H.B. No. 3276
 
 
 
 
AN ACT
  relating to the coverage by certain health benefit plans for the
  screening and treatment of autism spectrum disorder.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1355.015, Insurance Code, is amended by
  amending Subsections (a) and (b) and adding Subsections (a-1) and
  (f) to read as follows:
         (a)  At a minimum, a health benefit plan must provide
  coverage for screening a child for autism spectrum disorder at the
  ages of 18 and 24 months.
         (a-1)  At a minimum, a health benefit plan must provide
  coverage for treatment of autism spectrum disorder as provided by
  this section to an enrollee who is diagnosed with autism spectrum
  disorder from the date of diagnosis until the enrollee completes
  nine years of age.  If an enrollee who is being treated for autism
  spectrum disorder becomes 10 years of age or older and continues to
  need treatment, this subsection does not preclude coverage of
  treatment and services described by Subsection (b).
         (b)  The health benefit plan must provide coverage under this
  section to the enrollee for all generally recognized services
  prescribed in relation to autism spectrum disorder by the
  enrollee's primary care physician in the treatment plan recommended
  by that physician.  An individual providing treatment prescribed
  under this subsection must be:
               (1)  a health care practitioner:
                     (A) [(1)]  who is licensed, certified, or
  registered by an appropriate agency of this state;
                     (B) [(2)]  whose professional credential is
  recognized and accepted by an appropriate agency of the United
  States; or
                     (C) [(3)]  who is certified as a provider under
  the TRICARE military health system; or
               (2)  an individual acting under the supervision of a
  health care practitioner described by Subdivision (1).
         (f)  Subsection (a) does not apply to a qualified health plan
  defined by 45 C.F.R. Section 155.20 if a determination is made under
  45 C.F.R. Section 155.170 that:
               (1)  this subchapter requires the qualified health plan
  to offer benefits in addition to the essential health benefits
  required under 42 U.S.C. Section 18022(b); and
               (2)  this state must make payments to defray the cost of
  the additional benefits mandated by this subchapter.
         SECTION 2.  Section 1355.015, Insurance Code, as amended by
  this Act, applies only to a health benefit plan delivered, issued
  for delivery, or renewed on or after January 1, 2014. A health
  benefit plan delivered, issued for delivery, or renewed before
  January 1, 2014, is governed by the law in effect immediately before
  the effective date of this Act, and that law is continued in effect
  for that purpose.
         SECTION 3.  This Act takes effect September 1, 2013.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 3276 was passed by the House on May 9,
  2013, by the following vote:  Yeas 137, Nays 2, 3 present, not
  voting.
 
  ______________________________
  Chief Clerk of the House   
 
 
         I certify that H.B. No. 3276 was passed by the Senate on May
  21, 2013, by the following vote:  Yeas 22, Nays 9.
 
  ______________________________
  Secretary of the Senate    
  APPROVED:  _____________________
                     Date          
   
            _____________________
                   Governor