SRC-ARR H.B. 714 76(R)BILL ANALYSIS


Senate Research CenterH.B. 714
By: Naishtat (Moncrief)
Health Services
5/14/1999
Committee Report (Amended)


DIGEST 

Current law requires newborns in this state to be blood-screened for a
varity of conditions. However, the law does not require the screening of
newborns for congenital loss of hearing. Lack of early detection of hearing
loss has social and financial impacts on individuals, families, and this
state. H.B. 714 requires that a screening test for hearing loss be
administered to newborns and children, and establishes a newborn hearing,
tracking, and screening program. This bill also requires a state medical
assistance program or a private hospital benefit plan to provide coverage
for the screening test, as appropriate.  

PURPOSE

As proposed, H.B. 714 requires that a screening test for hearing loss be
administered to newborns and  children, and establish a newborn hearing,
tracking, and screening program. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Texas Department of Health SECTION 1
(Section 47.006, Health and Safety Code), SECTION 3 (Section 32.024(v),
Human Resources Code), the commissioner of insurance in SECTION 4 (Section
4(b), Insurance Code), and the Texas Board of Health in SECTION 7 of this
bill.  

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Tile 2B, Health and Safety Code, by adding Chapter 47, as
follows: 

CHAPTER 47. HEARING LOSS IN NEWBORNS

Sec. 47.001. DEFINITIONS. Defines "birth admission," "birthing facility,"
"health care provider," "hearing loss," "infant," "intervention or
follow-up care," "newborn," "parent," "physician," and "program."  

Sec. 47.002. APPLICABILITY OF CHAPTER. Provides that this chapter does not
apply to a facility operated by a midwife as defined by Section 1, Texas
Midwifery Act.  

Sec. 47.003. NEWBORN HEARING SCREENING, TRACKING, AND INTERVENTION PROGRAM.
Sets forth requirements for a newborn hearing screening, tracking, and
intervention program (program).  

Sec. 47.004. CERTIFICATION OF SCREENING PROGRAMS. Requires the Texas
Department of Health (department) or the department's designee to establish
certification criteria for the implementation of the program. Requires the
program to take certain actions, in order to be certified. Authorizes the
department to certify a program that meets and maintains the certification
criteria. Authorizes the department to renew the certification of a program
on a periodic basis as established by the Texas Board of Health (board)
rule in order to ensure quality services. Prohibits a fee from being
charged to certify or recertify a program.  

Sec. 47.005 INFORMATION CONCERNING SCREENING RESULTS AND FOLLOW UP CARE.
Sets forth requirements for screening results and follow-up care.  

Sec. 47.006. TECHNICAL ASSISTANCE BY DEPARTMENT. Authorizes the department
to consult with a birthing facility and provide to the facility technical
assistance associated with the implementation of a certified program.  

Sec. 47.007. INFORMATION MANAGEMENT, REPORTING, AND TRACKING SYSTEM.
Requires the department to provide each birthing facility that provides
newborn hearing screening with the appropriate information management,
reporting, and tracking software for the program. Sets forth requirements
for the information management, reporting, and tracking system (system).
Authorizes certain persons to access the system to provide certain
information where available to the department. Requires the department to
ensure that the written consent of a parent is obtained before a newborn is
included in the  system. 

Sec. 47.008. CONFIDENTIALITY AND GENERAL ACCESS TO DATA. Sets forth certain
requirements for the confidentiality and general access to data. Require
the department to develop guidelines, by rule to protect the
confidentiality of patients. Require the department to permit a parent or
guardian at any time to withdraw information provided to the department
under this chapter.  

Sec. 47.009. IMMUNITY FROM LIABILITY. Provides that certain persons and
entities are not criminally or civilly liable for furnishing information in
good faith to the department or its designee as required by this chapter.
Provides that this section does not apply to information gathered and
furnished after a parent of a newborn or infant declined screening offered
through a program.  

SECTION 2. Amends Section 36.004, Health and Safety Code, by adding
Subsection (i), to provide that a hearing and screening test performed
under Chapter 47.  

SECTION 3. Amends Section 32.024, Human Resources Code, by adding
Subsection (v), to require the department, by rule, to provide a screening
test for hearing loss in accordance with Chapter 47, Health and Safety
Code, and any necessary diagnostic follow-up care related to a the
screening test to child younger than 30 days old who receives medical
assistance.  

SECTION 4.  Amends Article 21.53F, Insurance Code, is amended by amending
Sections 3 and 4 and adding Sections 5, 6, and 7, as follows:  

Sec. 3. REQUIRED BENEFIT FOR CHILDHOOD IMMUNIZATIONS. Requires a health
benefit plan that provides benefits for a family member of the insured to
provide coverage for each covered child described by Section 5 of this
article, rather than Subsection (b) o f this section.  

Sec. 4. REQUIRED BENEFITS FOR SCREENING TEST FOR HEARING IMPAIRMENT. Sets
forth required benefits for a screening test for hearing impairments.
Authorizes the commissioner of insurance to adopt rules to implement the
requirements to this section. Set forth the health benefit plans to which
this section applies.  

Sec. 5. New heading: COVERED CHILDREN. Provides the a child is entitled to
benefits under this article, rather than section.  

Sec. 6. New heading: APPLICATION OF DEDUCTIBLE COPAYMENT, OR COINSURANCE
REQUIREMENT. Authorizes benefits required under Section 4 of this article
to  be subject to copayment and coinsurance requirements, but may not be
subject to a deductible requirement of dollar limit. Requires the
requirements of this section to be stated in the coverage document.  

Sec. 7. RULES. Authorizes the commissioner of insurance to adopt rules as
necessary to implement this article.  

 SECTION 5. Amends the heading of Article 21.53F, Insurance Code, as
follows: 

 Art. 21.53F. New heading: COVERAGE FOR CERTAIN BENEFITS FOR CHILDREN

SECTION 6. (a) Effective date: September 1, 1999.

(b) Requires certain birthing facilities to offer newborn hearing screening
during admission a provided by Section 47.003, Health and Safety Code, as
added by this Act, not later than May 1, 2000.  

(c) Requires certain birthing facilities to offer hearing screening during
birth admission in accordance with Section 47.003, Health and Safety Code,
as added by this Act Not later than April 1, 2001.  

SECTION 7. Requires the board to adopt certain rules not later than
December 1, 1999.  

SECTION 8. Requires the Health and Human Services Commission (commission)
and certain appropriate health and human services agency to adopt certain
rules no late than January 1, 2000. Requires the commission to request a
waiver or authorization from a federal agency if needed. 

SECTION 9. Provides that the change in law made by SECTION 4 of this Act
applies only to a health benefit plan that is delivered, issued for
delivery, or renewed on or after January 1, 2000.  

SECTION 10. Provides that this Act takes effect only if a specific
appropriation for the implementation of the Act is provided in H.B. No. 1
(General Appropriations Act), Acts of the 76th Legislature, Regular
Session, 1999. Provides that if no specific appropriations is provided in
H.B. No. 1,  the General Appropriations Act, this Act has no effect.  

SECTION 11. Emergency clause.