AN ACT
1-1 relating to prevention and treatment of diabetes.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 ARTICLE 1. TEXAS DIABETES CARE PILOT PROGRAM
1-4 SECTION 1.01. In this article:
1-5 (1) "Commission" means the Health and Human Services
1-6 Commission.
1-7 (2) "Council" means the Texas Diabetes Council.
1-8 (3) "Program" means the Texas Diabetes Care Pilot
1-9 Program established under this article.
1-10 SECTION 1.02. (a) The Health and Human Services Commission
1-11 by rule shall develop a Texas Diabetes Care Pilot Program for
1-12 initial implementation in counties, selected by the commission,
1-13 with a high incidence of and a high death rate from diabetes.
1-14 (b) The program shall provide continuous care, including
1-15 preventive services such as structured outpatient diabetes
1-16 education, nutrition counseling, and case management, to Medicaid
1-17 recipients who have diabetes-related conditions. In developing the
1-18 program, the commission shall consider the program operated in 1993
1-19 and 1994 in Maryland.
1-20 (c) The Texas Diabetes Council shall administer the program
1-21 under the direction of the commission.
1-22 (d) Except as provided by Section 1.04 of this article, the
1-23 commission and the council shall implement the program not later
2-1 than November 1, 1997.
2-2 SECTION 1.03. (a) Not later than September 1, 1998, the
2-3 commission shall submit an interim written report to the lieutenant
2-4 governor and the speaker of the house of representatives on the
2-5 effectiveness, including the cost-effectiveness, of the program.
2-6 (b) Not later than September 1, 1999, the commission shall
2-7 submit a final written report to the lieutenant governor and the
2-8 speaker of the house of representatives on the effectiveness,
2-9 including the cost-effectiveness, of the program.
2-10 SECTION 1.04. If before implementing this article the
2-11 commission determines that a waiver or authorization from a federal
2-12 agency is necessary for implementation, the commission shall
2-13 request the waiver or authorization and may delay implementing this
2-14 section until the waiver or authorization is granted.
2-15 SECTION 1.05. This article expires September 1, 2001.
2-16 ARTICLE 2. BENEFITS FOR DIABETES CARE PROVIDED UNDER HEALTH
2-17 BENEFIT PLANS
2-18 SECTION 2.01. Subchapter E, Chapter 21, Insurance Code, is
2-19 amended by adding Article 21.53D to read as follows:
2-20 Art. 21.53D. GUIDELINES FOR DIABETES CARE
2-21 Sec. 1. DEFINITIONS. In this article:
2-22 (1) "Enrollee" means a person entitled to coverage
2-23 under a health benefit plan.
2-24 (2) "Health benefit plan" means a plan described by
2-25 Section 2 of this article.
3-1 Sec. 2. SCOPE OF ARTICLE. (a) This article applies only to
3-2 a health benefit plan that provides benefits for medical or
3-3 surgical expenses incurred as a result of a health condition,
3-4 accident, or sickness, including:
3-5 (1) an individual, group, blanket, or franchise
3-6 insurance policy or insurance agreement, a group hospital service
3-7 contract, or an individual or group evidence of coverage that is
3-8 offered by:
3-9 (A) an insurance company;
3-10 (B) a group hospital service corporation
3-11 operating under Chapter 20 of this code;
3-12 (C) a fraternal benefit society operating under
3-13 Chapter 10 of this code;
3-14 (D) a stipulated premium insurance company
3-15 operating under Chapter 22 of this code; or
3-16 (E) a health maintenance organization operating
3-17 under the Texas Health Maintenance Organization Act (Chapter 20A,
3-18 Vernon's Texas Insurance Code);
3-19 (2) to the extent permitted by the Employee Retirement
3-20 Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a
3-21 health benefit plan that is offered by:
3-22 (A) a multiple employer welfare arrangement as
3-23 defined by Section 3, Employee Retirement Income Security Act of
3-24 1974 (29 U.S.C. Section 1002); or
3-25 (B) another analogous benefit arrangement; or
4-1 (3) notwithstanding Section 172.014, Local Government
4-2 Code, or any other law, health and accident coverage provided by a
4-3 risk pool created under Chapter 172, Local Government Code.
4-4 (b) This article does not apply to:
4-5 (1) a plan that provides coverage:
4-6 (A) only for a specified disease;
4-7 (B) only for accidental death or dismemberment;
4-8 (C) for wages or payments in lieu of wages for a
4-9 period during which an employee is absent from work because of
4-10 sickness or injury;
4-11 (D) as a supplement to liability insurance;
4-12 (E) dental or vision care only; or
4-13 (F) hospital confinement indemnity coverage
4-14 only;
4-15 (2) a plan written under Chapter 26 of this code;
4-16 (3) a Medicare supplemental policy as defined by
4-17 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
4-18 (4) workers' compensation insurance coverage;
4-19 (5) medical payment insurance issued as part of a
4-20 motor vehicle insurance policy; or
4-21 (6) a long-term care policy, including a nursing home
4-22 fixed indemnity policy, unless the commissioner determines that the
4-23 policy provides benefit coverage so comprehensive that the policy
4-24 is a health benefit plan as described by Subsection (a) of this
4-25 section.
5-1 Sec. 3. DIABETES CARE GUIDELINES. (a) The commissioner, in
5-2 consultation with the Texas Diabetes Council, shall by rule adopt
5-3 minimum standards for benefits provided to enrollees with diabetes.
5-4 (b) Each health care benefit plan shall provide benefits for
5-5 the care required by the minimum standards adopted under Subsection
5-6 (a) of this section.
