| |
| |
| |
|
|
AN ACT
|
|
|
relating to health benefit plan coverage for ovarian cancer |
|
|
screening. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. The heading to Chapter 1370, Insurance Code, is |
|
|
amended to read as follows: |
|
|
CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS, |
|
|
OVARIAN CANCER, AND CERVICAL CANCER |
|
|
SECTION 2. Section 1370.002, Insurance Code, is amended to |
|
|
read as follows: |
|
|
Sec. 1370.002. EXCEPTIONS [EXCEPTION]. (a) This chapter |
|
|
does not apply to: |
|
|
(1) a plan that provides coverage: |
|
|
(A) only for benefits for a specified disease or |
|
|
for another limited benefit, other than a plan that provides |
|
|
benefits for cancer treatment or similar services; |
|
|
(B) only for accidental death or dismemberment; |
|
|
(C) for wages or payments in lieu of wages for a |
|
|
period during which an employee is absent from work because of |
|
|
sickness or injury; |
|
|
(D) as a supplement to a liability insurance |
|
|
policy; |
|
|
(E) only for dental or vision care; or |
|
|
(F) only for indemnity for hospital confinement; |
|
|
(2) a Medicare supplemental policy as defined by |
|
|
Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); |
|
|
(3) a workers' compensation insurance policy; |
|
|
(4) medical payment insurance coverage provided under |
|
|
an automobile insurance policy; |
|
|
(5) a credit insurance policy; |
|
|
(6) a limited benefit policy that does not provide |
|
|
coverage for physical examinations or wellness exams; or |
|
|
(7) a long-term care insurance policy, including a |
|
|
nursing home fixed indemnity policy, unless the commissioner |
|
|
determines that the policy provides benefit coverage so |
|
|
comprehensive that the policy is a health benefit plan as described |
|
|
by Section 1370.001. |
|
|
(b) To the extent that providing coverage for ovarian cancer |
|
|
screening under this chapter would otherwise require this state to |
|
|
make a payment under 42 U.S.C. Section 18031(d)(3)(B)(ii), a |
|
|
qualified health plan, as defined by 45 C.F.R. Section 155.20, is |
|
|
not required to provide a benefit for the ovarian cancer screening |
|
|
under this chapter that exceeds the specified essential health |
|
|
benefits required under 42 U.S.C. Section 18022(b). |
|
|
SECTION 3. Sections 1370.003(a) and (b), Insurance Code, |
|
|
are amended to read as follows: |
|
|
(a) A health benefit plan t |
|
|
hat provides coverage for |
|
|
diagnostic medical procedures must provide to each woman 18 years |
|
|
of age or older enrolled in the plan coverage for expenses for an |
|
|
annual medically recognized diagnostic examination for the early |
|
|
detection of ovarian cancer and cervical cancer. |
|
|
(b) Coverage required under this section includes at a |
|
|
minimum: |
|
|
(1) a CA 125 blood test; and |
|
|
(2) a conventional Pap smear screening or a screening |
|
|
using liquid-based cytology methods, as approved by the United |
|
|
States Food and Drug Administration, alone or in combination with a |
|
|
test approved by the United States Food and Drug Administration for |
|
|
the detection of the human papillomavirus. |
|
|
SECTION 4. The change in law made by this Act applies only |
|
|
to a health benefit plan that is delivered, issued for delivery, or |
|
|
renewed on or after the effective date of this Act. A plan that is |
|
|
delivered, issued for delivery, or renewed before the effective |
|
|
date of this Act 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 5. This Act takes effect September 1, 2015. |
| |
| |
| |
______________________________ |
______________________________ |
| |
President of the Senate |
Speaker of the House |
| |
| |
|
|
I certify that H.B. No. 2813 was passed by the House on April |
|
|
22, 2015, by the following vote: Yeas 129, Nays 8, 2 present, not |
|
|
voting; and that the House concurred in Senate amendments to H.B. |
|
|
No. 2813 on May 18, 2015, by the following vote: Yeas 123, Nays 6, |
|
|
1 present, not voting. |
|
|
|
|
|
______________________________ |
|
|
Chief Clerk of the House |
| |
|
|
I certify that H.B. No. 2813 was passed by the Senate, with |
|
|
amendments, on May 13, 2015, by the following vote: Yeas 22, Nays |
|
|
9. |
|
|
|
|
|
______________________________ |
|
|
Secretary of the Senate |
|
|
APPROVED: __________________ |
|
|
Date |
|
|
|
|
|
__________________ |
|
|
Governor |