BILL ANALYSIS

C.S.H.B. 3276

By: Simmons

Insurance

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Current law requires insurers to cover expenses for enrollees diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age.  However, interested parties assert that a critical oversight exists with respect to insurers' coverage of screening for autism spectrum disorder, even though coverage of treatment begins on the date a child is diagnosed. C.S.H.B. 3276 seeks to address this oversight by requiring a health benefit plan to, at a minimum, provide coverage for screening for autism spectrum disorder at 18 and 24 months.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 3276 amends the Insurance Code to require a health benefit plan to provide coverage for screening a child for autism spectrum disorder at the ages of 18 and 24 months, at a minimum.  The bill clarifies that the required coverage provided to an enrollee who is diagnosed with the disorder up until a certain age is for the treatment of that disorder and expands the restricted group of individuals authorized to provide the prescribed treatment to include an individual acting under the supervision of a health care practitioner licensed, certified, or registered in Texas. The bill exempts from that screening requirement a qualified health plan as defined for purposes of an exchange under the federal Patient Protection and Affordable Care Act if a determination has been made under federal law that state law requires the qualified health plan to offer benefits in addition to the essential health benefits required under federal law and that Texas would subsequently be required to make payments to defray the cost of those additional benefits.

C.S.H.B. 3276 includes an individual acting under the supervision of a health care practitioner who has the necessary license, certification, registration, or credential to those who are authorized to provide treatment of autism spectrum disorder. 

C.S.H.B. 3276 applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2014.

EFFECTIVE DATE

September 1, 2013.

COMPARISON OF ORIGINAL AND SUBSTITUTE

C.S.H.B. 3276 differs from the original in minor or nonsubstantive ways to make technical corrections and by conforming to certain bill drafting conventions.