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


Office of House Bill AnalysisH.B. 2748
By: Smithee
Insurance
3/28/1999
Introduced



BACKGROUND AND PURPOSE 

Current 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 currently
responsible for providing payment for such examinations.  Until 1998,
reimbursement for Newborn Screening (NBS) 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 clarifies that NBS for genetic diseases is considered a part "of
well-child care from birth" under federal and state law and, therefore, is
covered under health plans.  This bill also allows the Texas Department of
Insurance to enforce this legislation with respect to health plans that are
not currently covering NBS.  

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 (Chapter 20A, Section 9E, V.T.C.S.) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 20A, V.T.C.S. (The Texas Health Maintenance
Organization Act), by adding Section 9E, as follows: 

Sec. 9E.  WELL-CHILD CARE FROM BIRTH.  Defines "well-child care from
birth." Requires each health maintenance organization to ensure that each
health care plan provided by the organization 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. 

SECTION 2.  Emergency clause.