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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for certain mental disorders in children under |
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a health coverage plan established by the Teacher Retirement System |
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of Texas under the Texas School Employees Uniform Group Health |
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Coverage Act. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter C, Chapter 1579, Insurance Code, is |
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amended by adding Section 1579.107 to read as follows: |
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Sec. 1579.107. CERTAIN MENTAL DISORDERS IN CHILDREN. (a) |
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In this section, "child" means a person younger than 19 years of |
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age. |
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(b) A health coverage plan under this chapter must include |
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coverage for an enrollee who is a child for the diagnosis and |
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treatment of anorexia nervosa and bulimia nervosa, as defined by |
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the Diagnostic and Statistical Manual of Mental Disorders, fourth |
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edition, or a subsequent edition of that manual that the |
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commissioner by rule adopts for the purposes of this section. |
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Except as provided by this section, coverage required under this |
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subsection must be provided under the same terms and conditions as |
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coverage for diagnosis and treatment of physical illness. |
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(c) Coverage required under this section may be provided or |
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offered through a managed care plan. |
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(d) Except as provided by this subsection, the health |
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coverage plan must cover inpatient stays and outpatient visits |
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under this section under the same terms and conditions as the plan |
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covers inpatient stays and outpatient visits for treatment of a |
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physical illness. Coverage required by this section may not be |
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subject to an annual or lifetime limit on the number of days of |
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inpatient treatment or the number of outpatient visits covered |
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under the plan. |
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(e) Coverage provided under this section must be subject to |
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the same amount limits, deductibles, copayments, and coinsurance |
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factors as coverage for physical illness. |
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(f) The trustee shall adopt rules as necessary to implement |
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this section. |
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SECTION 2. (a) On or before September 1, 2012, the Sunset |
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Advisory Commission shall conduct a study to determine: |
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(1) to what extent the health benefit plan coverage |
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required by Section 1579.107, Insurance Code, as added by this Act, |
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is being used by enrollees in health coverage plans to which that |
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section applies; and |
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(2) the impact of the required coverage on the cost of |
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those health coverage plans. |
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(b) The Sunset Advisory Commission shall report its |
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findings under this section to the legislature on or before January |
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1, 2013. |
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(c) The Teacher Retirement System of Texas, the Texas |
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Department of Insurance, and any other state agency shall cooperate |
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with the Sunset Advisory Commission as necessary to implement this |
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section. |
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SECTION 3. This Act applies only to group health coverage |
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under Chapter 1579, Insurance Code, as amended by this Act, on or |
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after September 1, 2007. |
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SECTION 4. This Act takes effect September 1, 2007. |