BILL ANALYSIS
By: Eissler
Committee Report (Substituted)
BACKGROUND AND PURPOSE
Currently, many private insurance policies do not provide coverage for a child's mental illness that is comparable to the coverage provided for a physical illness. H.B. 712 requires health coverage plans established by the Teacher Retirement System of Texas under the Texas School Employees Uniform Group Health Coverage Act to provide the same level of health care coverage for certain mental disorders of a child that if provides for a child's physical health.
RULEMAKING AUTHORITY
Rulemaking authority is expressly granted to the Teacher Retirement System of Texas in SECTION 1 (Section 1579.109, Insurance Code), of this bill.
ANALYSIS
SECTION 1. Amends Subchapter C, Chapter 1579, Insurance Code, by adding Section 1579.109 as follows:
Section 1579.109. CERTAIN MENTAL DISORDERS IN CHILDREN
(a) Definitions
(b) Requires that a health coverage plan under this chapter to provide coverage for an enrollee who is a child for the diagnoses and treatment of bulimia nervosa or anorexia. Requires a health coverage plan to provide coverage required under this subsection under the same terms and conditions as coverage for diagnosis and treatment of physical illness.
(c) Authorizes coverage under this article to be provided or offered through a managed care plan.
(d) Requires a health coverage plan to cover inpatient stays and outpatient visits under this section under the same terms and conditions as the plan covers inpatient stays and outpatient visits for treatment of a physical illness. Prohibits coverage required by this section from being subject to an annual or lifetime limit on the number of days of inpatient treatment of the number of outpatient visits covered under the plan.
(e) Requires coverage provided under this section to be subject to the same amount of limits, deductibles, co-payments, and coinsurance factors as coverage for physical illness.
(f) Require the trustee to adopt rules as necessary to implement this section.
SECTION 2. (a) Requires the Sunset Advisory Commission, on or before September 1, 2010, to conduct a study to determine certain things.
(b) Requires that the Sunset Advisory Commission report its finding under this section to the legislature on or before January 1, 2007.
(c) Requires the Teacher Retirement System of Texas, The Texas Department of Insurance, and any other state agency to cooperate with the Sunset Advisory Commission as necessary to implement this section.
SECTION 3. Provides that this Act applies only to group health coverage under Chapter 1579, Insurance Code, as amended by this Act, on or after September 1, 2005.
EFFECTIVE DATE
This Act takes effect September 1, 2005.
COMPARISON OF ORIGINAL TO SUBSTITUTE
C.S.H.B. 712 differs from the original, in that it limits the term “mental disorder” to only cover anorexia and bulimia nervosa under Section 1579.109.