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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 a transplant of an organ |
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that originated from or is transplanted in a country known to have |
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participated in organ harvesting. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle E, Title 8, Insurance Code, is amended |
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by adding Chapter 1380 to read as follows: |
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CHAPTER 1380. HUMAN ORGAN TRANSPLANT |
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Sec. 1380.001. APPLICABILITY OF CHAPTER. (a) This chapter |
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applies only to a health benefit plan that provides benefits for |
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medical or surgical expenses incurred as a result of a health |
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condition, accident, or sickness, including an individual, group, |
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blanket, or franchise insurance policy or insurance agreement, a |
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group hospital service contract, or an individual or group evidence |
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of coverage or similar coverage document that is 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 health maintenance organization operating under |
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Chapter 843; |
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(4) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844; |
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(5) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; |
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(6) a stipulated premium company operating under |
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Chapter 884; |
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(7) a fraternal benefit society operating under |
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Chapter 885; |
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(8) a Lloyd's plan operating under Chapter 941; or |
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(9) an exchange operating under Chapter 942. |
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(b) Notwithstanding any other law, this chapter applies to: |
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(1) a small employer health benefit plan subject to |
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Chapter 1501, including coverage provided through a health group |
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cooperative under Subchapter B of that chapter; |
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(2) a standard health benefit plan issued under |
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Chapter 1507; |
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(3) a basic coverage plan under Chapter 1551; |
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(4) a basic plan under Chapter 1575; |
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(5) a primary care coverage plan under Chapter 1579; |
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(6) a plan providing basic coverage under Chapter |
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1601; |
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(7) health benefits provided by or through a church |
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benefits board under Subchapter I, Chapter 22, Business |
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Organizations Code; |
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(8) the state Medicaid program, including the Medicaid |
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managed care program operated under Chapter 533, Government Code; |
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(9) the child health plan program under Chapter 62, |
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Health and Safety Code; |
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(10) a regional or local health care program operated |
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under Section 75.104, Health and Safety Code; |
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(11) a self-funded health benefit plan sponsored by a |
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professional employer organization under Chapter 91, Labor Code; |
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(12) county employee group health benefits provided |
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under Chapter 157, Local Government Code; and |
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(13) health and accident coverage provided by a risk |
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pool created under Chapter 172, Local Government Code. |
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Sec. 1380.002. COVERAGE PROHIBITED. (a) A health benefit |
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plan issuer may not cover a human organ transplant if: |
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(1) the transplant operation is performed in China or |
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another country known to have participated in organ harvesting, as |
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designated by the commissioner of state health services; or |
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(2) the human organ to be transplanted was procured by |
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a sale or donation originating in China or another country known to |
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have participated in organ harvesting, as designated by the |
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commissioner of state health services. |
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(b) The commissioner of state health services may designate |
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additional countries who are known to have participated in organ |
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harvesting and shall provide written notice to the commissioner, |
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Teacher Retirement System of Texas, Employees Retirement System of |
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Texas, and executive commissioner of the Health and Human Services |
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Commission when the commissioner of state health services |
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designates an additional country. |
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SECTION 2. 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 3. Chapter 1380, Insurance Code, as added by this |
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Act, applies only to a health benefit plan delivered, issued for |
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delivery, or renewed on or after January 1, 2024. |
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SECTION 4. This Act takes effect September 1, 2023. |