BILL ANALYSIS

C.S.H.B. 170

By: Bernal

Insurance

Committee Report (Substituted)

BACKGROUND AND PURPOSE

It has been noted that individuals with dense breast tissue, cancer survivors, and people with a family history of breast cancer may require a diagnostic screening to detect the presence of a tumor and that adequate insurance coverage for these screenings may play an essential role in increasing early detection. C.S.H.B. 170 seeks to increase the use of these screenings by requiring certain health benefit plans to provide coverage for a diagnostic mammogram that is no less favorable than the coverage provided for a screening mammogram.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 170 amends the Insurance Code to require a health benefit plan that provides coverage for a screening mammogram to provide coverage for a diagnostic mammogram that is no less favorable than the coverage for a screening mammogram. The bill extends the applicability of provisions relating to coverage for mammography under certain health benefit plans to:

·         a basic plan under the Texas Public School Retired Employees Group Benefits Act;

·         a primary care coverage plan under the Texas School Employees Uniform Group Health Coverage Act;

·         basic coverage under the State University Employees Uniform Insurance Benefits Act; and

·         to the extent allowed by federal law, the state Medicaid program and the Medicaid managed care program.

C.S.H.B. 170 applies only to a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2020.

C.S.H.B. 170 repeals Section 1356.0021, Insurance Code, which exempts certain health benefit plans from the applicability of provisions relating to coverage for mammography.

EFFECTIVE DATE

September 1, 2019.

COMPARISON OF ORIGINAL AND SUBSTITUTE

While C.S.H.B. 170 may differ from the original in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

The substitute does not include a provision extending the applicability of provisions relating to coverage for mammography under certain health benefit plans to a county employee health benefit plan.