76R10944 DB-D By Coleman H.B. No. 1650 Substitute the following for H.B. No. 1650: By Thompson C.S.H.B. No. 1650 A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to health benefit plan coverage for certain physical 1-3 injuries that are self-inflicted by a minor. 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 21.53P to read as follows: 1-7 Art. 21.53P. COVERAGE FOR CERTAIN SELF-INFLICTED PHYSICAL 1-8 INJURIES BY MINORS 1-9 Sec. 1. DEFINITIONS. In this article: 1-10 (1) "Enrollee" means an individual enrolled in a 1-11 health benefit plan. 1-12 (2) "Health benefit plan" means a plan described by 1-13 Section 2(a) of this article. 1-14 (3) "Serious mental illness" means: 1-15 (A) the following psychiatric illnesses as 1-16 defined by the American Psychiatric Association's Diagnostic and 1-17 Statistical Manual designated DSM-IV: 1-18 (i) schizophrenia; 1-19 (ii) paranoid and other psychotic 1-20 disorders; 1-21 (iii) bipolar disorders (hypomanic, manic, 1-22 depressive, and mixed); 1-23 (iv) major depressive disorders (single 1-24 episode or recurrent); 2-1 (v) schizo-affective disorders (bipolar or 2-2 depressive); 2-3 (vi) pervasive developmental disorders; 2-4 (vii) obsessive-compulsive disorders; and 2-5 (viii) depression; or 2-6 (B) a diagnosable behavioral or emotional 2-7 disorder or a neuropsychiatric condition: 2-8 (i) that results in a serious disability 2-9 requiring sustained treatment interventions; 2-10 (ii) that is of sufficient duration to 2-11 meet diagnostic criteria specified in the American Psychiatric 2-12 Association's Diagnostic and Statistical Manual designated DSM-IV; 2-13 and 2-14 (iii) with respect to which the person 2-15 exhibits impairment in thought, perception, affect, or behavior 2-16 that substantially interferes with or limits the person's role or 2-17 functioning in the person's community, school, family, or peer 2-18 group. 2-19 Sec. 2. SCOPE OF ARTICLE. (a) This article applies only to 2-20 a health benefit plan that provides benefits for medical or 2-21 surgical expenses incurred as a result of a health condition, 2-22 accident, or sickness, including an individual, group, blanket, or 2-23 franchise insurance policy or insurance agreement, a group hospital 2-24 service contract, or an individual or group evidence of coverage or 2-25 similar coverage document that is offered by: 2-26 (1) an insurance company; 2-27 (2) a group hospital service corporation operating 3-1 under Chapter 20 of this code; 3-2 (3) a fraternal benefit society operating under 3-3 Chapter 10 of this code; 3-4 (4) a stipulated premium insurance company operating 3-5 under Chapter 22 of this code; 3-6 (5) a reciprocal exchange operating under Chapter 19 3-7 of this code; 3-8 (6) a health maintenance organization operating under 3-9 the Texas Health Maintenance Organization Act (Chapter 20A, 3-10 Vernon's Texas Insurance Code); 3-11 (7) a multiple employer welfare arrangement that holds 3-12 a certificate of authority under Article 3.95-2 of this code; 3-13 (8) an approved nonprofit health corporation that 3-14 holds a certificate of authority issued by the commissioner under 3-15 Article 21.52F of this code; 3-16 (9) an agency of the state under: 3-17 (A) the Texas Employees Uniform Group Insurance 3-18 Benefits Act (Article 3.50-2, Vernon's Texas Insurance Code); 3-19 (B) the Texas State College and University 3-20 Employees Uniform Insurance Benefits Act (Article 3.50-3, Vernon's 3-21 Texas Insurance Code); or 3-22 (C) Article 3.50-4 of this code; 3-23 (10) a political subdivision under Chapter 172, Local 3-24 Government Code; or 3-25 (11) a school district in accordance with Section 3-26 22.004, Education Code. 3-27 (b) This article does not apply to: 4-1 (1) a plan that provides coverage: 4-2 (A) for wages or payments in lieu of wages for a 4-3 period during which an employee is absent from work because of 4-4 sickness or injury; 4-5 (B) as a supplement to liability insurance; 4-6 (C) for credit insurance; 4-7 (D) only for dental or vision care; 4-8 (E) only for hospital expenses; or 4-9 (F) only for indemnity for hospital confinement; 4-10 (2) a small employer health benefit plan written under 4-11 Chapter 26 of this code, except when an independent school district 4-12 elects to participate in a small employer market in accordance with 4-13 Article 26.036 of this code; 4-14 (3) a Medicare supplemental policy as defined by 4-15 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), 4-16 and its subsequent amendments; 4-17 (4) workers' compensation insurance coverage; 4-18 (5) medical payment insurance coverage issued as part 4-19 of a motor vehicle insurance policy; or 4-20 (6) a long-term care policy, including a nursing home 4-21 fixed indemnity policy, unless the commissioner determines that the 4-22 policy provides benefit coverage so comprehensive that the policy 4-23 is a health benefit plan as described by Subsection (a) of this 4-24 section. 4-25 Sec. 3. COVERAGE REQUIRED. Regardless of whether a health 4-26 benefit plan provides mental health coverage, a health benefit plan 4-27 must provide coverage for an enrollee, from birth through the date 5-1 the enrollee is 18 years of age, for a physical injury to the 5-2 enrollee that is self-inflicted: 5-3 (1) in an attempt to commit suicide, regardless of: 5-4 (A) the state of mental health of the enrollee; 5-5 or 5-6 (B) whether the injury results in the death of 5-7 the enrollee; or 5-8 (2) by an enrollee with a serious mental illness. 5-9 Sec. 4. DEDUCTIBLE, COINSURANCE, AND COPAYMENT REQUIREMENTS. 5-10 The benefits required under this article may not be made subject to 5-11 a deductible, coinsurance, or copayment requirement that exceeds 5-12 the deductible, coinsurance, or copayment requirements applicable 5-13 to other physical injury benefits provided under the health benefit 5-14 plan. 5-15 Sec. 5. RULES. The commissioner shall adopt rules as 5-16 necessary to administer this article. 5-17 SECTION 2. This Act takes effect September 1, 1999, and 5-18 applies only to a health benefit plan that is delivered, issued for 5-19 delivery, or renewed on or after January 1, 2000. A health benefit 5-20 plan that is delivered, issued for delivery, or renewed before 5-21 January 1, 2000, is governed by the law as it existed immediately 5-22 before the effective date of this Act, and that law is continued in 5-23 effect for that purpose. 5-24 SECTION 3. The importance of this legislation and the 5-25 crowded condition of the calendars in both houses create an 5-26 emergency and an imperative public necessity that the 5-27 constitutional rule requiring bills to be read on three several 6-1 days in each house be suspended, and this rule is hereby suspended.