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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 ovarian cancer |
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screening. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Chapter 1370, Insurance Code, is |
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amended to read as follows: |
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CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS, |
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OVARIAN CANCER, AND CERVICAL CANCER |
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SECTION 2. |
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Section 1370.002, Insurance Code, is amended to |
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read as follows: |
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Sec. 1370.002. EXCEPTIONS [EXCEPTION]. (a) This chapter |
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does not apply to: |
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(1) a plan that provides coverage: |
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(A) only for benefits for a specified disease or |
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for another limited benefit, other than a plan that provides |
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benefits for cancer treatment or similar services; |
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(B) only for accidental death or dismemberment; |
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(C) for wages or payments in lieu of wages for a |
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period during which an employee is absent from work because of |
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sickness or injury; |
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(D) as a supplement to a liability insurance |
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policy; |
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(E) only for dental or vision care; or |
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(F) only for indemnity for hospital confinement; |
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(2) a Medicare supplemental policy as defined by |
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Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); |
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(3) a workers' compensation insurance policy; |
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(4) medical payment insurance coverage provided under |
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an automobile insurance policy; |
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(5) a credit insurance policy; |
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(6) a limited benefit policy that does not provide |
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coverage for physical examinations or wellness exams; or |
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(7) a long-term care insurance policy, including a |
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nursing home fixed indemnity policy, unless the commissioner |
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determines that the policy provides benefit coverage so |
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comprehensive that the policy is a health benefit plan as described |
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by Section 1370.001. |
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(b) This chapter does not apply to a qualified health plan |
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if a determination is made under 45 C.F.R. Section 155.170 that: |
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(1) this chapter requires the plan to offer benefits |
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in addition to the essential health benefits required under 42 |
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U.S.C. Section 18022(b); and |
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(2) this state is required to defray the cost of the |
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benefits mandated under this chapter. |
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SECTION 3. Sections 1370.003(a) and (b), Insurance Code, |
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are amended to read as follows: |
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(a) A health benefit plan that provides coverage for |
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diagnostic medical procedures must provide to each woman 18 years |
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of age or older enrolled in the plan coverage for expenses for an |
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annual medically recognized diagnostic examination for the early |
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detection of ovarian cancer and cervical cancer. |
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(b) Coverage required under this section includes at a |
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minimum: |
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(1) a CA 125 blood test; and |
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(2) a conventional Pap smear screening or a screening |
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using liquid-based cytology methods, as approved by the United |
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States Food and Drug Administration, alone or in combination with a |
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test approved by the United States Food and Drug Administration for |
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the detection of the human papillomavirus. |
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SECTION 4. 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 the effective date of this Act. A plan that is |
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delivered, issued for delivery, or renewed before the effective |
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date of this Act is governed by the law as it existed immediately |
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before the effective date of this Act, and that law is continued in |
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effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2015. |