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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for certain children |
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diagnosed with autism spectrum disorder. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Sections 1355.015(b) and (c), Insurance Code, |
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are amended to read as follows: |
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(b) The health benefit plan must provide coverage under this |
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section to the enrollee for all generally recognized services |
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prescribed in relation to autism spectrum disorder by the |
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enrollee's primary care physician in the treatment plan developed |
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[recommended] by that physician in consultation with the enrollee's |
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parent or guardian. An individual providing treatment prescribed |
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under this subsection must be a health care practitioner: |
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(1) who is licensed, certified, or registered by an |
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appropriate agency of this state; |
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(2) whose professional credential is recognized and |
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accepted by an appropriate agency of the United States; or |
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(3) who is certified as a provider under the TRICARE |
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military health system. |
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(c) For purposes of Subsection (b), "generally recognized |
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services" may include services such as: |
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(1) evaluation and assessment services; |
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(2) applied behavior analysis; |
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(3) behavior training and behavior management; |
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(4) speech therapy; |
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(5) occupational therapy; |
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(6) physical therapy; [or] |
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(7) therapy to develop appropriate social, emotional, |
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and interpersonal skills; or |
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(8) medications or nutritional supplements used to |
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address symptoms of autism spectrum disorder. |
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SECTION 2. The change in law made by this Act applies only |
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to a health benefit plan that is delivered, issued for delivery, or |
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renewed on or after January 1, 2012. A health benefit plan that is |
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delivered, issued for delivery, or renewed before January 1, 2012, |
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is covered by the law in effect at the time the health benefit plan |
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is delivered, issued for delivery, or renewed, and that law is |
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continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2011. |