Bill Text: TX SB943 | 2013-2014 | 83rd Legislature | Introduced
Bill Title: Relating to health benefit plan coverage of hearing aids for certain individuals.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2013-03-12 - Referred to State Affairs [SB943 Detail]
Download: Texas-2013-SB943-Introduced.html
| 83R7057 MEW-D | ||
| By: Davis | S.B. No. 943 | |
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| relating to health benefit plan coverage of hearing aids for | ||
| certain individuals. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1367, Insurance Code, is amended by | ||
| adding Subchapter F to read as follows: | ||
| SUBCHAPTER F. HEARING AIDS | ||
| Sec. 1367.251. 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 fraternal benefit society operating under | ||
| Chapter 885; | ||
| (4) a Lloyd's plan operating under Chapter 941; | ||
| (5) a stipulated premium insurance company operating | ||
| under Chapter 884; | ||
| (6) a reciprocal exchange operating under Chapter 942; | ||
| (7) a health maintenance organization operating under | ||
| Chapter 843; | ||
| (8) a multiple employer welfare arrangement that holds | ||
| a certificate of authority under Chapter 846; or | ||
| (9) an approved nonprofit health corporation that | ||
| holds a certificate of authority under Chapter 844. | ||
| (b) This subchapter applies to a small employer health | ||
| benefit plan written under Chapter 1501. | ||
| (c) This subchapter applies to group health coverage made | ||
| available by a school district in accordance with Section 22.004, | ||
| Education Code. | ||
| (d) Notwithstanding Section 172.014, Local Government Code, | ||
| or any other law, this subchapter applies to health and accident | ||
| coverage provided by a risk pool created under Chapter 172, Local | ||
| Government Code. | ||
| (e) Notwithstanding any provision in Chapter 1551, 1575, | ||
| 1579, or 1601 or any other law, this subchapter applies to: | ||
| (1) a basic coverage plan under Chapter 1551; | ||
| (2) a basic plan under Chapter 1575; | ||
| (3) a primary care coverage plan under Chapter 1579; | ||
| and | ||
| (4) basic coverage under Chapter 1601. | ||
| (f) Notwithstanding any other law, a standard health | ||
| benefit plan provided under Chapter 1507 must provide the coverage | ||
| required by this subchapter. | ||
| Sec. 1367.252. EXCEPTION. This subchapter does not apply | ||
| to: | ||
| (1) a plan that provides coverage: | ||
| (A) for wages or payments in lieu of wages for a | ||
| period during which an employee is absent from work because of | ||
| sickness or injury; | ||
| (B) as a supplement to a liability insurance | ||
| policy; | ||
| (C) for credit insurance; | ||
| (D) only for dental or vision care; | ||
| (E) only for hospital expenses; 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 | ||
| a motor vehicle insurance policy; | ||
| (5) a long-term care 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 1367.251; | ||
| (6) a Medicaid managed care program operated under | ||
| Chapter 533, Government Code; or | ||
| (7) a Medicaid program operated under Chapter 32, | ||
| Human Resources Code. | ||
| Sec. 1367.253. COVERAGE REQUIRED. (a) A health benefit | ||
| plan that provides coverage for a child who is 18 years of age or | ||
| younger must provide coverage for the cost of a hearing aid if the | ||
| child suffers from hearing loss or impairment that cannot be | ||
| corrected by a medical procedure covered in the child's health | ||
| benefit plan. | ||
| (b) Coverage required under this section is limited to one | ||
| hearing aid in each ear every three years. | ||
| (c) Coverage required under this section: | ||
| (1) may not be less favorable than coverage for | ||
| physical illness generally under the plan; and | ||
| (2) must be subject to the same durational limits, | ||
| dollar limits, deductibles, and coinsurance factors as coverage for | ||
| physical illness generally under the plan. | ||
| SECTION 2. The change in law made 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. | ||
