86R24953 SMT-F
 
  By: Lucio III H.B. No. 1410
 
  Substitute the following for H.B. No. 1410:
 
  By:  Lucio III C.S.H.B. No. 1410
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to payment for care provided by a chiropractor under
  certain health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter I, Chapter 843, Insurance Code, is
  amended by adding Section 843.3042 to read as follows:
         Sec. 843.3042.  CHIROPRACTIC SERVICES. (a)  A health
  maintenance organization offering a health care plan that covers a
  service that is within the scope of the practice of chiropractic as
  described by Section 201.002, Occupations Code, may not refuse to
  provide reimbursement to an in-network chiropractor for the
  performance of the covered service solely because the service is
  provided by a chiropractor.
         (b)  This section does not require a health maintenance
  organization to cover a particular health care service.
         (c)  This section does not affect the right of a health
  maintenance organization to determine whether a health care service
  is medically necessary. 
         SECTION 2.  Subchapter B, Chapter 1301, Insurance Code, is
  amended by adding Section 1301.0516 to read as follows:
         Sec. 1301.0516.  CHIROPRACTIC SERVICES. (a)  An insurer
  offering a preferred provider benefit plan, other than an exclusive
  provider benefit plan, that covers a service that is within the
  scope of the practice of chiropractic as described by Section
  201.002, Occupations Code, may not refuse to provide reimbursement
  for the performance of the covered service solely because the
  service is provided by a chiropractor.
         (b)  An insurer offering an exclusive provider benefit plan
  that covers a service that is within the scope of the practice of
  chiropractic as described by Section 201.002, Occupations Code, may
  not refuse to provide reimbursement to a chiropractor who is a
  preferred provider for the performance of the covered service
  solely because the service is provided by a chiropractor.
         (c)  This section does not require an insurer to cover a
  particular medical or health care service.
         (d)  This section does not affect the right of an insurer to
  determine whether a medical or health care service is medically
  necessary.
         SECTION 3.  The change in law made by this Act applies only
  to a health benefit plan that is delivered, issued for delivery, or
  renewed on or after January 1, 2020. A health benefit plan that is
  delivered, issued for delivery, or renewed before January 1, 2020,
  is governed by the law as it existed immediately before the
  effective date of this Act, and that law is continued in effect for
  that purpose.
         SECTION 4.  This Act takes effect September 1, 2019.