HBA-NRS H.B. 329 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 329
By: Lewis, Glenn
Insurance
2/22/2001
Introduced



BACKGROUND AND PURPOSE
 
Many preexisting health conditions such as chronic illness, diabetes, and
consistent miscarriages may effect the outcome of a pregnancy or
childbirth, and insurance providers may be reluctant to offer benefits to
women with these types of preexisting risk factors. Insurance coverage for
pregnant women can lead to better prenatal care and lower infant mortality
rates. House Bill 329 establishes that a health benefit plan must provide a
woman with benefits under the plan for medically necessary expenses
incurred as a result of pregnancy or childbirth, regardless of preexisting
risk factors related to pregnancy or childbirth. 

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 (Section 3, Article 21.53H, Insurance Code) of this bill. 

ANALYSIS

House Bill 329 amends the Insurance Code to establish that certain health
benefit plans must provide a woman with benefits for medically necessary
expenses incurred as a result of pregnancy or childbirth, regardless of
whether the woman has preexisting risk factors related to pregnancy or
childbirth. The bill authorizes such health benefit plans to be subject to
annual deductibles, copayments, and coinsurance that are consistent with
annual deductibles, copayments, and coinsurance required for other benefits
under the plan. The bill prohibits required benefits from being subject to
dollar limitations other than the health benefit plan's lifetime maximum
benefits. The bill authorizes the commissioner of insurance to adopt rules
as necessary to implement coverage for maternity benefits. The bill
provides that coverage for maternity benefits applies only to certain
health benefits plans that provide benefits for medical or surgical
expenses incurred as a  result of a health condition, accident, or
sickness. The bill provides that a "health benefit plan" does not include
certain coverage plans, a Medicare supplemental policy, a workers'
compensation insurance policy, medical payment insurance coverage provided
under a motor vehicle insurance policy, or a long-term care insurance
policy, unless the commissioner of insurance makes a specified
determination.  

EFFECTIVE DATE

September 1, 2001, and applies only to a health benefit plan delivered,
issued for delivery, or renewed on or after January 1, 2002.