88R7283 JES-D
	By: LaMantia	S.B. No. 2176

	A BILL TO BE ENTITLED
	AN ACT
	relating to health benefit plan coverage for treatment of autism.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 1355.001(3), Insurance Code, is amended
	to read as follows:
	(3)  "Autism spectrum disorder" means:
	(A)  a neurobiological disorder or developmental
	disability that significantly affects verbal communication,
	nonverbal communication, and social interaction and that meets the
	diagnostic criteria for autism spectrum disorder specified by the
	Diagnostic and Statistical Manual of Mental Disorders, 5th edition,
	or a later edition; or
	(B)  a diagnosis made using a previous edition of
	the Diagnostic and Statistical Manual of Mental Disorders of
	[includes] autism, Asperger's syndrome, or Pervasive Developmental
	Disorder--Not Otherwise Specified.
	SECTION 2.  Sections 1355.015(a-1) and (c-1), Insurance
	Code, are amended to read as follows:
	(a-1)  At a minimum, a health benefit plan must provide
	coverage for treatment of autism spectrum disorder as provided by
	this section to an enrollee who is diagnosed with autism spectrum
	disorder from the date of diagnosis[, only if the diagnosis was in
	place prior to the child's 10th birthday].
	(c-1)  The health benefit plan may [is] not require [required
	to provide coverage under Subsection (b) for benefits for] an
	enrollee to be evaluated for autism spectrum disorder more than
	once every 10 years [of age or older for applied behavior analysis
	in an amount that exceeds $36,000 per year].
	SECTION 3.  The changes in law made by this Act apply only to
	a health benefit plan delivered, issued for delivery, or renewed on
	or after January 1, 2024. A health benefit plan delivered, issued
	for delivery, or renewed before January 1, 2024, is governed by the
	law as it existed immediately before the effective date of this Act,
	and that law is continued in effect for that purpose.
	SECTION 4.  This Act takes effect September 1, 2023.

Statutes affected:
Introduced: Insurance Code 1355.001 (Insurance Code 1355)