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A BILL TO BE ENTITLED
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AN ACT
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relating to the participation of campus-based mental health |
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professionals in certain health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 843.010, Insurance Code, is amended to |
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read as follows: |
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Sec. 843.010. APPLICABILITY OF CERTAIN PROVISIONS TO |
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GOVERNMENTAL HEALTH BENEFIT PLANS. (a) Sections 843.306(f) and |
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843.363(a)(4) do not apply to coverage under: |
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(1) the child health plan program under Chapter 62, |
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Health and Safety Code, or the health benefits plan for children |
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under Chapter 63, Health and Safety Code; or |
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(2) a Medicaid program, including a Medicaid managed |
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care program operated under Chapter 533, Government Code. |
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(b) Section 843.3046 applies to: |
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(1) a basic coverage plan under Chapter 1551; |
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(2) a basic plan under Chapter 1575; |
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(3) a primary care coverage plan under Chapter 1579; |
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(4) a plan providing basic coverage under Chapter |
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1601; |
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(5) the Medicaid managed care program operated under |
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Chapter 533, Government Code; and |
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(6) the child health plan program under Chapter 62, |
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Health and Safety Code. |
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SECTION 2. Subchapter I, Chapter 843, Insurance Code, is |
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amended by adding Section 843.3046 to read as follows: |
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Sec. 843.3046. CAMPUS-BASED MENTAL HEALTH PROFESSIONALS. |
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(a) In this section: |
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(1) "Campus-based mental health professional" means a |
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licensed clinical social worker, professional counselor, |
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psychological associate, or psychologist who provides mental |
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health care services primarily or exclusively at a campus of a |
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school district or an open-enrollment charter school. |
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(2) "Open-enrollment charter school" means a school |
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that has been granted a charter under Subchapter D, Chapter 12, |
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Education Code. |
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(3) "School district" means a public school district |
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created under the laws of this state. |
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(b) If a health maintenance organization includes mental |
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health care services in the services covered by the health |
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maintenance organization's health care plan, the health |
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maintenance organization may not reject the initial application of |
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a campus-based mental health professional to contract with the |
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health maintenance organization to provide mental health care |
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services on behalf of the health maintenance organization based on |
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a determination that the health maintenance organization has |
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contracted with sufficient qualified mental health care providers |
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in the applicant's geographic area. |
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(c) A campus-based mental health professional who applies |
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to a health maintenance organization to contract with the health |
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maintenance organization to provide mental health care services on |
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behalf of the health maintenance organization is entitled to an |
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expedited decision on the application. |
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SECTION 3. Subchapter C, Chapter 848, Insurance Code, is |
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amended by adding Section 848.111 to read as follows: |
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Sec. 848.111. CAMPUS-BASED MENTAL HEALTH PROFESSIONALS. |
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(a) In this section: |
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(1) "Campus-based mental health professional" means a |
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licensed clinical social worker, professional counselor, |
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psychological associate, or psychologist who provides mental |
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health care services primarily or exclusively at a campus of a |
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school district or an open-enrollment charter school. |
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(2) "Open-enrollment charter school" means a school |
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that has been granted a charter under Subchapter D, Chapter 12, |
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Education Code. |
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(3) "School district" means a public school district |
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created under the laws of this state. |
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(b) If a health care collaborative includes mental health |
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care services in the services covered by the health care |
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collaborative's health care plan, the health care collaborative may |
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not reject the initial application of a campus-based mental health |
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professional to contract with the health care collaborative to |
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provide mental health care services as part of the health care |
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collaborative's delivery network based on a determination that the |
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health care collaborative has contracted with sufficient qualified |
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mental health care providers in the applicant's geographic area. |
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(c) A campus-based mental health professional who applies |
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to a health care collaborative for inclusion in the health care |
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collaborative's delivery network is entitled to an expedited |
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decision on the application. |
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SECTION 4. Subchapter B, Chapter 1301, Insurance Code, is |
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amended by adding Section 1301.0516 to read as follows: |
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Sec. 1301.0516. CERTAIN CAMPUS-BASED MENTAL HEALTH |
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SERVICES. (a) In this section: |
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(1) "Campus-based mental health professional" means a |
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licensed clinical social worker, professional counselor, |
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psychological associate, or psychologist who provides mental |
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health care services primarily or exclusively at a campus of a |
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school district or an open-enrollment charter school. |
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(2) "Open-enrollment charter school" means a school |
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that has been granted a charter under Subchapter D, Chapter 12, |
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Education Code. |
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(3) "School district" means a public school district |
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created under the laws of this state. |
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(b) Notwithstanding any other law, this section applies to: |
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(1) a basic coverage plan under Chapter 1551; |
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(2) a basic plan under Chapter 1575; |
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(3) a primary care coverage plan under Chapter 1579; |
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and |
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(4) a plan providing basic coverage under Chapter |
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1601. |
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(c) If an insurer offers a preferred provider benefit plan |
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that includes mental health care services in the services covered |
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by the plan, the insurer may not reject the initial application of a |
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campus-based mental health professional to contract for |
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designation as a preferred provider under the plan based on a |
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determination that the insurer has contracted with sufficient |
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qualified mental health care providers in the applicant's |
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geographic area. |
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(d) A campus-based mental health professional who applies |
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to an insurer for designation as a preferred provider is entitled to |
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an expedited decision on the application. |
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SECTION 5. (a) Section 843.3046, Insurance Code, as added |
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by this Act, applies only to an application to contract with a |
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health maintenance organization submitted on or after the effective |
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date of this Act. |
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(b) Section 848.111, Insurance Code, as added by this Act, |
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applies only to an application to contract with a health care |
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collaborative submitted on or after the effective date of this Act. |
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(c) Section 1301.0516, Insurance Code, as added by this Act, |
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applies only to an application to contract with an insurer |
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submitted on or after the effective date of this Act. |
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SECTION 6. This Act takes effect September 1, 2019. |