
Chapter 884; | ||
(5) an 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. | ||
(b) This subchapter applies to group health coverage made | ||
available by a school district in accordance with Section 22.004, | ||
Education Code. | ||
(c) Notwithstanding Section 172.014, Local Government Code, | ||
or any other law, this subchapter applies to health and accident | ||
coverage provided by a risk pool created under Chapter 172, Local | ||
Government Code. | ||
(d) 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. | ||
(e) Notwithstanding Section 1501.251 or any other law, this | ||
subchapter applies to coverage under a small employer health | ||
benefit plan subject to Chapter 1501. | ||
Sec. 1356.053. APPLICABILITY TO CERTAIN GOVERNMENT | ||
PROGRAMS. To the extent allowed by federal law, the state Medicaid | ||
program and a managed care organization that contracts with the | ||
Health and Human Services Commission to provide health care | ||
services to Medicaid recipients through a managed care plan shall | ||
provide the benefits required under this subchapter to a Medicaid | ||
recipient. | ||
Sec. 1356.054. 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; | ||
(B) as a supplement to a liability insurance | ||
policy; | ||
(C) for credit insurance; | ||
(D) only for dental or vision care; | ||
(E) only for hospital expenses; or | ||
(F) only for indemnity for hospital confinement; | ||
(2) a Medicare supplemental policy as defined by | ||
Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); | ||
(3) a workers' compensation insurance policy; | ||
(4) medical payment insurance coverage provided under | ||
a motor vehicle insurance policy; or | ||
(5) a long-term care policy, including a nursing home | ||
fixed indemnity policy, unless the commissioner determines that the | ||
policy provides benefit coverage so comprehensive that the policy | ||
is a health benefit plan as described by Section 1356.052. | ||
Sec. 1356.055. COVERAGE REQUIRED. A health benefit plan | ||
that provides coverage for mammography, including coverage for | ||
low-dose mammography required by Subchapter A, must also provide | ||
coverage for supplemental breast cancer screening if a physician | ||
treating the enrollee or screening the enrollee for breast cancer | ||
finds that the enrollee has: | ||
(1) dense breast tissue, as defined by the Breast | ||
Imaging Reporting and Database System (Fourth Edition) established | ||
by the American College of Radiology; and | ||
(2) additional risk factors for breast cancer that the | ||
physician believes warrant supplemental breast cancer screening | ||
beyond mammography. | ||
SECTION 11. This Act applies only to a health benefit plan | ||
that is delivered, issued for delivery, or renewed on or after | ||
January 1, 2012. A health benefit plan that is delivered, issued | ||
for delivery, or renewed before January 1, 2012, 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 12. This Act takes effect September 1, 2011. |