HB3735 - Relating to health benefit plan coverage for prenatal care, childbirth, and postnatal care provided in a hospital, birthing center, or home setting.

  89R14545 SCF-D     By: Shofner H.B. No. 3735       A BILL TO BE ENTITLED   AN ACT   relating to health benefit plan coverage for prenatal care,   childbirth, and postnatal care provided in a hospital, birthing   center, or home setting.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 1366, Insurance Code, is amended by   adding Subchapter D to read as follows:   SUBCHAPTER D. COVERAGE FOR PRENATAL CARE, CHILDBIRTH, AND POSTNATAL   CARE           Sec.   1366.151.     DEFINITION. In this subchapter, "birthing   center" has the meaning assigned by Section 244.002, Health and   Safety Code.           Sec.   1366.152.     APPLICABILITY OF SUBCHAPTER. (a) This   subchapter applies only to a health benefit plan that provides   benefits for medical, surgical, or prescription drug 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 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;                 (4)     a plan providing basic coverage under Chapter   1601;                 (5)     county employee group health benefits provided   under Chapter 157, Local Government Code; and                 (6)     health and accident coverage provided by a risk   pool created under Chapter 172, Local Government Code.           Sec.   1366.153.     COVERAGE REQUIRED. (a) A health benefit   plan that provides maternity benefits must provide coverage for   prenatal care, childbirth, and postnatal care provided in a   hospital, birthing center, or home setting.             (b)  The coverage required under this section includes:                 (1)     prenatal care, childbirth, and postnatal care   provided by a nurse midwife licensed as an advanced practice   registered nurse;                 (2)     prenatal care visits, including an ultrasound,   dating scan, or anatomy scan;                 (3)     glucose, blood, and urine tests related to   prenatal care, childbirth, and postnatal care;                 (4)     childbirth in a hospital, birthing center, or home   setting;                 (5)     prescription drugs related to childbirth,   including prescription drugs related to pain management during   labor;                 (6)  newborn screening and hearing tests; and                 (7)     vitamin K injections, hepatitis B vaccines, and   antibiotic eye ointment provided to a newborn.          SECTION 2.  Subchapter D, Chapter 1366, 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 3.  This Act takes effect September 1, 2025.