76R10917 DLF-D
By Coleman H.B. No. 2424
Substitute the following for H.B. No. 2424:
By Greenberg C.S.H.B. No. 2424
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to application of certain coverage requirements for
1-3 serious mental illness.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 3(a)(19), Texas Employees Uniform Group
1-6 Insurance Benefits Act (Article 3.50-2, Vernon's Texas Insurance
1-7 Code), as added by Section 11.106, Chapter 242, Acts of the 72nd
1-8 Legislature, Regular Session, 1991, is redesignated as Section
1-9 3(a)(23), Texas Employees Uniform Group Insurance Benefits Act
1-10 (Article 3.50-2, Vernon's Texas Insurance Code), and amended to
1-11 read as follows:
1-12 (23) "Serious [(19) For the purposes of this section,
1-13 "serious] mental illness" has the meaning assigned by Section 1,
1-14 Article 3.51-14, Insurance Code [means the following psychiatric
1-15 illnesses as defined by the American Psychiatric Association in the
1-16 Diagnostic and Statistical Manual (DSM) III-R:]
1-17 [(A) schizophrenia;]
1-18 [(B) paranoid and other psychotic disorders;]
1-19 [(C) bipolar disorders (mixed, manic, and
1-20 depressive);]
1-21 [(D) major depressive disorders (single episode
1-22 or recurrent); and]
1-23 [(E) schizo-affective disorders (bipolar or
1-24 depressive)].
2-1 SECTION 2. Section 3(a)(16), Texas State College and
2-2 University Employees Uniform Insurance Benefits Act (Article
2-3 3.50-3, Vernon's Texas Insurance Code), as added by Section 11.108,
2-4 Chapter 242, Acts of the 72nd Legislature, Regular Session, 1991,
2-5 is redesignated as Section 3(a)(19), Texas State College and
2-6 University Employees Uniform Insurance Benefits Act (Article
2-7 3.50-3, Vernon's Texas Insurance Code), and amended to read as
2-8 follows:
2-9 (19) "Serious [(16) For purposes of this section,
2-10 "serious] mental illness" has the meaning assigned by Section 1,
2-11 Article 3.51-14, Insurance Code [means the following psychiatric
2-12 illnesses as defined by the American Psychiatric Association in the
2-13 Diagnostic and Statistical Manual (DSM) III-R:]
2-14 [(A) schizophrenia;]
2-15 [(B) paranoid and other psychotic disorders;]
2-16 [(C) bipolar disorders (mixed, manic, and
2-17 depressive);]
2-18 [(D) major depressive disorders (single episode
2-19 or recurrent); and]
2-20 [(E) schizo-affective disorders (bipolar or
2-21 depressive)].
2-22 SECTION 3. Article 3.51-5A(b), Insurance Code, is amended to
2-23 read as follows:
2-24 (b) For purposes of this article, "serious mental illness"
2-25 has the meaning assigned by Section 1, Article 3.51-14, of this
2-26 code [means the following psychiatric illnesses as defined by the
2-27 American Psychiatric Association in the Diagnostic and Statistical
3-1 Manual (DSM) III-R:]
3-2 [(1) schizophrenia;]
3-3 [(2) paranoid and other psychotic disorders;]
3-4 [(3) bipolar disorders (mixed, manic, and depressive);]
3-5 [(4) major depressive disorders (single episode or
3-6 recurrent); and]
3-7 [(5) schizo-affective disorders (bipolar or
3-8 depressive)].
3-9 SECTION 4. Section 2(b), Article 3.51-14, Insurance Code, is
3-10 amended to read as follows:
3-11 (b) This article does not apply to coverage under:
3-12 (1) a blanket accident and health insurance policy as
3-13 that term is defined under Section 2, Article 3.51-6, of this code;
3-14 (2) a short-term travel policy;
3-15 (3) an accident-only policy;
3-16 (4) a limited or specified-disease policy, other than
3-17 a plan that provides benefits for mental health care or similar
3-18 services; [or]
3-19 (5) a plan offered under the Texas Employees Uniform
3-20 Group Insurance Benefits Act (Article 3.50-2, Vernon's Texas
3-21 Insurance Code) or the Texas State College and University Employees
3-22 Uniform Insurance Benefits Act (Article 3.50-3, Vernon's Texas
3-23 Insurance Code) or in accordance with Article 3.51-5A of this code;
3-24 or
3-25 (6) a medicare supplement policy, as that term is
3-26 defined under Section 1(b)(3) [1(3)], Article 3.74, of this code.
3-27 SECTION 5. Section 3(a), Article 3.51-14, Insurance Code, is
4-1 amended to read as follows:
4-2 (a) Except as provided by Section 4 of this article, a group
4-3 health benefit plan:
4-4 (1) must provide coverage for the following treatment
4-5 of serious mental illness in each calendar year:
4-6 (A) 45 days of inpatient treatment; and
4-7 (B) 60 visits for outpatient treatment,
4-8 including group and individual outpatient treatment;
4-9 (2) may not include a lifetime limit on the number of
4-10 days of inpatient treatment or the number of outpatient visits
4-11 covered under the plan; and
4-12 (3) must include the same amount limits, deductibles,
4-13 copayments, and coinsurance factors for serious mental illness as
4-14 for physical illness.
4-15 SECTION 6. This Act takes effect September 1, 1999, and
4-16 applies only to a health benefit plan that is delivered, issued for
4-17 delivery, or renewed on or after January 1, 2000. A health benefit
4-18 plan that is delivered, issued for delivery, or renewed before
4-19 January 1, 2000, is governed by the law as it existed immediately
4-20 before the effective date of this Act, and that law is continued in
4-21 effect for this purpose.
4-22 SECTION 7. The importance of this legislation and the
4-23 crowded condition of the calendars in both houses create an
4-24 emergency and an imperative public necessity that the
4-25 constitutional rule requiring bills to be read on three several
4-26 days in each house be suspended, and this rule is hereby suspended.