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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage of prescription |
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contraceptive drugs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1369.102, Insurance Code, is amended to |
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read as follows: |
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Sec. 1369.102. APPLICABILITY OF SUBCHAPTER. Except as |
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otherwise provided by this subchapter, this [This] subchapter |
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applies only to a health benefit plan, including a small employer |
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health benefit plan written under Chapter 1501, that provides |
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benefits for medical or surgical expenses incurred as a result of a |
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health condition, accident, or sickness, including an individual, |
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group, blanket, or franchise insurance policy or insurance |
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agreement, a group hospital service contract, or an individual or |
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group evidence of coverage or similar coverage document that is |
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offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating |
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under Chapter 842; |
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(3) a fraternal benefit society operating under |
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Chapter 885; |
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(4) a stipulated premium company operating under |
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Chapter 884; |
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(5) a reciprocal exchange operating under Chapter 942; |
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(6) a health maintenance organization operating under |
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Chapter 843; |
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(7) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; or |
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(8) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844. |
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SECTION 2. Subchapter C, Chapter 1369, Insurance Code, is |
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amended by adding Section 1369.1031 to read as follows: |
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Sec. 1369.1031. CERTAIN COVERAGE REQUIRED. (a) This |
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section applies to a health benefit plan described by Section |
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1369.102. |
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(b) Notwithstanding any other law, this section applies to: |
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(1) a standard health benefit plan issued under |
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Chapter 1507; |
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(2) a basic coverage plan under Chapter 1551; |
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(3) a basic plan under Chapter 1575; |
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(4) a primary care coverage plan under Chapter 1579; |
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(5) a plan providing basic coverage under Chapter |
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1601; |
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(6) group health coverage made available by a school |
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district in accordance with Section 22.004, Education Code; and |
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(7) the state Medicaid program, including the Medicaid |
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managed care program operated under Chapter 533, Government Code. |
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(c) A health benefit plan that provides benefits for a |
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prescription contraceptive drug must provide for an enrollee to |
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obtain up to: |
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(1) a three-month supply of the covered prescription |
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contraceptive drug at one time the first time the enrollee obtains |
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the drug; and |
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(2) a 12-month supply of the covered prescription |
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contraceptive drug at one time each subsequent time the enrollee |
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obtains the same drug, regardless of whether the enrollee was |
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enrolled in the health benefit plan the first time the enrollee |
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obtained the drug. |
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(d) An enrollee may obtain only one 12-month supply of a |
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covered prescription contraceptive drug during each 12-month |
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period. |
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SECTION 3. 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, 2024. A health benefit plan that is |
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delivered, issued for delivery, or renewed before January 1, 2024, |
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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 4. This Act takes effect September 1, 2023. |
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* * * * * |