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A BILL TO BE ENTITLED
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AN ACT
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relating to HIV and AIDS tests and to health benefit plan coverage |
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of HIV and AIDS tests. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Subchapter D, Chapter 85, Health |
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and Safety Code, is amended to read as follows: |
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SUBCHAPTER D. HIV TESTING, TESTING PROGRAMS, AND COUNSELING |
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SECTION 2. Subchapter D, Chapter 85, Health and Safety |
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Code, is amended by adding Section 85.0815 to read as follows: |
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Sec. 85.0815. OPT-OUT HIV TESTING IN CERTAIN ROUTINE |
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MEDICAL SCREENINGS. (a) A health care provider who takes a sample |
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of a person's blood as part of a medical screening may submit the |
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sample for an HIV diagnostic test, regardless of whether an HIV test |
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is part of a primary diagnosis, unless the person opts out of the |
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HIV test. |
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(b) Before taking a sample of a person's blood as part of a |
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medical screening, a health care provider must obtain the person's |
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written consent for an HIV diagnostic test or verbally inform the |
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person that an HIV diagnostic test will be performed unless the |
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person opts out of the HIV test. |
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(c) A health care provider who submits a person's blood for |
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an HIV diagnostic test shall provide to each person who receives a |
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positive result of the test information on available HIV health |
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services and referrals to community support programs. |
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(d) The executive commissioner shall adopt rules to |
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implement this section. In adopting rules, the executive |
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commissioner must consider the most recent recommendations of the |
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Centers for Disease Control and Prevention for HIV testing of |
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adults and adolescents. |
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SECTION 3. Section 32.024, Human Resources Code, is amended |
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by adding Subsection (ee) to read as follows: |
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(ee) The executive commissioner shall adopt rules to |
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require the commission to provide an HIV test in accordance with |
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Section 85.0815, Health and Safety Code, to a person who receives |
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medical assistance. |
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SECTION 4. Chapter 1364, Insurance Code, is amended by |
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adding Subchapter D to read as follows: |
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SUBCHAPTER D. COVERAGE OF CERTAIN TESTING REQUIRED |
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Sec. 1364.151. DEFINITIONS. In this subchapter, "AIDS" and |
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"HIV" have the meanings assigned by Section 81.101, Health and |
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Safety Code. |
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Sec. 1364.152. APPLICABILITY OF SUBCHAPTER. (a) This |
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subchapter applies only to a health benefit plan, including a large |
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or small employer health benefit plan written under Chapter 1501, |
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that provides benefits for medical or surgical expenses incurred as |
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a result of a health condition, accident, or sickness, including an |
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individual, group, blanket, or franchise insurance policy or |
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insurance agreement, a group hospital service contract, or an |
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individual or group evidence of coverage or similar coverage |
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document that is offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating |
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under Chapter 842; |
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(3) a fraternal benefit society operating under |
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Chapter 885; |
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(4) a stipulated premium company operating under |
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Chapter 884; |
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(5) a reciprocal exchange operating under Chapter 942; |
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(6) a Lloyd's plan operating under Chapter 941; |
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(7) a health maintenance organization operating under |
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Chapter 843; |
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(8) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; or |
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(9) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844. |
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(b) Notwithstanding any provision in Chapter 1551, 1575, |
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1579, or 1601 or any other law, this subchapter applies to: |
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(1) a basic coverage plan under Chapter 1551; |
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(2) a basic plan under Chapter 1575; |
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(3) a primary care coverage plan under Chapter 1579; |
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and |
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(4) basic coverage under Chapter 1601. |
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Sec. 1364.153. EXCEPTION. This subchapter does not apply |
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to a qualified health plan defined by 45 C.F.R. Section 155.20 if a |
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determination is made under 45 C.F.R. Section 155.170 that: |
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(1) this subchapter requires the plan to offer |
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benefits in addition to the essential health benefits required |
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under 42 U.S.C. Section 18022(b); and |
