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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for certain at-home |
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testing kits. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle E, Title 8, Insurance Code, is amended |
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by adding Chapter 1381 to read as follows: |
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CHAPTER 1381. COVERAGE FOR AT-HOME TESTING KITS |
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Sec. 1381.001. APPLICABILITY OF CHAPTER. (a) This chapter |
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applies only to a health benefit plan that provides benefits for |
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medical or surgical expenses incurred as a result of a health |
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condition, accident, or sickness, including an individual, group, |
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blanket, or franchise insurance policy or insurance agreement, a |
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group hospital service contract, or an individual or group evidence |
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of coverage or similar coverage document that is issued 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 health maintenance organization operating under |
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Chapter 843; |
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(4) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844; |
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(5) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; |
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(6) a stipulated premium company operating under |
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Chapter 884; |
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(7) a fraternal benefit society operating under |
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Chapter 885; |
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(8) a Lloyd's plan operating under Chapter 941; or |
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(9) an exchange operating under Chapter 942. |
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(b) Notwithstanding any other law, this chapter applies to: |
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(1) a small employer health benefit plan subject to |
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Chapter 1501, including coverage provided through a health group |
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cooperative under Subchapter B of that chapter; |
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(2) a standard health benefit plan issued under |
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Chapter 1507; |
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(3) a basic coverage plan under Chapter 1551; |
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(4) a basic plan under Chapter 1575; |
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(5) a primary care coverage plan under Chapter 1579; |
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(6) a plan providing basic coverage under Chapter |
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1601; |
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(7) the state Medicaid program, including the Medicaid |
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managed care program operated under Chapter 540, Government Code; |
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(8) the child health plan program under Chapter 62, |
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Health and Safety Code; and |
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(9) a self-funded health benefit plan sponsored by a |
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professional employer organization under Chapter 91, Labor Code. |
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Sec. 1381.002. COVERAGE REQUIRED FOR CERTAIN AT-HOME |
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TESTING KITS. (a) A health benefit plan must provide coverage in |
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accordance with this section for an at-home testing kit that tests |
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for: |
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(1) coronavirus, influenza, or both coronavirus and |
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influenza and is approved by the United States Food and Drug |
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Administration for that use; or |
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(2) a disease for which the kit has been approved by |
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the United States Food and Drug Administration for emergency use. |
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(b) A health benefit plan must provide coverage for at least |
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four kits described by Subsection (a) per enrollee per month. |
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SECTION 2. 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 3. Chapter 1381, Insurance Code, as added by this |
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Act, applies only to a health benefit plan delivered, issued for |
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delivery, or renewed on or after January 1, 2026. |
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SECTION 4. This Act takes effect September 1, 2025. |