HBA-NRS C.S.S.B. 427 77(R)BILL ANALYSIS


Office of House Bill AnalysisC.S.S.B. 427
By: Lucio
Insurance
5/17/2001
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

The type and extent of medical care that is necessary for any given patient
is determined by that patient's physician on a case-by-case basis. Many
feel that this should be the case for all patients, regardless of their
diagnoses. C.S.S.B. 427 prohibits an insurance carrier from denying
coverage  for treatment, equipment, or therapy to a patient with autism or
a pervasive developmental disorder.  

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the commissioner of insurance in
SECTION 1 (Section 4, Article 21.53X, Insurance Code) of this bill. 

ANALYSIS

C.S.S.B. 427 amends the Insurance Code to prohibit a health benefit plan
from excluding coverage or denying benefits otherwise available to an
enrollee for treatment, equipment, or therapy based on the enrollee's
having autism or a pervasive development disorder.  The bill requires the
commissioner of insurance to adopt rules as necessary to administer this
bill.  The bill specifies the health benefits plans and coverages to which
this bill applies. 

EFFECTIVE DATE

September 1, 2001. The Act applies only to a health benefit plan delivered,
issued for delivery, or renewed on or after January 1, 2002. 

COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.S.B. 427 modifies the original bill to include a Lloyd's plan and a
plan that provides benefits for mental health or similar services in the
list of insurers that are prohibited from excluding or denying coverage or
benefits otherwise available to an enrollee for treatment, equipment, or
therapy based on the enrollee's having autism or a pervasive developmental
disorder.