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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for treatment of craniofacial abnormalities |
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under certain health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 1367, Insurance Code, is |
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amended by adding Section 1367.1535 to read as follows: |
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Sec. 1367.1535. COVERAGE FOR TREATMENT OF CRANIOFACIAL |
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ABNORMALITIES. A health benefit plan described by Section 1367.153 |
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that provides coverage for reconstructive surgery for craniofacial |
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abnormalities, as defined in accordance with that section, must |
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provide coverage for the treatment of the primary conditions |
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constituting craniofacial abnormalities and secondary conditions |
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related to or arising from craniofacial abnormalities, including: |
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(1) oral and facial surgery, surgical management, and |
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follow-up care; |
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(2) prosthetic treatments, including obturators and |
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speech and feeding appliances; |
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(3) orthodontic treatment and management; |
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(4) preventive and restorative dentistry to ensure |
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good health and adequate dental structures for orthodontic |
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treatment or prosthetic management or therapy; |
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(5) speech-language pathology services, including |
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evaluation and therapy; |
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(6) audiological assessments and amplification |
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devices; |
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(7) otolaryngological treatment and management; |
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(8) psychological assessment and counseling; and |
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(9) genetic assessment counseling for the parents and |
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child. |
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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, 2018. A plan delivered, issued for |
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delivery, or renewed before January 1, 2018, is governed by the law |
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as it existed immediately before the effective date of this Act, and |
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that law is continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2017. |