S.B. No. 1484
 
 
 
 
AN ACT
  relating to health benefit plan coverage for enrollees diagnosed
  with autism spectrum disorder.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1355.015, Insurance Code, is amended by
  amending Subsection (a) and adding Subsections (c-1) and (f) to
  read as follows:
         (a)  At a minimum, a health benefit plan must provide
  coverage as provided by this section to an enrollee who is diagnosed
  with autism spectrum disorder from the date of diagnosis, only if
  the diagnosis was in place prior to the child's 10th birthday [until
  the enrollee completes nine years of age.   If an enrollee who is
  being treated for autism spectrum disorder becomes 10 years of age
  or older and continues to need treatment, this subsection does not
  preclude coverage of treatment and services described by Subsection
  (b)].
         (c-1)  The health benefit plan is not required to provide
  coverage under Subsection (b) for benefits for an enrollee 10 years
  of age or older for applied behavior analysis in an amount that
  exceeds $36,000 per year.
         (f)  To the extent that this section would otherwise require
  this state to make a payment under 42 U.S.C. Section
  18031(d)(3)(B)(ii), a qualified health plan, as defined by 45
  C.F.R. Section 155.20, is not required to provide a benefit under
  this section that exceeds the specified essential health benefits
  required under 42 U.S.C. Section 18022(b).
         SECTION 2.  The heading to Section 1355.015, Insurance Code,
  is amended to read as follows:
         Sec. 1355.015.  REQUIRED COVERAGE FOR CERTAIN ENROLLEES 
  [CHILDREN].
         SECTION 3.  Section 1355.015, Insurance Code, as amended by
  this Act, applies only to a health benefit plan that is delivered,
  issued for delivery, or renewed on or after the effective date of
  this Act. A health benefit plan that is delivered, issued for
  delivery, or renewed before the effective date of this Act is
  covered by the law in effect at the time the health benefit plan is
  delivered, issued for delivery, or renewed, and that law is
  continued in effect for that purpose.
         SECTION 4.  This Act takes effect September 1, 2013.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1484 passed the Senate on
  May 1, 2013, by the following vote:  Yeas 18, Nays 13.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1484 passed the House on
  May 21, 2013, by the following vote:  Yeas 147, Nays 0, two
  present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor