88R449 JES-F
 
  By: Johnson of Dallas H.B. No. 757
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to preauthorization of certain benefits by certain health
  benefit plan issuers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1356.005, Insurance Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  A health benefit plan issuer that provides coverage
  under this section may not require preauthorization for a screening
  mammogram or diagnostic imaging described by Subsection (a) or
  (a-1). This subsection may not be construed to authorize a
  physician or other health care provider to provide the medical care
  or health care described by this section if providing the care is
  outside of the scope of the individual's applicable license or
  other authorization issued under Title 3, Occupations Code.
         SECTION 2.  Section 1357.004, Insurance Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  A health benefit plan issuer that provides coverage
  under this section may not require preauthorization for a
  reconstruction, surgery, prostheses, or treatment described by
  Subsection (a). This subsection may not be construed to authorize a
  physician or other health care provider to provide the medical care
  or health care described by this section if providing the care is
  outside of the scope of the individual's applicable license or
  other authorization issued under Title 3, Occupations Code.
         SECTION 3.  Section 1357.054, Insurance Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  A health benefit plan issuer that provides coverage
  under this section may not require preauthorization for inpatient
  care described by Subsection (a). This subsection may not be
  construed to authorize a physician or other health care provider to
  provide the medical care or health care described by this section if
  providing the care is outside of the scope of the individual's
  applicable license or other authorization issued under Title 3,
  Occupations Code.
         SECTION 4.  Section 1358.054, Insurance Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  A health benefit plan issuer that provides coverage
  under this section may not require preauthorization for the
  provision to a qualified enrollee of diabetes equipment, diabetes
  supplies, or diabetes self-management training described by
  Subsection (a). This subsection may not be construed to authorize a
  physician or other health care provider to provide the medical care
  or health care described by this section if providing the care is
  outside of the scope of the individual's applicable license or
  other authorization issued under Title 3, Occupations Code.
         SECTION 5.  Section 1361.003, Insurance Code, is amended to
  read as follows:
         Sec. 1361.003.  COVERAGE REQUIRED. (a) A group health
  benefit plan must provide to a qualified enrollee coverage for
  medically accepted bone mass measurement to detect low bone mass
  and to determine the enrollee's risk of osteoporosis and fractures
  associated with osteoporosis.
         (b)  A group health benefit plan issuer that provides
  coverage under this section may not require preauthorization for
  the provision to a qualified enrollee of a bone mass measurement
  described by Subsection (a). This subsection may not be construed
  to authorize a physician or other health care provider to provide
  the medical care or health care described by this section if
  providing the care is outside of the scope of the individual's
  applicable license or other authorization issued under Title 3,
  Occupations Code.
         SECTION 6.  Section 1362.003, Insurance Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  A health benefit plan issuer that provides coverage
  under this section to an enrolled male may not require
  preauthorization for a diagnostic examination described by
  Subsection (a). This subsection may not be construed to authorize a
  physician or other health care provider to provide the medical care
  or health care described by this section if providing the care is
  outside of the scope of the individual's applicable license or
  other authorization issued under Title 3, Occupations Code.
         SECTION 7.  Section 1363.003, Insurance Code, is amended by
  adding Subsection (d) to read as follows:
         (d)  A health benefit plan issuer that provides coverage
  under this section may not require preauthorization for a screening
  examination described by Subsection (a). This subsection may not
  be construed to authorize a physician or other health care provider
  to provide the medical care or health care described by this section
  if providing the care is outside of the scope of the individual's
  applicable license or other authorization issued under Title 3,
  Occupations Code.
         SECTION 8.  This Act applies only to a health benefit plan
  that is delivered, issued for delivery, or renewed on or after
  January 1, 2024.
         SECTION 9.  This Act takes effect September 1, 2023.