HBA-ATS, NIK H.B. 2748 76(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 2748
By: Smithee
Insurance
6/15/1999
Enrolled



BACKGROUND AND PURPOSE 

State and federal laws require all newborns to be tested for certain
treatable genetic and metabolic disorders.  This testing is known as
"well-child care from birth" and health care plans are responsible for
providing payment for such examinations.  Until 1998, reimbursement for
newborn screening (screening) for all children was the responsibility of
the Texas Department of Health (TDH). However, in early 1998, TDH imposed a
fee on private pay patients under a rider relating to the building of its
new laboratory.  While health plans are responsible for providing payments
for the examinations, the reimbursements have not been consistent.   

H.B. 2748 provides that "well-child care from birth" includes screening
required by TDH.  Under this bill, each health maintenance organization
(HMO) is required to ensure that each of its health care plans (plans)
includes well-child care from birth that complies with federal requirements
adopted and rules adopted by TDH.  In addition, each HMO is required to
include in its plans coverage for immunization against rotovirus and any
other immunization required by statute  or rule. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Department of Health in
SECTION 1 (Section 9E, Chapter 20A, V.T.I.C.) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 20A, V.T.I.C. (Texas Health Maintenance
Organization Act), by adding Sections 9E and 9F, as follows: 

Sec. 9E. WELL-CHILD CARE FROM BIRTH.  Defines "well-child care from birth."
Requires each health maintenance organization (HMO) to ensure that each
health care plan (plan) provided by the HMO includes well-child care from
birth that complies with the federal requirements adopted under Chapter XI,
Public Health Service Act (42 U.S.C. Section 300e et seq.), and its
subsequent amendments, and the rules adopted by the Texas Department of
Health to implement those requirements. 

Sec. 9F. IMMUNIZATIONS FOR CHILDREN.  Requires each HMO to include in its
plans coverage for immunization against rotovirus and any other
immunization required by statute or rule. 

SECTION 2.Provides that this Act takes effect immediately except as
provided by SECTION 3. 

SECTION 3.Effective date for Section 9F: September 1, 1999.
Makes application of Section 9F prospective for an evidence of coverage
that is delivered, issued for delivery, or renewed on or after January 1,
2000. 

SECTION 4.  Emergency clause.