HBA-NMO H.B. 714 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 714 By: Naishtat Public Health 3/26/99 Introduced BACKGROUND AND PURPOSE Current law requires newborns in this state to be blood-screened for a variety of conditions. However, the law does not require the screening of newborns for congenital loss of hearing. Lack of early detection of hearing loss may have social and financial impacts on individuals, families, and this state. H.B. 714 requires that a screening test for hearing impairments be administered to newborn children. This bill also requires a state medical assistance program or a health benefit plan to provide coverage for the screening test, as appropriate. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 1 (Section 34.011, Health and Safety Code); the Health and Human Services Commission or an agency operating part of the medical assistance program, as appropriate, in SECTION 3 (Section 32.024, Human Resources Code); and the commissioner of insurance in SECTION 4 (Article 21.53F, Insurance Code, as added by Chapter 683, Acts of the 75th Legislature, Regular Session, 1997), of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subtitle B, Title 2, Health and Safety Code, by adding Chapter 34, as follows: CHAPTER 34. HEARING IMPAIRMENTS SUBCHAPTER A. GENERAL PROVISIONS Sec. 34.001. DEFINITIONS. Defines "hearing impairment" and "screening test." SUBCHAPTER B. NEWBORN SCREENING Sec. 34.011. TEST REQUIREMENT. Requires the physician attending a newborn child or the person attending the delivery of a newborn child that is not attended by a physician to ensure that the child is subjected to a screening test approved by the Texas Department of Health for hearing impairments before the child is 181 days old. Requires the Texas Board of Health, by rule, to prescribe the screening test procedures to be used and the standards of accuracy and precision required for each test. Sec. 34.012. EXEMPTION. Prohibits a screening test from being administered to a newborn child whose parent, managing conservator, or guardian objects to the administration of the test on religious grounds. Requires the physician or person attending the newborn child, upon the objection, to ensure that it is entered into the medical record of the child. Requires the parent, managing conservator, or guardian to sign the entry. Sec. 34.013. LIMITATION ON LIABILITY. Provides that the person administering a screening test is not liable or responsible because of the failure or refusal of a parent, managing conservator, or guardian to consent to the test. SECTION 2. Amends Section 36.004, Health and Safety Code, by adding Subsection (i), as follows: (i) Provides that a hearing screening performed under this section is in addition to any hearing screening test performed under Chapter 34. SECTION 3. Amends Section 32.024, Human Resources Code, by adding Subsection (v), as follows: (v) Requires the Health and Human Services Commission or an agency operating part of the medical assistance program, as appropriate, by rule, to provide a screening test for hearing impairments as required by Texas Board of Health rule under Chapter 34, Health and Safety Code, to a child younger than 181 days old who receives medical assistance. SECTION 4. Amends Article 21.53F, Insurance Code, as added by Chapter 683, Acts of the 75th Legislature, Regular Session, 1997, by amending Sections 3 and 4 and adding Sections 5 and 6, as follows: Sec. 3. REQUIRED BENEFIT FOR CHILDHOOD IMMUNIZATIONS. Makes conforming changes. Sec. 4. REQUIRED BENEFITS FOR SCREENING TEST FOR HEARING IMPAIRMENT. Requires a health benefit plan to provide coverage for each child described by Section 5, from birth through the date the child is 180 days old, for a screening test for hearing impairments required by Texas Board of Health rule under Chapter 34, Health and Safety Code. Authorizes the commissioner of insurance to adopt rules to implement the requirement of this section. Sec. 5. COVERED CHILDREN. Entitles a child to benefits under this article if the child, as a result of the child's relationship to an enrollee in the health benefit plan, would be entitled to benefits under an accident and sickness insurance policy under Subsection (K), (L), or (M), Section 2, Article 3.70-2, Insurance Code (Form of Policy). Makes conforming changes. Sec. 6. FIRST DOLLAR COVERAGE REQUIRED. Prohibits benefits required under Sections 3 and 4 from being made subject to a deductible, copayment, or coinsurance requirement. Provides, however, that this section does not prohibit the application of a deductible, copayment, or coinsurance requirement to another service provided at the same time as the immunization or hearing screening. SECTION 5. Redesignates Article 21.53F, Insurance Code, as added by Chapter 683, Acts of the 75th Legislature, Regular Session, 1997, as Article 21.53J and amends the heading of that article, as follows: Art. 21.53J. New Title: COVERAGE FOR CERTAIN BENEFITS FOR CHILDREN. Deletes "childhood immunizations" from existing title. Adds "certain benefits for children." SECTION 6. Effective date: September 1, 1999. Provides that a physician or other person attending the birth of a child is not required to comply with Section 34.011, Health and Safety Code, before September 1, 2000. SECTION 7. Requires the Texas Board of Health to adopt the rules required by Section 34.011, Health and Safety Code, not later than August 31, 2000. SECTION 8. Requires the Health and Human Services Commission and each appropriate health and human services agency that operates part of the state medical assistance program under Chapter 32, Human Resources Code (Medical Assistance Program), not later than August 31, 2000, to adopt rules required by Section 32.024(v), Human Resources Code. Requires the commission, if before implementing Section 32.024(v) it determines that a waiver or authorization from a federal agency is necessary for implementation, to request the waiver or authorization and authorizes it to delay implementing that provision until the waiver or authorization is granted. SECTION 9. Makes application of the change in law made by SECTION 4 prospective beginning with a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2000. SECTION 10. Emergency clause.