75R5716 SAW-D                           

         By Van de Putte, Kuempel, Maxey, et al.                H.B. No. 262

         Substitute the following for H.B. No. 262:

         By Averitt                                         C.S.H.B. No. 262

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to coverage under certain health benefit plans for

 1-3     reconstructive surgery incident to mastectomy.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Subchapter E, Chapter 21, Insurance Code, is

 1-6     amended by adding Article 21.53D to read as follows:

 1-7           Art. 21.53D.  COVERAGE FOR RECONSTRUCTIVE SURGERY AFTER

 1-8     MASTECTOMY

 1-9           Sec. 1.  DEFINITIONS.  In this article:

1-10                 (1)  "Health benefit plan" means a plan described by

1-11     Section 2 of this article.

1-12                 (2)  "Breast reconstruction" means reconstruction of a

1-13     breast incident to mastectomy to restore or achieve breast

1-14     symmetry.  The term includes surgical reconstruction of a breast on

1-15     which mastectomy surgery has been performed and surgical

1-16     reconstruction of a breast on which  mastectomy surgery has not

1-17     been performed.

1-18           Sec. 2.  SCOPE OF ARTICLE.  (a)  This article applies to a

1-19     health benefit plan that:

1-20                 (1)  provides benefits for medical or surgical expenses

1-21     incurred as a result of a health condition, accident, or sickness,

1-22     including:

1-23                       (A)  an individual, group, blanket, or franchise

1-24     insurance policy or insurance agreement, a group hospital service

 2-1     contract, or an individual or group evidence of coverage that is

 2-2     offered by:

 2-3                             (i)  an insurance company;

 2-4                             (ii)  a group hospital service corporation

 2-5     operating under Chapter 20 of this code;

 2-6                             (iii)  a fraternal benefit society

 2-7     operating under Chapter 10 of this code;

 2-8                             (iv)  a stipulated premium insurance

 2-9     company operating under Chapter 22 of this code; or

2-10                             (v)  a health maintenance organization

2-11     operating under the Texas Health Maintenance Organization Act

2-12     (Chapter 20A, Vernon's Texas Insurance Code); or

2-13                       (B)  to the extent permitted by the Employee

2-14     Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et

2-15     seq.), a health benefit plan that is offered by:

2-16                             (i)  a multiple employer welfare

2-17     arrangement as defined by Section 3, Employee Retirement Income

2-18     Security Act of 1974 (29 U.S.C. Section 1002); or

2-19                             (ii)  another analogous benefit

2-20     arrangement; or

2-21                 (2)  is offered by an approved nonprofit health

2-22     corporation that is certified under Section 5.01(a), Medical

2-23     Practice Act (Article 4495b, Vernon's Texas Civil Statutes), and

2-24     that holds a certificate of authority  issued by the commissioner

2-25     under Article 21.52F of this code.

2-26           (b)  This article does not apply to:

2-27                 (1)  a plan that provides coverage:

 3-1                       (A)  only for a specified disease;

 3-2                       (B)  only for accidental death or dismemberment;

 3-3                       (C)  for wages or payments in lieu of wages for a

 3-4     period during which an employee is absent from work because of

 3-5     sickness or injury; or

 3-6                       (D)  as a supplement to liability insurance;

 3-7                 (2)  a plan written under Chapter 26 of this code;

 3-8                 (3)  a Medicare supplemental policy as defined by

 3-9     Section 1882(g)(1), Social Security Act (42 U.S.C. 1395ss);

3-10                 (4)  workers' compensation insurance coverage;

3-11                 (5)  medical payment insurance issued as part of a

3-12     motor vehicle insurance policy; or

3-13                 (6)  a long-term care policy, including a nursing home

3-14     fixed indemnity policy, unless the commissioner determines that the

3-15     policy provides benefit coverage so comprehensive that the policy

3-16     is a health benefit plan as described by Subsection (a) of this

3-17     section.

3-18           Sec. 3.  COVERAGE REQUIRED.  A health benefit plan that

3-19     provides coverage for mastectomy must provide coverage for breast

3-20     reconstruction.  The coverage may be subject to the same deductible

3-21     or copayment applicable to mastectomy.

3-22           Sec. 4.  PROHIBITION.  A health benefit plan may not offer a

3-23     financial incentive for a patient to forego breast reconstruction

3-24     or to waive the coverage required by Section 3 of this article.

3-25           Sec. 5.  RULES.  The commissioner may adopt rules to

3-26     implement this article.

3-27           SECTION 2.  This Act takes effect September 1, 1997, and

 4-1     applies only to a health benefit plan that is delivered, issued for

 4-2     delivery, or renewed on or after January 1, 1998.  A health benefit

 4-3     plan that is delivered, issued for delivery, or renewed before

 4-4     January 1, 1998, is governed by the law as it existed immediately

 4-5     before the effective date of this Act, and that law is continued in

 4-6     effect for this purpose.

 4-7           SECTION 3.  The importance of this legislation and the

 4-8     crowded condition of the calendars in both houses create an

 4-9     emergency and an imperative public necessity that the

4-10     constitutional rule requiring bills to be read on three several

4-11     days in each house be suspended, and this rule is hereby suspended.