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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for serious mental illness under certain group |
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health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1355.001, Insurance Code, is amended by |
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amending Subdivision (1) and adding Subdivision (5) to read as |
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follows: |
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(1) "Serious mental illness" means the following |
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psychiatric illnesses as defined by the American Psychiatric |
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Association in the Diagnostic and Statistical Manual of Mental |
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Disorders (DSM), fifth edition, or a later edition adopted by the |
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commissioner: |
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(A) bipolar disorders (hypomanic, manic, |
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depressive, and mixed); |
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(B) depression in childhood and adolescence; |
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(C) major depressive disorders (single episode |
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or recurrent); |
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(D) obsessive-compulsive disorders; |
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(E) paranoid and other psychotic disorders; |
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(F) posttraumatic stress disorder; |
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(G) schizo-affective disorders (bipolar or |
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depressive); and |
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(H) [(G)] schizophrenia. |
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(5) "Posttraumatic stress disorder" means a disorder |
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that: |
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(A) meets the diagnostic criteria for |
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posttraumatic stress disorder specified by the American |
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Psychiatric Association in the Diagnostic and Statistical Manual of |
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Mental Disorders, fifth edition, or a later edition adopted by the |
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commissioner; and |
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(B) results in an impairment of a person's |
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functioning in the person's community, employment, family, school, |
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or social group. |
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SECTION 2. The heading to Section 1355.003, Insurance Code, |
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is amended to read as follows: |
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Sec. 1355.003. EXCEPTIONS [EXCEPTION]. |
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SECTION 3. Section 1355.003, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) This subchapter, or the applicable portion of this |
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subchapter, does not apply to a qualified health plan to the extent |
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that a determination is made under 45 C.F.R. Section 155.170 that: |
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(1) this subchapter or a portion of this subchapter |
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requires the plan to offer benefits in addition to the essential |
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health benefits required under 42 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 subchapter or a portion of this |
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subchapter. |
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SECTION 4. The change in law made by this Act applies only |
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to a group health benefit plan that is delivered, issued for |
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delivery, or renewed on or after January 1, 2018. A group health |
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benefit plan that is delivered, issued for delivery, or renewed |
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before January 1, 2018, is governed by the law as it existed |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2017. |