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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for diagnostic imaging for breast cancer under |
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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. The heading to Chapter 1356, Insurance Code, is |
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amended to read as follows: |
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CHAPTER 1356. MAMMOGRAPHY AND OTHER BREAST IMAGING |
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SECTION 2. Section 1356.001(1-a), Insurance Code, is |
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amended to read as follows: |
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(1-a) "Diagnostic imaging [mammogram]" means an |
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imaging examination using mammography, ultrasound imaging, or |
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magnetic resonance imaging that is designed to evaluate: |
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(A) a subjective or objective abnormality |
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detected by a physician or patient in a breast; |
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(B) an abnormality seen by a physician on a |
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screening mammogram; |
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(C) an abnormality previously identified by a |
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physician as probably benign in a breast for which follow-up |
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imaging is recommended by a physician; or |
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(D) an individual with a personal history of |
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breast cancer or dense breast tissue. |
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SECTION 3. Section 1356.005(a-1), Insurance Code, is |
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amended to read as follows: |
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(a-1) A health benefit plan that provides coverage for a |
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screening mammogram must provide coverage for [a] diagnostic |
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imaging [mammogram] that is no less favorable than the coverage for |
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a screening mammogram. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. The change in law made by this Act applies only |
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to a health benefit plan that is delivered, issued for delivery, or |
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renewed on or after January 1, 2022. A health benefit plan that is |
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delivered, issued for delivery, or renewed before January 1, 2022, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 6. This Act takes effect September 1, 2021. |