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A BILL TO BE ENTITLED
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AN ACT
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relating to establishing a health and wellness initiative program |
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to reduce health plan costs for certain public employees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter E, Chapter 1551, Insurance Code, is |
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amended by adding Section 1551.226 to read as follows: |
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Sec. 1551.226. ESTABLISHMENT OF HEALTH AND WELLNESS |
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INITIATIVE PROGRAM. (a) In this section: |
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(1) "Critical illness" means an illness designated by |
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the board of trustees as a critical illness, including: |
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(A) a major cancer, Alzheimer's disease, |
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multiple sclerosis, HIV/AIDS contracted during a blood transfusion |
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or operation, or Parkinson's disease; |
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(B) an organ failure or organ transplant; |
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(C) the loss of independent existence; and |
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(D) any terminal illness. |
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(2) "Initiative program" means the health and wellness |
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initiative program established under this section. |
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(b) The board of trustees by rule shall design and establish |
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a health and wellness initiative program. The initiative program |
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must: |
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(1) include: |
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(A) an early detection incentive for individuals |
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covered by the group benefits program who participate in the |
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initiative program; |
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(B) a no-smoking campaign; and |
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(C) a plan designed to match an individual to a |
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clinical trial; |
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(2) encourage an individual who participates in the |
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initiative program to: |
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(A) obtain a second opinion from a physician or |
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other health care provider about: |
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(i) a diagnosis of cancer or other critical |
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illness; or |
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(ii) treatment options; or |
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(B) visit a certified National Cancer Institute; |
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(3) from available funds, provide a $100 wellness |
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benefit to an employee for undergoing eligible screening tests as |
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designated by the board of trustees; and |
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(4) be available to individuals covered by the group |
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benefits program regardless of the individual's health history. |
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(c) The board of trustees shall establish an Internet |
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website for the initiative program. The board of trustees may |
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develop a list of eligible resources and support services, which |
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may be posted on the website, for individuals diagnosed with cancer |
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or other critical illness. |
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(d) The eligible resources and support services designated |
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under Subsection (c) may provide to individuals diagnosed with |
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cancer or another critical illness and those individuals' friends |
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and families: |
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(1) information about health-related topics, |
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including: |
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(A) obtaining a positive prognosis after a |
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|
diagnosis; |
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(B) living a healthy lifestyle; and |
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(C) reducing the risk of illness; |
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(2) one-on-one support; |
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(3) counseling and referrals to other resources; and |
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(4) information regarding financial and insurance |
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concerns. |
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(e) The board of trustees shall periodically update the list |
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established under Subsection (c). |
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SECTION 2. Subchapter D, Chapter 1575, Insurance Code, is |
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amended by adding Section 1575.172 to read as follows: |
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Sec. 1575.172. ESTABLISHMENT OF HEALTH AND WELLNESS |
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INITIATIVE PROGRAM. (a) In this section: |
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(1) "Critical illness" means an illness designated by |
|
|
the board of trustees as a critical illness, including: |
|
|
(A) a major cancer, Alzheimer's disease, |
|
|
multiple sclerosis, HIV/AIDS contracted during a blood transfusion |
|
|
or operation, or Parkinson's disease; |
|
|
(B) an organ failure or organ transplant; |
|
|
(C) the loss of independent existence; and |
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|
(D) any terminal illness. |
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(2) "Initiative program" means the health and wellness |
|
|
initiative program established under this section. |
|
|
(b) The trustee by rule shall design and establish a health |
|
|
and wellness initiative program. The initiative program must: |
|
|
(1) include: |
|
|
(A) an early detection incentive for individuals |
|
|
covered by the group program who participate in the initiative |
|
|
program; |
|
|
(B) a no-smoking campaign; and |
|
|
(C) a plan designed to match an individual to a |
|
|
clinical trial; |
|
|
(2) encourage an individual who participates in the |
|
|
initiative program to: |
|
|
(A) obtain a second opinion from a physician or |
|
|
other health care provider about: |
|
|
(i) a diagnosis of cancer or other critical |
|
|
illness; or |
|
|
(ii) treatment options; or |
|