5-7 (c) The benefits required under this article may not be
5-8 subject to a deductible, coinsurance, or copayment requirement that
5-9 exceeds the applicable deductible, coinsurance, or copayment
5-10 applicable to other similar benefits provided under the plan.
5-11 SECTION 2.02. The Commissioner of Insurance shall, in
5-12 consultation with the Texas Diabetes Council, adopt the minimum
5-13 benefits required under Article 21.53D, Insurance Code, as added by
5-14 this Act, not later than September 1, 1998.
5-15 SECTION 2.03. Article 21.53D, Insurance Code, as added by
5-16 this Act, applies only to a health benefit plan that is delivered,
5-17 issued for delivery, or renewed on or after January 1, 1999. A
5-18 policy that is delivered, issued for delivery, or renewed before
5-19 January 1, 1999, is governed by the law as it existed immediately
5-20 before the effective date of this Act, and that law is continued in
5-21 effect for that purpose.
5-22 ARTICLE 3. COMPOSITION OF THE TEXAS DIABETES COUNCIL
5-23 SECTION 3.01. Section 103.005, Health and Safety Code, is
5-24 amended to read as follows:
5-25 Sec. 103.005. TERMS. (a) Council members appointed by the
6-1 governor serve for staggered six-year [four-year] terms, with the
6-2 terms of four [six citizen] members [and two agency
6-3 representatives] expiring February 1 of each odd-numbered year [and
6-4 the terms of six citizen members and three agency representatives
6-5 expiring February 1 of each even-numbered year].
6-6 (b) A council member appointed as a representative of an
6-7 agency serves at the will of the appointing agency.
6-8 SECTION 3.02. Subsection (a), Section 103.008, Health and
6-9 Safety Code, is amended to read as follows:
6-10 (a) The office of a member appointed by an agency becomes
6-11 vacant when the person terminates employment with the agency or
6-12 when the agency elects to replace the person as provided by Section
6-13 103.005.
6-14 SECTION 3.03. (a) The Texas Diabetes Council is abolished
6-15 on the effective date of this Act. As soon as possible after the
6-16 effective date of this Act, the governor and each state agency
6-17 listed in Section 103.002, Health and Safety Code, as appropriate,
6-18 shall appoint a new Texas Diabetes Council to accomplish the
6-19 membership plan for the council established by this Act. This
6-20 subsection does not prohibit the governor or a state agency from
6-21 appointing to the council a person serving on the council on the
6-22 effective date of this Act.
6-23 (b) In making appointments to the Texas Diabetes Council
6-24 under Subsection (a) of this section, the governor shall appoint
6-25 four members for terms expiring February 1, 1999, four members for
7-1 terms expiring February 1, 2001, and four members for terms
7-2 expiring February 1, 2003.
7-3 ARTICLE 4. DIABETES INFORMATION AND EDUCATION
7-4 SECTION 4.01. Chapter 103, Health and Safety Code, is
7-5 amended by amending Section 103.017 and adding Section 103.0175 to
7-6 read as follows:
7-7 Sec. 103.017. PUBLIC AWARENESS AND TRAINING. (a) The
7-8 department, the Texas Commission for the Blind, the Texas
7-9 Rehabilitation Commission, the Texas Department of Human Services,
7-10 and the Texas [Central] Education Agency shall work with the
7-11 council to jointly develop, produce, and implement a general public
7-12 awareness strategy focusing on diabetes, its complications, and
7-13 techniques for achieving good management. Each agency shall pay
7-14 for the costs of producing and disseminating information on
7-15 diabetes to clients served by that agency.
7-16 (b) The strategy developed under Subsection (a) must include
7-17 a plan under which the council provides public awareness
7-18 information through businesses, civic organizations, and similar
7-19 entities.
7-20 (c) The department, the Texas Commission for the Blind, the
7-21 Texas Rehabilitation Commission, the Texas Department of Human
7-22 Services, and the Texas [Central] Education Agency may jointly
7-23 develop and implement a statewide plan for conducting regional
7-24 training sessions for public and private service providers,
7-25 including institutional health care providers, who have routine
8-1 contact with persons with diabetes.
8-2 (d) [(c)] The council must approve the strategies and plans
8-3 developed under this section.
8-4 Sec. 103.0175. MATERIALS FOR SCHOOL-BASED AND SCHOOL-LINKED
8-5 CLINICS. The council, in consultation with the department, shall
8-6 develop and make available materials that provide information about
8-7 diabetes to be distributed to students and the parents of students
8-8 by health clinics at public primary or secondary schools.
8-9 SECTION 4.02. Section 28.002, Education Code, is amended by
8-10 adding Subsection (k) to read as follows:
8-11 (k) The State Board of Education, in consultation with the
8-12 Texas Department of Health and the Texas Diabetes Council, shall
8-13 develop a diabetes education program that a school district may use
8-14 in the health curriculum under Subsection (a)(2)(B).
8-15 ARTICLE 5. EFFECTIVE DATE; EMERGENCY
8-16 SECTION 5.01. This Act takes effect September 1, 1997.
8-17 SECTION 5.02. The importance of this legislation and the
8-18 crowded condition of the calendars in both houses create an
8-19 emergency and an imperative public necessity that the
8-20 constitutional rule requiring bills to be read on three several
8-21 days in each house be suspended, and this rule is hereby suspended.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 162 passed the Senate on
March 10, 1997, by a viva-voce vote; and that the Senate concurred
in House amendments on May 28, 1997, by a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 162 passed the House, with
amendments, on May 24, 1997, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor