Bill Text: TX HB616 | 2025-2026 | 89th Legislature | Introduced
Bill Title: Relating to health benefit plan coverage for certain at-home testing kits.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2024-11-12 - Filed [HB616 Detail]
Download: Texas-2025-HB616-Introduced.html
| 89R3978 SCF-D | ||
| By: Bucy | H.B. No. 616 | |
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| relating to health benefit plan coverage for certain at-home | ||
| testing kits. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subtitle E, Title 8, Insurance Code, is amended | ||
| by adding Chapter 1381 to read as follows: | ||
| CHAPTER 1381. COVERAGE FOR AT-HOME TESTING KITS | ||
| Sec. 1381.001. APPLICABILITY OF CHAPTER. (a) This chapter | ||
| 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 issued 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 chapter 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) the state Medicaid program, including the Medicaid | ||
| managed care program operated under Chapter 540, Government Code; | ||
| (8) the child health plan program under Chapter 62, | ||
| Health and Safety Code; and | ||
| (9) a self-funded health benefit plan sponsored by a | ||
| professional employer organization under Chapter 91, Labor Code. | ||
| Sec. 1381.002. COVERAGE REQUIRED FOR CERTAIN AT-HOME | ||
| TESTING KITS. (a) A health benefit plan must provide coverage in | ||
| accordance with this section for an at-home testing kit that tests | ||
| for: | ||
| (1) coronavirus, influenza, or both coronavirus and | ||
| influenza and is approved by the United States Food and Drug | ||
| Administration for that use; or | ||
| (2) a disease for which the kit has been approved by | ||
| the United States Food and Drug Administration for emergency use. | ||
| (b) A health benefit plan must provide coverage for at least | ||
| four kits described by Subsection (a) per enrollee per month. | ||
| 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 that provision until the | ||
| waiver or authorization is granted. | ||
| SECTION 3. Chapter 1381, Insurance Code, as added by this | ||
| Act, applies only to a health benefit plan delivered, issued for | ||
| delivery, or renewed on or after January 1, 2026. | ||
| SECTION 4. This Act takes effect September 1, 2025. | ||
