HB2119 - Relating to preauthorization of certain benefits by certain health benefit plan issuers.

  89R419 CJD-F     By: Garcia Hernandez H.B. No. 2119       A BILL TO BE ENTITLED   AN ACT   relating to preauthorization of certain benefits by certain health   benefit plan issuers.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 1356.005, Insurance Code, is amended by   adding Subsection (c) to read as follows:           (c)     A health benefit plan issuer that provides coverage   under this section may not require preauthorization for a screening   mammogram or diagnostic imaging described by Subsection (a) or   (a-1). This subsection may not be construed to authorize a   physician or other health care provider to provide the medical care   or health care described by this section if providing the care is   outside of the scope of the individual's applicable license or   other authorization issued under Title 3, Occupations Code.          SECTION 2.  Section 1357.004, Insurance Code, is amended by   adding Subsection (c) to read as follows:           (c)     A health benefit plan issuer that provides coverage   under this section may not require preauthorization for a   reconstruction, surgery, prostheses, or treatment described by   Subsection (a). This subsection may not be construed to authorize a   physician or other health care provider to provide the medical care   or health care described by this section if providing the care is   outside of the scope of the individual's applicable license or   other authorization issued under Title 3, Occupations Code.          SECTION 3.  Section 1357.054, Insurance Code, is amended by   adding Subsection (c) to read as follows:           (c)     A health benefit plan issuer that provides coverage   under this section may not require preauthorization for inpatient   care described by Subsection (a). This subsection may not be   construed to authorize a physician or other health care provider to   provide the medical care or health care described by this section if   providing the care is outside of the scope of the individual's   applicable license or other authorization issued under Title 3,   Occupations Code.          SECTION 4.  Section 1358.054, Insurance Code, is amended by   adding Subsection (c) to read as follows:           (c)     A health benefit plan issuer that provides coverage   under this section may not require preauthorization for the   provision to a qualified enrollee of diabetes equipment, diabetes   supplies, or diabetes self-management training described by   Subsection (a). This subsection may not be construed to authorize a   physician or other health care provider to provide the medical care   or health care described by this section if providing the care is   outside of the scope of the individual's applicable license or   other authorization issued under Title 3, Occupations Code.          SECTION 5.  Section 1361.003, Insurance Code, is amended to   read as follows:          Sec. 1361.003.  COVERAGE REQUIRED. (a) A group health   benefit plan must provide to a qualified enrollee coverage for   medically accepted bone mass measurement to detect low bone mass   and to determine the enrollee's risk of osteoporosis and fractures   associated with osteoporosis.           (b)     A group health benefit plan issuer that provides   coverage under this section may not require preauthorization for   the provision to a qualified enrollee of a bone mass measurement   described by Subsection (a). This subsection may not be construed   to authorize a physician or other health care provider to provide   the medical care or health care described by this section if   providing the care is outside of the scope of the individual's   applicable license or other authorization issued under Title 3,   Occupations Code.          SECTION 6.  Section 1362.003, Insurance Code, is amended by   adding Subsection (c) to read as follows:           (c)     A health benefit plan issuer that provides coverage   under this section to an enrolled male may not require   preauthorization for a diagnostic examination described by   Subsection (a). This subsection may not be construed to authorize a   physician or other health care provider to provide the medical care   or health care described by this section if providing the care is   outside of the scope of the individual's applicable license or   other authorization issued under Title 3, Occupations Code.          SECTION 7.  Section 1363.003, Insurance Code, is amended by   adding Subsection (d) to read as follows:           (d)     A health benefit plan issuer that provides coverage   under this section may not require preauthorization for a screening   examination described by Subsection (a). This subsection may not   be construed to authorize a physician or other health care provider   to provide the medical care or health care described by this section   if providing the care is outside of the scope of the individual's   applicable license or other authorization issued under Title 3,   Occupations Code.          SECTION 8.  This Act applies only to a health benefit plan   that is delivered, issued for delivery, or renewed on or after   January 1, 2026.          SECTION 9.  This Act takes effect September 1, 2025.