Bill Text: TX HB3034 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to notice regarding nonemergency ambulance and certain nonemergency health care coverage in health benefit plans.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-04-25 - Withdrawn from schedule [HB3034 Detail]
Download: Texas-2023-HB3034-Introduced.html
| 88R12290 CJD-D | ||
| By: Talarico | H.B. No. 3034 | |
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| relating to notice regarding nonemergency ambulance and certain | ||
| nonemergency health care coverage in health benefit plans. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1210, Insurance Code, is amended to read | ||
| as follows: | ||
| CHAPTER 1210. NOTICE OF CERTAIN POLICY PROVISIONS | ||
| SUBCHAPTER A. NOTICE OF PROVISIONS RELATED TO RENEWAL OR NONRENEWAL | ||
| Sec. 1210.001. NOTICE REQUIRED. A policy, contract, or | ||
| certificate of insurance that insures against loss resulting from | ||
| sickness or accidental bodily injury and that is subject to an | ||
| increase in the premium at time of renewal or to nonrenewal on the | ||
| insured attaining a certain age may not be delivered, issued, or | ||
| used in this state unless the document contains on the first page | ||
| above the policy provisions a printed notice in 10-point type that | ||
| states that the policy, contract, or certificate is subject to | ||
| either or both conditions. | ||
| SUBCHAPTER B. AMBULANCE AND CERTAIN NONEMERGENCY HEALTH CARE | ||
| COVERAGE PROVISIONS | ||
| Sec. 1210.011. DEFINITION. In this subchapter, "emergency | ||
| medical services personnel" has the meaning assigned by Section | ||
| 773.003, Health and Safety Code. | ||
| Sec. 1210.012. APPLICABILITY OF SUBCHAPTER. (a) This | ||
| subchapter applies only to a health benefit plan that provides | ||
| benefits for medical or surgical expenses incurred as a result of a | ||
| health condition, accident, or sickness, including an individual, | ||
| group, blanket, or franchise insurance policy or insurance | ||
| agreement, a group hospital service contract, or an individual or | ||
| group evidence of coverage or similar coverage document that is | ||
| offered by: | ||
| (1) an insurance company; | ||
| (2) a group hospital service corporation operating | ||
| under Chapter 842; | ||
| (3) a health maintenance organization operating under | ||
| Chapter 843; | ||
| (4) an approved nonprofit health corporation | ||
| that holds a certificate of authority under Chapter 844; | ||
| (5) a multiple employer welfare arrangement that holds | ||
| a certificate of authority under Chapter 846; | ||
| (6) a stipulated premium company operating under | ||
| Chapter 884; | ||
| (7) a fraternal benefit society operating under | ||
| Chapter 885; | ||
| (8) a Lloyd's plan operating under Chapter 941; or | ||
| (9) an exchange operating under Chapter 942. | ||
| (b) Notwithstanding any other law, this subchapter applies | ||
| to: | ||
| (1) a small employer health benefit plan subject to | ||
| Chapter 1501, including coverage provided through a health group | ||
| cooperative under Subchapter B of that chapter; | ||
| (2) a standard health benefit plan issued under | ||
| Chapter 1507; | ||
| (3) a basic coverage plan under Chapter 1551; | ||
| (4) a basic plan under Chapter 1575; | ||
| (5) a primary care coverage plan under Chapter 1579; | ||
| (6) a plan providing basic coverage under Chapter | ||
| 1601; | ||
| (7) nonprofit agricultural organization health | ||
| benefits offered by a nonprofit agricultural organization under | ||
| Chapter 1682; | ||
| (8) alternative health benefit coverage offered by a | ||
| subsidiary of the Texas Mutual Insurance Company under Subchapter | ||
| M, Chapter 2054; | ||
| (9) health benefits provided by or through a church | ||
| benefits board under Subchapter I, Chapter 22, Business | ||
| Organizations Code; | ||
| (10) the state Medicaid program, including the | ||
| Medicaid managed care program operated under Chapter 533, | ||
| Government Code; | ||
| (11) the child health plan program under Chapter 62, | ||
| Health and Safety Code; | ||
| (12) a regional or local health care program operated | ||
| under Section 75.104, Health and Safety Code; | ||
| (13) a self-funded health benefit plan sponsored by a | ||
| professional employer organization under Chapter 91, Labor Code; | ||
| (14) county employee group health benefits provided | ||
| under Chapter 157, Local Government Code; and | ||
| (15) health and accident coverage provided by a risk | ||
| pool created under Chapter 172, Local Government Code. | ||
| Sec. 1210.013. NOTICE REQUIRED. (a) This section applies | ||
| only with respect to a health benefit plan that does not provide | ||
| coverage for nonemergency ambulance services or nonemergency | ||
| health care services provided by emergency medical services | ||
| personnel. | ||
| (b) A health benefit plan issuer or administrator shall | ||
| provide written notice in the form and manner prescribed by the | ||
| commissioner in an explanation of benefits provided to an enrollee | ||
| that the enrollee's plan does not cover nonemergency ambulance | ||
| services or nonemergency health care services provided by emergency | ||
| medical services personnel. | ||
| SECTION 2. If before implementing any provision of this Act | ||
| a state agency determines that a waiver or authorization from a | ||
| federal agency is necessary for implementation of that provision, | ||
| the agency affected by the provision shall request the waiver or | ||
| authorization and may delay implementing the provision until the | ||
| waiver or authorization is granted. | ||
| SECTION 3. This Act takes effect September 1, 2023. | ||
