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A BILL TO BE ENTITLED
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AN ACT
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relating to the coverage and provision of abortion, contraception, |
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and sterilization under Medicaid and certain health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.024(e), Human Resources Code, is |
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amended to read as follows: |
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(e) Except as provided by Section 32.03118, the [The] |
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commission may not authorize the provision of any service to any |
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person under the program unless federal matching funds are |
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available to pay the cost of the service. |
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SECTION 2. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.03118 to read as follows: |
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Sec. 32.03118. REIMBURSEMENT FOR CERTAIN REPRODUCTIVE |
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HEALTH SERVICES. (a) Regardless of whether federal matching funds |
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are available to pay the cost of the services, the commission shall |
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ensure that medical assistance reimbursement is provided for the |
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provision of the following services to medical assistance |
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recipients: |
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(1) abortion services; |
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(2) forms of contraception approved by the United |
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States Food and Drug Administration, including the insertion and |
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removal of devices; and |
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(3) voluntary sterilization, including vasectomies. |
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(b) The commission shall ensure that abortion, |
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contraception, and sterilization services are provided in |
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accordance with applicable state and federal law. |
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(c) Notwithstanding any other law, abortion, contraception, |
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and sterilization services provided under the medical assistance |
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program may not be subject to: |
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(1) a cost-sharing requirement, including a |
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deductible or coinsurance; |
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(2) utilization review; |
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(3) a prior authorization or step-therapy |
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requirement; or |
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(4) any restrictions on or delays in coverage. |
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SECTION 3. The heading to Chapter 1218, Insurance Code, is |
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amended to read as follows: |
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CHAPTER 1218. COVERAGE FOR REPRODUCTIVE HEALTH SERVICES [ELECTIVE |
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ABORTION; PROHIBITIONS AND REQUIREMENTS] |
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SECTION 4. Sections 1218.001 and 1218.004, Insurance Code, |
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are amended to read as follows: |
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Sec. 1218.001. DEFINITIONS [DEFINITION]. In this chapter: |
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(1) "Abortion" has the meaning assigned[, "elective |
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abortion" means an abortion, as defined] by Section 245.002, Health |
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and Safety Code[, other than an abortion performed due to a medical |
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emergency as defined by Section 171.002, Health and Safety Code]. |
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(2) "Effective pain and anxiety management" means |
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evidence-based pain and anxiety management, including prescription |
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anti-anxiety medication, local anesthesia, topical anesthetic, |
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paracervical block, and minimal and moderate sedation. |
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Sec. 1218.004. COVERAGE REQUIRED [BY HEALTH BENEFIT |
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PLAN]. (a) A health benefit plan shall [may] provide coverage for |
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abortion services, all forms of contraception approved by the |
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United States Food and Drug Administration, including the insertion |
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and removal of devices, counseling on effective pain and anxiety |
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management for the insertion or removal of devices, and provision |
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of effective pain and anxiety management for the insertion or |
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removal of devices, and voluntary sterilization, including |
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vasectomies, in accordance with applicable state and federal law. |
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(b) Coverage required under this section is not subject to |
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[elective abortion only if]: |
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(1) a cost-sharing requirement, including a |
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deductible or coinsurance [the coverage is provided to an enrollee |
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separately from other health benefit plan coverage offered by the |
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health benefit plan issuer]; |
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(2) utilization review [the enrollee pays the premium |
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for coverage for elective abortion separately from, and in addition |
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to, the premium for other health benefit plan coverage, if any]; |
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[and] |
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(3) a prior authorization or step-therapy |
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requirement; or |
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(4) any restrictions on or delays inStatutes affected:
Introduced: Human Resources Code 32.024, Insurance Code 1218.001 (Human Resources Code 32, Insurance Code 1218)
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