S.B. No. 182
AN ACT
1-1 relating to prohibiting discrimination by certain insurers in
1-2 issuing health insurance policies to women with fibrocystic breast
1-3 conditions; imposing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 21, Insurance Code, is
1-6 amended by adding Article 21.21-6 to read as follows:
1-7 Art. 21.21-6. FIBROCYSTIC BREAST CONDITIONS. (a) In this
1-8 article, "insurer" means an insurer who delivers or issues for
1-9 delivery or renews any health insurance policy or contract in this
1-10 state, including any group policy, contract, or certificate of
1-11 health insurance or evidence of coverage delivered, issued for
1-12 delivery, or renewed in this state. The term includes a group
1-13 hospital service corporation under Chapter 20 of this code and a
1-14 health maintenance organization under the Texas Health Maintenance
1-15 Organization Act (Chapter 20A, Vernon's Texas Insurance Code).
1-16 (b) An insurer, solely or in part because an individual has
1-17 been diagnosed with or has a history of a fibrocystic breast
1-18 condition, may not:
1-19 (1) deny coverage to the individual;
1-20 (2) refuse to renew a policy of insurance covering the
1-21 individual;
1-22 (3) cancel a policy of insurance covering the
1-23 individual;
1-24 (4) limit the amount, extent, or kind of coverage
2-1 available to the individual for any other breast condition; or
2-2 (5) charge the individual or a group to which the
2-3 individual belongs a different rate for the same coverage.
2-4 (c) An insurer who violates this article commits an unfair
2-5 and deceptive practice as defined by Article 21.21 of this code and
2-6 is subject to the penalties imposed under that article.
2-7 (d) Nothing in this article requires insurers to pay for
2-8 fibrocystic breast disease.
2-9 SECTION 2. Subsection (b), Section 14, Texas Health
2-10 Maintenance Organization Act (Article 20A.14, Vernon's Texas
2-11 Insurance Code), is amended to read as follows:
2-12 (b) Articles 21.21, 21.21A, 21.21-2, <and> 21.21-3, and
2-13 21.21-6, Insurance Code, and Chapter 122, Acts of the 57th
2-14 Legislature, Regular Session, 1961 (Article 21.21-1, Vernon's Texas
2-15 Insurance Code), apply to health maintenance organizations that
2-16 offer both basic and single health care coverages and to basic and
2-17 single health care plans and the evidence of coverage under those
2-18 plans, except to the extent that the commissioner determines that
2-19 the nature of health maintenance organizations and health care
2-20 plans and evidence of coverage renders any provision of those
2-21 articles clearly inappropriate.
2-22 SECTION 3. This Act takes effect September 1, 1995, and
2-23 applies only to an insurance policy or an evidence of coverage that
2-24 is delivered, issued for delivery, or renewed on or after January
2-25 1, 1996. A policy or evidence of coverage that is delivered,
2-26 issued for delivery, or renewed before January 1, 1996, is governed
2-27 by the law as it existed immediately before the effective date of
3-1 this Act, and that law is continued in effect for that purpose.
3-2 SECTION 4. The importance of this legislation and the
3-3 crowded condition of the calendars in both houses create an
3-4 emergency and an imperative public necessity that the
3-5 constitutional rule requiring bills to be read on three several
3-6 days in each house be suspended, and this rule is hereby suspended.