By Coleman                                            H.B. No. 2040
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to coverage of serious mental illness under certain group
    1-3  health insurance programs.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 3C, Article 3.51-6, Insurance Code, is
    1-6  redesignated 3F and is amended to read as follows:
    1-7        Sec. <3C>3F.  COVERAGE OF CERTAIN ILLNESSES, (a)  No group
    1-8  policy of accident, health, or accident and health insurance
    1-9  including group contracts issued by any hospital and medical
   1-10  service plan corporation subject to Chapter 20 of this code and
   1-11  health maintance organization subject to Chapter 20A of this code
   1-12  shall be delivered or issued for delivery or renewed that:
   1-13              (1)  excludes or denies coverage for HIV, AIDS, or
   1-14  HIV-related illnesses<.>: or
   1-15              (2)  provides coverage for serious mental illness that
   1-16  is not equal to the same terms and conditions that apply to the
   1-17  benefits available under the group policy or contract for physical
   1-18  illness.
   1-19        (b)  For the purpose of this section, "serious mental
   1-20  illness" means the following psychiatric illnessess defined by the
   1-21  American Psychiatric Association in the Diagnostic and Statistical
   1-22  Manual of Mental Disorders (DSM):
   1-23              (1)  Schizophrenia;
    2-1              (2)  Paranoid and other psychotic disorders;
    2-2              (3)  bipolar disorders (mild, manic, and depressive);
    2-3              (4)  major depressive disorders (single episode or
    2-4  recurrent);
    2-5              (5)  schizo-affective disorders (bipolar or
    2-6  depressive).
    2-7        SECTION 2.  Article 3.51-14, Section 1, Insurance Code, is
    2-8  amended to read as follows:
    2-9        Sec. 1.  Definition.  For the purposes of this article,
   2-10  "serious mental illness" means the following psychiatric illnesses
   2-11  as defined by the American Psychiatric Association in the
   2-12  Diagnostic and Statistical Manual of Mental Disorders (DSM <IIIR>):
   2-13              (1)  Schizophrenia;
   2-14              (2)  Paranoid and other psychotic disorders;
   2-15              (3)  bipolar disorders (mild, manic, and depressive);
   2-16              (4)  major depressive disorders (single episode or
   2-17  recurrent);
   2-18              (5)  schizo-affective disorders (bipolar or
   2-19  depressive).
   2-20        SECTION 3.  Article 3.51-14, Section 2(a) Insurance Code, is
   2-21  amended to read as follows:
   2-22        Sec. 2.  Mandatory coverage; exemption.  (a)  Each insurer,
   2-23  nonprofit hospital service plan corporation subject to Chapter 20
   2-24  of this code, health maintenance organization subject to the Texas
   2-25  Health Maintenance Organization Act (Chapter 20A, Vernon's Texas
    3-1  Insurance Code), employer, multiple employer, union, association,
    3-2  trustee, or other self-funded or self-insured welfare or benefit
    3-3  plan, program, or arrangement that issues group health insurance
    3-4  policies, enters into health care service contracts or plans, or
    3-5  provides for group health benefits, coverage, or services in this
    3-6  state for hospital, medical, or surgical expenses incurred as a
    3-7  result of accident or sickness shall offer and make available to
    3-8  each group policyholder, contract holder, employer, multiple
    3-9  employer, union, association, or trustee under a group policy,
   3-10  contract, plan, program, or arrangement that provides hospital,
   3-11  surgical, or medical benefits on an expense-incurred, service, or
   3-12  prepaid basis for expenses incurred for the necessary care,
   3-13  diagnosis, and treatment of serious mental illnesses<.>, that is
   3-14  equal to the same terms and conditions that apply to the benefits
   3-15  available under the coverage for services and benefits for physical
   3-16  illness.