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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for supplemental ultrasound imaging to screen |
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for breast cancer under certain health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Chapter 1356, Insurance Code, is |
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amended to read as follows: |
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CHAPTER 1356. MAMMOGRAPHY AND OTHER BREAST IMAGING |
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SECTION 2. Chapter 1356, Insurance Code, is amended by |
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adding Section 1356.006 to read as follows: |
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Sec. 1356.006. SUPPLEMENTAL COVERAGE REQUIRED. (a) An |
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issuer of a health benefit plan that provides coverage under |
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Section 1356.005 must provide coverage for supplemental two- or |
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three-dimensional breast ultrasound imaging as part of an annual |
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screening covered under the plan if a licensed health care |
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professional treating the enrollee or screening the enrollee for |
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breast cancer finds that the enrollee has dense breast tissue, as |
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defined by the Breast Imaging Reporting and Database System (Fifth |
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Edition) established by the American College of Radiology. |
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(b) Coverage required by this section: |
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(1) may not be less favorable than coverage for other |
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radiological examinations under the plan; and |
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(2) must be subject to the same dollar limits, |
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deductibles, and coinsurance factors as coverage for other |
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radiological examinations under the plan. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. 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, 2022. A health benefit plan that is delivered, issued |
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for delivery, or renewed before January 1, 2022, is governed by the |
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law as it existed immediately before the effective date of this Act, |
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and that law is continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2021. |