| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
| |
|
|
relating to a parity complaint portal and educational materials and |
|
|
parity law training regarding benefits for mental health conditions |
|
|
and substance use disorders to be made available through the portal |
|
|
and otherwise; designating October as mental health condition and |
|
|
substance use disorder parity awareness month. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter D, Chapter 662, Government Code, is |
|
|
amended by adding Section 662.115 to read as follows: |
|
|
Sec. 662.115. MENTAL HEALTH CONDITION AND SUBSTANCE USE |
|
|
DISORDER PARITY AWARENESS MONTH. (a) October is Mental Health |
|
|
Condition and Substance Use Disorder Parity Awareness Month to |
|
|
increase awareness of and compliance with state and federal rules, |
|
|
regulations, and statutes concerning the availability of, and terms |
|
|
and conditions of, benefits for mental health conditions and |
|
|
substance use disorders. |
|
|
(b) Mental Health Condition and Substance Use Disorder |
|
|
Parity Awareness Month may be regularly observed through |
|
|
appropriate activities in communities to increase awareness of and |
|
|
education on the available benefits for mental health conditions |
|
|
and substance use disorders. |
|
|
SECTION 2. Subchapter F, Chapter 1355, Insurance Code, is |
|
|
amended by adding Sections 1355.2571 and 1355.2572 to read as |
|
|
follows: |
|
|
Sec. 1355.2571. PARITY COMPLAINT PORTAL. (a) The |
|
|
commissioner shall develop and maintain a parity complaint portal |
|
|
that is an integrated system that allows for the enrollee of a |
|
|
health benefit plan to submit complaints of suspected violations of |
|
|
the provisions of this subchapter. The parity complaint portal |
|
|
must: |
|
|
(1) allow for an enrollee to submit a complaint |
|
|
through multiple ways; |
|
|
(2) provide updates on the status of an enrollee's |
|
|
complaint; |
|
|
(3) ensure timely, effective, and equitable |
|
|
resolution for submitted complaints; |
|
|
(4) include educational materials regarding: |
|
|
(A) benefits for mental health conditions and |
|
|
substance use disorders required under this subchapter; |
|
|
(B) an enrollee's rights and responsibilities |
|
|
under a health benefit plan concerning coverage under this |
|
|
subchapter; |
|
|
(C) circumstances under which a claim may be |
|
|
denied; and |
|
|
(D) the processes for reviewing a complaint |
|
|
submitted through the portal; |
|
|
(5) adhere to national best practices as determined by |
|
|
the commissioner; and |
|
|
(6) include the findings of the report required by |
|
|
Section 1355.2572(b). |
|
|
(b) In developing the parity complaint portal under |
|
|
Subsection (a), the commissioner: |
|
|
(1) shall conduct an assessment of complaint portals |
|
|
and similar systems used by other relevant public or private |
|
|
entities; |
|
|
(2) shall develop best practice standards for |
|
|
complaint submissions and tracking consistent with the findings of |
|
|
the assessment conducted under Subdivision (1); and |
|
|
(3) may develop a new complaint portal or modify an |
|
|
existing complaint portal. |
|
|
(c) The Health and Human Services Commission shall appoint a |
|
|
liaison to the department to receive reports of concerns, |
|
|
complaints, and potential violations submitted through the parity |
|
|
complaint portal established under Subsection (a). |
|
|
Sec. 1355.2572. EDUCATIONAL MATERIALS AND PARITY LAW |
|
|
TRAINING; REPORT. (a) The commissioner, in collaboration with the |
|
|
Health and Human Services Commission's ombudsman for behavioral |
|
|
health, shall develop educational materials and parity law training |
|
|
sessions regarding the coverage for mental health conditions and |
|
|
substance use disorders required under this subchapter. The |
|
|
commissioner shall ensure that the materials and training sessions: |
|
|
(1) are available to health benefit plan issuers and |
|
|
enrollees; |
|
|
(2) include online, print, and in-person formats; |
|
|
(3) are made available through the parity complaint |
|
|
portal established under Section 1355.2571 and at relevant |
|
|
locations and settings, including: |
|
|
(A) any relevant agency offices; |
|
|
(B) health benefit plan provider service |
|
|
locations; and |
|
|
(C) relevant professional conferences and trade |
|
|
association meetings; and |
|
|
(4) include a list of relevant third-party |
|
|
organization educational and parity law awareness materials that |
|
|
provide additional information regarding mental health conditions |
|
|
and substance use disorder parity and, if provided in an online |
|
|
format, provide the links needed to access those materials online. |
|
|
(b) Not later than September 1 of each year, the |
|
|
commissioner, in collaboration with the Health and Human Services |
|
|
Commission's ombudsman for behavioral health, shall: |
|
|
(1) prepare and submit a report to the appropriate |
|
|
committees of the legislature and the appropriate state agencies on |
|
|
the status of: |
|
|
(A) rights and responsibilities for mental |
|
|
health condition and substance use disorder benefits; and |
|
|
(B) resolved and unresolved complaints submitted |
|
|
through the parity complaint portal established under Section |
|
|
1355.2571(a); and |
|
|
(2) publish the findings of the report under |
|
|
Subdivision (1) to the parity complaint portal established under |
|
|
Section 1355.2571(a). |
|
|
SECTION 3. As soon as practicable after the effective date |
|
|
of this Act, the commissioner of insurance shall develop: |
|
|
(1) the parity complaint portal required by Section |
|
|
1355.2571, Insurance Code, as added by this Act; and |
|
|
(2) the educational materials and parity law training |
|
|
sessions required by Section 1355.2572, Insurance Code, as added by |
|
|
this Act. |
|
|
SECTION 4. This Act takes effect September 1, 2021. |
|
|
|
|
|
* * * * * |