83R10411 KFF-F
 
  By: Bonnen of Galveston H.B. No. 2217
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the provision of a cranial molding orthosis under the
  medical assistance and child health plan programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter D, Chapter 62, Health and Safety
  Code, is amended by adding Section 62.1511 to read as follows:
         Sec. 62.1511.  CHILD HEALTH PLAN COVERAGE FOR CRANIAL
  MOLDING ORTHOSIS. (a) Subject to the requirements of this section,
  the child health plan must provide a cranial molding orthosis as a
  covered benefit for a child health plan enrollee who is at least 3
  months of age but younger than 18 months of age.
         (b)  To qualify for coverage as a child health plan benefit,
  a cranial molding orthosis must be:
               (1)  medically necessary, as established by
  demonstrating that the child health plan enrollee has a cranial
  vault asymmetry index of at least 6.25 or a cephalic index that is
  at least two standard deviations above or below the age-adjusted
  mean for the enrollee; and
               (2)  used as part of:
                     (A)  a nonsurgical treatment program if the
  enrollee is diagnosed with plagiocephaly, brachycephaly, or
  scaphocephaly; or
                     (B)  a surgical treatment program if the cranial
  remolding orthosis is for postsurgical use to address additional
  cranial deformities, including craniosynostosis.
         SECTION 2.  Section 32.024, Human Resources Code, is amended
  by adding Subsection (kk) to read as follows:
         (kk)  Subject to the requirements of this subsection, the
  department shall provide medical assistance for a cranial molding
  orthosis for a child who is at least 3 months of age but younger than
  18 months of age. The cranial molding orthosis must be:
               (1)  medically necessary, as established by
  demonstrating that the recipient has a cranial vault asymmetry
  index of at least 6.25 or a cephalic index that is at least two
  standard deviations above or below the age-adjusted mean for the
  recipient; and
               (2)  used as part of:
                     (A)  a nonsurgical treatment program if the
  recipient is diagnosed with plagiocephaly, brachycephaly, or
  scaphocephaly; or
                     (B)  a surgical treatment program if the cranial
  remolding orthosis is for postsurgical use to address additional
  cranial deformities, including craniosynostosis.
         SECTION 3.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 4.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2013.