HB616 - Relating to health benefit plan coverage for certain at-home testing kits.

  89R3978 SCF-D     By: Bucy H.B. No. 616       A BILL TO BE ENTITLED   AN ACT   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.