88R9541 KBB-D
 
  By: Price, Paul, Johnson of Dallas, Plesa, H.B. No. 3460
      Harris of Williamson, et al.
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to coverage for mental health conditions and substance use
  disorders under certain governmental health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1355.002(b), Insurance Code, is amended
  to read as follows:
         (b)  Except as otherwise provided by this subchapter, but
  notwithstanding [Notwithstanding any provision in Chapter 1575 or
  1579 or] any other law, this subchapter [Section 1355.015] applies
  to:
               (1)  a basic coverage plan under Chapter 1551;
               (2)  a basic plan under Chapter 1575; [and]
               (3) [(2)]  a primary care coverage plan under Chapter
  1579; and
               (4)  a plan providing basic coverage under Chapter
  1601.
         SECTION 2.  Section 1355.003(a), Insurance Code, is amended
  to read as follows:
         (a)  This subchapter does not apply to coverage under:
               (1)  a blanket accident and health insurance policy, as
  described by Chapter 1251;
               (2)  a short-term travel policy;
               (3)  an accident-only policy;
               (4)  a limited or specified-disease policy that does
  not provide benefits for mental health care or similar services;
               (5)  [except as provided by Subsection (b), a plan
  offered under Chapter 1551 or Chapter 1601;
               [(6)]  a plan offered in accordance with Section
  1355.151; or
               (6) [(7)]  a Medicare supplement benefit plan, as
  defined by Section 1652.002.
         SECTION 3.  Section 1355.015(e), Insurance Code, is amended
  to read as follows:
         (e)  Notwithstanding any other law, this section does not
  apply to:
               (1)  a standard health benefit plan provided under
  Chapter 1507;
               (2)  a basic coverage plan under Chapter 1551; or
               (3)  a plan providing basic coverage under Chapter
  1601.
         SECTION 4.  Section 1355.252, Insurance Code, is amended by
  adding Subsection (d) to read as follows:
         (d)  Notwithstanding any other law, this subchapter applies
  to:
               (1)  a basic coverage plan under Chapter 1551;
               (2)  a basic plan under Chapter 1575;
               (3)  a primary care coverage plan under Chapter 1579;
  and
               (4)  a plan providing basic coverage under Chapter
  1601.
         SECTION 5.  Section 1355.255, Insurance Code, is amended to
  read as follows:
         Sec. 1355.255.  COMPLIANCE.  (a)  Except as provided by
  Subsection (b), the [The] commissioner shall enforce compliance
  with Section 1355.254 by evaluating the benefits and coverage
  offered by a health benefit plan for quantitative and
  nonquantitative treatment limitations in the following categories:
               (1)  in-network and out-of-network inpatient care;
               (2)  in-network and out-of-network outpatient care;
               (3)  emergency care; and
               (4)  prescription drugs.
         (b)  With respect to a plan described by Section 1355.252(d),
  the applicable trustee, board of trustees, or system shall enforce
  compliance with Section 1355.254 by evaluating the benefits and
  coverage offered by a health benefit plan for quantitative and
  nonquantitative treatment limitations in the following categories:
               (1)  in-network and out-of-network inpatient care;
               (2)  in-network and out-of-network outpatient care;
               (3)  emergency care; and
               (4)  prescription drugs.
         SECTION 6.  Section 1355.003(b), Insurance Code, is
  repealed.
         SECTION 7.  The changes in law made by this Act apply only to
  a plan year that commences on or after January 1, 2024. A plan year
  that commenced before January 1, 2024, 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 8.  This Act takes effect September 1, 2023.