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A BILL TO BE ENTITLED
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AN ACT
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relating to preauthorization by certain health benefit plan issuers |
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of certain benefits. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1356.005, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section may not require preauthorization of a screening |
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described by Subsection (a). |
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SECTION 2. Section 1357.004, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section may not require preauthorization of a |
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reconstruction, surgery, prostheses, or treatment described by |
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Subsection (a). |
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SECTION 3. Section 1357.054, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section may not require preauthorization for inpatient |
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care described by Subsection (a). |
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SECTION 4. Section 1358.054, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section may not require a qualified enrollee to obtain |
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preauthorization for diabetes equipment, diabetes supplies, or |
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self-management training described by Subsection (a). |
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SECTION 5. Section 1361.003, Insurance Code, is amended to |
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read as follows: |
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Sec. 1361.003. COVERAGE REQUIRED. (a) A group health |
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benefit plan must provide to a qualified enrollee coverage for |
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medically accepted bone mass measurement to detect low bone mass |
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and to determine the enrollee's risk of osteoporosis and fractures |
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associated with osteoporosis. |
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(b) A group health benefit plan issuer that provides |
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coverage under this section may not require a qualified enrollee to |
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obtain preauthorization for a bone mass measurement described by |
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Subsection (a). |
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SECTION 6. Section 1362.003, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section to an enrolled male may not require |
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preauthorization of a diagnostic examination described by |
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Subsection (a). |
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SECTION 7. Section 1363.003, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) A health benefit plan issuer that provides coverage |
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under this section may not require preauthorization of a screening |
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examination described by Subsection (a). |
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SECTION 8. This Act applies only to a health benefit plan |
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that is delivered, issued for delivery, or renewed on or after |
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January 1, 2020. |
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SECTION 9. This Act takes effect September 1, 2019. |