HBA-ATS H.B. 1750 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1750
By: Van de Putte
Insurance
3/16/1999
Introduced



BACKGROUND AND PURPOSE 

Many insurers use utilization review agents to determine whether they
should pay for health care services provided to, or requested by, a
consumer.  In 1997, the Texas Department of Insurance adopted a rule that
prohibits a licensed utilization review agent from requiring, as a
condition of treatment approval, or for any other reason, the observation
of a psychotherapy session or the submission or review of a mental health
therapist's process or progress notes.  The rule does not encompass
insurance companies and health maintenance organizations. 

H.B. 1750 prohibits an insurer from requiring, as a condition of coverage
or for any other reason, the observation of mental health services,
including services provided in a psychotherapy session, by a representative
of the insurer, or the submission, for review, of a mental health care
provider's process or progress notes to an insurer.  This bill also
prohibits an insurer from denying benefits for mental health services,
including services provided in a psychotherapy session, on the grounds that
the enrollee refuses medication.  In addition, this bill prohibits an
insurer from denying benefits for mental health services on the grounds
that the services are provided in a group session with family members or
other individuals. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the commissioner of insurance in
SECTION 1 (Article 21.53S, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter E, Chapter 21, Insurance Code, by adding
Article 21.53S, as follows: 

Art. 21.53S.  RESTRICTIONS APPLICABLE TO CERTAIN MENTAL HEALTH SERVICES

Sec. 1.  DEFINITIONS.  Defines "enrollee" and "health benefit plan."

Sec. 2.  SCOPE OF ARTICLE.  (a) Specifies that Article 21.53S applies only
to a comprehensive health benefit plan that provides benefits for medical
or surgical expenses incurred because of a health condition, accident, or
sickness.  These types of plans include an individual, group, blanket, or
franchise insurance policy or insurance agreement, and a group hospital
service contract.  Also included is individual or group coverage offered by
an insurance company; a group hospital service corporation; a fraternal
benefit society; a stipulated premium insurance company; a reciprocal
exchange; a health maintenance organization; a multiple employer welfare
arrangement; or an approved nonprofit health corporation. 

(b) Provides that Article 21.53S does not apply to a plan that provides
coverage only for a specific disease or other limited benefit; only for
accidental death or dismemberment; for wages or payments for a period
during which an employee is absent from work because of sickness or injury;
as a supplement to liability insurance; for credit insurance; only for
dental or vision care; only for hospital expenses; or only for indemnity
for  hospital confinement.  Also excluded is a small employer health
benefit plan; a Medicare supplemental policy; workers' compensation
insurance coverage; medical payment insurance coverage issued as part of a
motor vehicle insurance policy; or a long-term care policy. 

Sec. 3.  CERTAIN REQUIREMENTS RELATING TO MENTAL HEALTH SERVICES
PROHIBITED.  Prohibits an insurer from requiring, as a condition of
coverage or for any other reason, the observation of mental health
services, including services provided in a psychotherapy session, by a
representative of the insurer, or the submission, for review, of a mental
health care provider's process or progress notes to an insurer.  Prohibits
an insurer from denying benefits for mental health services, including
services provided in a psychotherapy session, on the grounds that the
enrollee refuses medication.  Prohibits an insurer from denying benefits
for mental health services on the grounds that the services are provided in
a group session with family members or other individuals. 

Sec. 4.  RULES.  Authorizes the commissioner of insurance to adopt rules as
necessary to administer this article. 

SECTION 2.  Makes application of this Act prospective for health benefit
plans that are delivered, issued for delivery, or renewed on or after the
effective date of this Act. 

SECTION 3.Emergency clause.
  Effective date: upon passage.