|
(B) visit a certified National Cancer Institute; |
|
|
(3) from available funds, provide a $100 wellness |
|
|
benefit to a retiree for undergoing eligible screening tests as |
|
|
designated by the trustee; and |
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|
(4) be available to individuals covered by the group |
|
|
program regardless of the individual's health history. |
|
|
(c) The trustee shall establish an Internet website for the |
|
|
initiative program. The trustee may develop a list of eligible |
|
|
resources and support services, which may be posted on the website, |
|
|
for individuals diagnosed with cancer or other critical illness. |
|
|
(d) The eligible resources and support services designated |
|
|
under Subsection (c) may provide to individuals diagnosed with |
|
|
cancer or another critical illness and those individuals' friends |
|
|
and families: |
|
|
(1) information about health-related topics, |
|
|
including: |
|
|
(A) obtaining a positive prognosis after a |
|
|
diagnosis; |
|
|
(B) living a healthy lifestyle; and |
|
|
(C) reducing the risk of illness; |
|
|
(2) one-on-one support; |
|
|
(3) counseling and referrals to other resources; and |
|
|
(4) information regarding financial and insurance |
|
|
concerns. |
|
|
(e) The trustee shall periodically update the list |
|
|
established under Subsection (c). |
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|
SECTION 3. Subchapter C, Chapter 1579, Insurance Code, is |
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amended by adding Section 1579.110 to read as follows: |
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Sec. 1579.110. ESTABLISHMENT OF HEALTH AND WELLNESS |
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INITIATIVE PROGRAM. (a) In this section: |
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(1) "Critical illness" means an illness designated by |
|
|
the board of trustees as a critical illness, including: |
|
|
(A) a major cancer, Alzheimer's disease, |
|
|
multiple sclerosis, HIV/AIDS contracted during a blood transfusion |
|
|
or operation, or Parkinson's disease; |
|
|
(B) an organ failure or organ transplant; |
|
|
(C) the loss of independent existence; and |
|
|
(D) any terminal illness. |
|
|
(2) "Initiative program" means the health and wellness |
|
|
initiative program established under this section. |
|
|
(b) The trustee by rule shall design and establish a health |
|
|
and wellness initiative program. The initiative program must: |
|
|
(1) include: |
|
|
(A) an early detection incentive for individuals |
|
|
covered by the uniform group coverage program who participate in |
|
|
the initiative program; |
|
|
(B) a no-smoking campaign; and |
|
|
(C) a plan designed to match an individual to a |
|
|
clinical trial; |
|
|
(2) encourage an individual who participates in the |
|
|
initiative program to: |
|
|
(A) obtain a second opinion from a physician or |
|
|
other health care provider about: |
|
|
(i) a diagnosis of cancer or other critical |
|
|
illness; or |
|
|
(ii) treatment options; or |
|
|
(B) visit a certified National Cancer Institute; |
|
|
(3) from available funds, provide a $100 wellness |
|
|
benefit to an employee for undergoing eligible screening tests as |
|
|
designated by the trustee; and |
|
|
(4) be available to individuals covered by the uniform |
|
|
group coverage program regardless of the individual's health |
|
|
history. |
|
|
(c) The trustee shall establish an Internet website for the |
|
|
initiative program. The trustee may develop a list of eligible |
|
|
resources and support services, which may be posted on the website, |
|
|
for individuals diagnosed with cancer or other critical illness. |
|
|
(d) The eligible resources and support services designated |
|
|
under Subsection (c) may provide to individuals diagnosed with |
|
|
cancer or another critical illness and those individuals' friends |
|
|
and families: |
|
|
(1) information about health-related topics, |
|
|
including: |
|
|
(A) obtaining a positive prognosis after a |
|
|
diagnosis; |
|
|
(B) living a healthy lifestyle; and |
|
|
(C) reducing the risk of illness; |
|
|
(2) one-on-one support; |
|
|
(3) counseling and referrals to other resources; and |
|
|
(4) information regarding financial and insurance |
|
|
concerns. |
|
|
(e) The trustee shall periodically update the list |
|
|
established under Subsection (c). |
|
|
SECTION 4. Subchapter C, Chapter 1601, Insurance Code, is |
|
|
amended by adding Section 1601.112 to read as follows: |
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|
Sec. 1601.112. ESTABLISHMENT OF HEALTH AND WELLNESS |
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|
INITIATIVE PROGRAM. (a) In this section: |
|
|
(1) "Critical illness" means an illness designated by |
|
|
the board of trustees as a critical illness, including: |
|
|
(A) a major cancer, Alzheimer's disease, |
|
|
multiple sclerosis, HIV/AIDS contracted during a blood transfusion |
|
|
or operation, or Parkinson's disease; |
|
|
(B) an organ failure or organ transplant; |
|
|
(C) the loss of independent existence; and |
|
|
(D) any terminal illness. |
|
|
(2) "Initiative program" means the health and wellness |
|
|
initiative program established under this section. |
|
|
(b) Each system by rule shall design and establish a health |
|
|
and wellness initiative program. The initiative program must: |
|
|
(1) include: |
|
|
(A) an early detection incentive for individuals |
|
|
covered by a uniform program who participate in the initiative |
|
|
program; |
|
|
(B) a no-smoking campaign; and |
|
|
(C) a plan designed to match an individual to a |
|
|
clinical trial; |
|
|
(2) encourage an individual who participates in the |
|
|
initiative program to: |
|
|
(A) obtain a second opinion from a physician or |
|
|
other health care provider about: |
|
|
(i) a diagnosis of cancer or other critical |
|
|
illness; or |
|
|
(ii) treatment options; or |
|
|
(B) visit a certified National Cancer Institute; |
|
|
(3) from available funds, provide a $100 wellness |
|
|
benefit to an employee for undergoing eligible screening tests as |
|
|
designated by the system; and |
|
|
(4) be available to individuals covered by a uniform |
|
|
program regardless of the individual's health history. |
|
|
(c) Each system shall establish an Internet website for the |
|
|
initiative program. The system may develop a list of eligible |
|
|
resources and support services, which may be posted on the website, |
|
|
for individuals diagnosed with cancer or other critical illness. |
|
|
(d) The eligible resources and support services designated |
|
|
under Subsection (c) may provide to individuals diagnosed with |
|
|
cancer or another critical illness and those individuals' friends |
|
|
and families: |
|
|
(1) information about health-related topics, |
|
|
including: |
|
|
(A) obtaining a positive prognosis after a |
|
|
diagnosis; |
|
|
(B) living a healthy lifestyle; and |
|
|
(C) reducing the risk of illness; |
|
|
(2) one-on-one support; |
|
|
(3) counseling and referrals to other resources; and |
|
|
(4) information regarding financial and insurance |
|
|
concerns. |
|
|
(e) Each system shall periodically update the list |
|
|
established under Subsection (c). |
|
|
SECTION 5. The changes in law made by this Act apply only to |
|
|
health benefit plans provided under Chapters 1551, 1575, 1579, and |
|
|
1601, Insurance Code, beginning with the 2009-2010 plan year. A |
|
|
plan year before 2009-2010 is governed by the law as it existed |
|
|
immediately before September 1, 2009, and that law is continued in |
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|
effect for that purpose. |
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|
SECTION 6. This Act takes effect September 1, 2009. |