Bill Text: TX HB923 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to coverage of an alternative treatment after the approval of a utilization review.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-04-22 - Committee report sent to Calendars [HB923 Detail]
Download: Texas-2019-HB923-Introduced.html
| 86R5017 SMT-D | ||
| By: Zedler | H.B. No. 923 | |
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| relating to coverage of an alternative treatment after the approval | ||
| of a utilization review. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter A, Chapter 4201, Insurance Code, is | ||
| amended by adding Section 4201.005 to read as follows: | ||
| Sec. 4201.005. COVERAGE OF ALTERNATE HEALTH CARE SERVICES. | ||
| If a health care service is approved by a utilization review, the | ||
| payor or the payor's administrator may not deny coverage for an | ||
| alternate health care service if: | ||
| (1) the alternate health care service is approved by | ||
| the United States Food and Drug Administration to treat the | ||
| condition for which the utilization review was requested; and | ||
| (2) the cost of the alternate health care service does | ||
| not exceed the cost of the approved health care service. | ||
| SECTION 2. 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 January 1, 2020. A health benefit plan that is | ||
| delivered, issued for delivery, or renewed before January 1, 2020, | ||
| 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 3. This Act takes effect September 1, 2019. | ||