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(2) this state must make payments to defray the cost of |
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the additional benefits mandated by this subchapter. |
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Sec. 1364.154. COVERAGE OF CERTAIN TESTING REQUIRED. A |
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health benefit plan issuer may not exclude or deny coverage for the |
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performance of medical tests or procedures to determine HIV |
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infection, antibodies to HIV, or infection with any other probable |
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causative agent of AIDS, regardless of whether the test or medical |
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procedure is related to the primary diagnosis of the health |
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condition, accident, or sickness for which the enrollee seeks |
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medical or surgical treatment. |
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Sec. 1364.155. RULES. The commissioner may adopt rules |
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necessary to implement this subchapter. |
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SECTION 5. The heading to Section 1507.004, Insurance Code, |
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is amended to read as follows: |
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Sec. 1507.004. STANDARD HEALTH BENEFIT PLANS AUTHORIZED; |
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MINIMUM REQUIREMENTS [REQUIREMENT]. |
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SECTION 6. Section 1507.004, Insurance Code, is amended by |
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adding Subsections (c) and (d) to read as follows: |
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(c) Any standard health benefit plan must include coverage |
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for tests or procedures to determine HIV infection, antibodies to |
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HIV, or infection with any other probable causative agent of AIDS as |
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required by Subchapter D, Chapter 1364. |
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(d) Subsection (c) does not apply to a qualified health plan |
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defined by 45 C.F.R. Section 155.20 if a determination is made under |
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45 C.F.R. Section 155.170 that: |
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(1) Subsection (c) requires the plan to offer benefits |
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in addition to the essential health benefits required under 42 |
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U.S.C. Section 18022(b); and |
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(2) this state must make payments to defray the cost of |
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the additional benefits mandated by Subsection (c). |
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SECTION 7. Section 1507.054, Insurance Code, is amended to |
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read as follows: |
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Sec. 1507.054. STANDARD HEALTH BENEFIT PLANS AUTHORIZED; |
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MINIMUM REQUIREMENTS. (a) A health maintenance organization |
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authorized to issue an evidence of coverage in this state may offer |
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one or more standard health benefit plans. |
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(b) Any standard health benefit plan must include coverage |
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for tests or procedures to determine HIV infection, antibodies to |
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HIV, or infection with any other probable causative agent of AIDS as |
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required by Subchapter D, Chapter 1364. |
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(c) Subsection (b) does not apply to a qualified health plan |
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defined by 45 C.F.R. Section 155.20 if a determination is made under |
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45 C.F.R. Section 155.170 that: |
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(1) Subsection (b) requires the plan to offer benefits |
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in addition to the essential health benefits required under 42 |
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U.S.C. Section 18022(b); and |
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(2) this state must make payments to defray the cost of |
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the additional benefits mandated by Subsection (b). |
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SECTION 8. If before implementing the change in law made by |
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Section 32.024(ee), Human Resources Code, as added by this Act, a |
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state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that change in |
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law, the agency affected by the change in law shall request the |
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waiver or authorization and may delay implementing that change in |
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law until the waiver or authorization is granted. |
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SECTION 9. Subchapter D, Chapter 1364, Insurance Code, as |
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added by this Act, and Sections 1507.004 and 1507.054, Insurance |
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Code, as amended by this Act, apply 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, 2022. A health benefit plan that is delivered, issued |
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for delivery, or renewed before January 1, 2022, is covered by the |
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law in effect at the time the health benefit plan was delivered, |
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issued for delivery, or renewed, and that law is continued in effect |
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for that purpose. |
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SECTION 10. (a) The executive commissioner of the Health |
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and Human Services Commission shall adopt the rules required by |
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Section 85.0815, Health and Safety Code, as added by this Act, and |
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Section 32.024(ee), Human Resources Code, as added by this Act, not |
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later than January 1, 2022. |
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(b) Notwithstanding Section 85.0815, Health and Safety |
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Code, as added by this Act, a health care provider is not required |
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to comply with that section until January 1, 2022. |
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SECTION 11. This Act takes effect September 1, 2021. |