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A BILL TO BE ENTITLED
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AN ACT
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relating to a study on health benefit plan coverage for certain |
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treatments of traumatic brain injuries. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. (a) In this Act: |
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(1) "Department" means the Texas Department of |
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Insurance. |
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(2) "Traumatic brain injury" means an acquired injury |
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to the brain, including brain injuries caused by anoxia due to near |
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drowning. The term does not include brain dysfunction caused by |
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congenital or degenerative disorders or birth trauma. |
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(3) "Traumatic brain injury treatment" means |
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cognitive rehabilitation therapy, cognitive communication therapy, |
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neurocognitive therapy and rehabilitation, neurobehavioral, |
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neurophysiological, neuropsychological, and psychophysiological |
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testing and treatment, neurofeedback therapy, and remediation |
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required for and related to treatment of a traumatic brain injury. |
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(b) The department, in consultation with the Texas |
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Traumatic Brain Injury Advisory Council, shall conduct a study on |
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the effect of Chapter 1352, Insurance Code, on the coverage of |
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traumatic brain injury treatment by health benefit plans offered in |
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this state. |
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(c) In conducting the study, the department shall: |
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(1) review the number, types, and outcome of claims |
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made in this state for treatment of traumatic brain injuries; |
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(2) review the coverage offered for traumatic brain |
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injury treatment by health benefit plans in this state; |
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(3) determine the effect, if any, of substance abuse, |
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including opioid abuse and addiction, on traumatic brain injury |
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coverage and treatment in this state; and |
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(4) analyze the effect of any exclusions or exceptions |
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in health benefit plan coverage of traumatic brain injury |
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treatment, including exclusions for injuries caused by self-harm or |
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substance abuse. |
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(d) In conducting the study, the department may request from |
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a health benefit plan issuer and a health benefit plan issuer shall |
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provide deidentified and aggregated information on claims for |
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traumatic brain injuries. |
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(e) Not later than December 1, 2026, the department shall |
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submit to the governor, the lieutenant governor, the speaker of the |
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house of representatives, and the chair of the standing committee |
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of each house of the legislature with primary jurisdiction over the |
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department a written report that includes: |
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(1) the findings of the study conducted under this |
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section; and |
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(2) any recommendations for legislative or other |
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action related to coverage and treatment of traumatic brain |
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injuries. |
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(f) This Act expires September 1, 2027. |
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SECTION 2. This Act takes effect September 1, 2025. |