85R19293 PMO-D     By: Thompson of Harris, Hernandez, H.B. No. 1036       Laubenberg, Collier, Sheffield, et al.     Substitute the following for H.B. No. 1036:     By:  Phillips C.S.H.B. No. 1036       A BILL TO BE ENTITLED   AN ACT   relating to coverage for certain breast cancer screening procedures   under certain health benefit plans.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  The heading to Chapter 1356, Insurance Code, is   amended to read as follows:   CHAPTER 1356. [LOW-DOSE] MAMMOGRAPHY          SECTION 2.  Sections 1356.001 and 1356.002, Insurance Code,   are amended to read as follows:          Sec. 1356.001.  DEFINITIONS [DEFINITION]. In this chapter:                (1)  "Breast tomosynthesis" means a radiologic   mammography procedure that involves the acquisition of projection   images over a stationary breast to produce cross-sectional digital   three-dimensional images of the breast from which applicable breast   cancer screening diagnoses may be determined.                (2)  "Low-dose[, "low-dose] mammography" means:                      (A)  the x-ray examination of the breast using   equipment dedicated specifically for mammography, including an   x-ray tube, filter, compression device, and screens, [films, and   cassettes,] with an average radiation exposure delivery of less   than one rad mid-breast and[,] with two views for each breast;                      (B)  digital mammography; or                      (C)  breast tomosynthesis.          Sec. 1356.002.  APPLICABILITY OF CHAPTER. (a)  This chapter   applies [only] to a health benefit plan, including a small employer   health benefit plan written under Chapter 1501 or coverage that is   provided by a health group cooperative under Subchapter B of that   chapter, that provides benefits for medical or surgical expenses   incurred as a result of a health condition, accident, or sickness,   including [is delivered, issued for delivery, or renewed in this   state and that is] an individual,  [or] group, blanket, or franchise   [accident and health] insurance policy or insurance agreement, a   group hospital service contract, or an individual or group evidence   of coverage or similar coverage document offered by:                (1)  an insurance company;                (2)  a group hospital service corporation operating   under Chapter 842;                (3)  a health maintenance organization operating under   Chapter 843;                (4)  an approved nonprofit health corporation that   holds a certificate of authority under Chapter 844;                (5)  a multiple employer welfare arrangement that holds   a certificate of authority under Chapter 846;                (6)  a stipulated premium company operating under   Chapter 884;                (7)  a fraternal benefit society operating under   Chapter 885;                (8)  a Lloyd's plan operating under Chapter 941; or                (9)  an exchange operating under Chapter 942[,   including a policy issued by a group hospital service corporation   operating under Chapter 842].          (b)  This chapter applies to coverage under a group health   benefit plan described by Subsection (a) provided to a resident of   this state, regardless of whether the group policy or contract is   delivered, issued for delivery, or renewed within or outside this   state.          (c)  This chapter applies to group health coverage made   available by a school district in accordance with Section 22.004,   Education Code.          (d)  This chapter applies to a self-funded health benefit   plan sponsored by a professional employer organization under   Chapter 91, Labor Code.          (e)  Notwithstanding Section 22.409, Business Organizations   Code, or any other law, this chapter applies to a church benefits   board established under Chapter 22, Business Organizations Code.          (f)  Notwithstanding Section 75.104, Health and Safety Code,   or any other law, this chapter applies to a regional or local health   care program established under Chapter 75, Health and Safety Code.          (g)  Notwithstanding any provision in Chapter 1551 or any   other law, this chapter applies to a basic coverage plan under   Chapter 1551.          (h)  Notwithstanding any other law, a standard health   benefit plan provided under Chapter 1507 must provide the coverage   required by this chapter.          SECTION 3.  Chapter 1356, Insurance Code, is amended by   adding Section 1356.0021 to read as follows:          Sec. 1356.0021.  EXCEPTIONS.  This chapter does not apply   to:                (1)  the child health plan program operated under   Chapter 62, Health and Safety Code;                (2)  the health benefits plan for children operated   under Chapter 63, Health and Safety Code;                (3)  the state Medicaid program operated under Chapter   32, Human Resources Code; and                (4)  the Medicaid managed care program operated under   Chapter 533, Government Code.          SECTION 4.  Section 1356.005(a), Insurance Code, is amended   to read as follows:          (a)  A health benefit plan that provides coverage to a female   who is 35 years of age or older must include coverage for an annual   screening by all forms of low-dose mammography for the presence of   occult breast cancer.          SECTION 5.  The changes in law made by this Act apply only to   a health benefit plan that is delivered, issued for delivery, or   renewed on or after January 1, 2018. A plan delivered, issued for   delivery, or renewed before January 1, 2018, 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 6.  This Act takes effect September 1, 2017.