85R9412 LED-D     By: Thompson of Harris H.B. No. 3144       A BILL TO BE ENTITLED   AN ACT   relating to coverage for certain services relating to postpartum   depression under certain health benefit plans and the medical   assistance and CHIP perinatal programs.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 62, Health and Safety Code, is amended by   adding Subchapter E to read as follows:   SUBCHAPTER E. CHIP PERINATAL PROGRAM          Sec. 62.201.  DEFINITION. In this subchapter, "postpartum   depression" means a disorder with postpartum onset that is   categorized as a mood disorder by the American Psychiatric   Association in the Diagnostic and Statistical Manual of Mental   Disorders, 5th Edition (DSM-5), or a subsequent edition adopted by   rule by the executive commissioner.          Sec. 62.202.  COVERAGE FOR CERTAIN SERVICES REQUIRED. (a)   The covered services under the CHIP perinatal program must include,   for each woman who gives birth to a child who is enrolled in the CHIP   perinatal program before birth, screening and treatment for   postpartum depression for the 12-month period after the date the   woman gives birth to the child.          (b)  The coverage for postpartum depression provided under   Subsection (a):                (1)  must provide mental health services to a woman   regardless of whether the woman has been found to be a danger to   herself or others; and                (2)  may not place an arbitrary or artificial limit on   the amount of services that may be provided.          (c)  The executive commissioner shall adopt rules necessary   to implement this section.          SECTION 2.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.0249 to read as follows:          Sec. 32.0249.  SERVICES RELATED TO POSTPARTUM DEPRESSION.     (a)  For purposes of this section, "postpartum depression" means a   disorder with postpartum onset that is categorized as a mood   disorder by the American Psychiatric Association in the Diagnostic   and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), or   a subsequent edition adopted by rule by the executive commissioner.          (b)  The commission shall provide to a woman who receives   medical assistance benefits during a pregnancy screening and   treatment for postpartum depression for the 12-month period after   the date the woman gives birth.          (c)  The commission shall provide mental health services to a   woman under Subsection (b) regardless of whether the woman has been   found to be a danger to herself or others.          (d)  The commission may not place an arbitrary or artificial   limit on the amount of services that may be provided under   Subsection (b).          (e)  The executive commissioner shall adopt rules necessary   to implement this section.          SECTION 3.  Chapter 1366, Insurance Code, is amended by   adding Subchapter C to read as follows:   SUBCHAPTER C. COVERAGE FOR POSTPARTUM DEPRESSION TREATMENT          Sec. 1366.101.  DEFINITION. In this subchapter, "postpartum   depression" means a disorder with postpartum onset that is   categorized as a mood disorder by the American Psychiatric   Association in the Diagnostic and Statistical Manual of Mental   Disorders, 5th Edition (DSM-5), or a subsequent edition adopted by   rule by the commissioner.          Sec. 1366.102.  APPLICABILITY OF SUBCHAPTER. (a)  This   subchapter applies only to a health benefit plan that provides   benefits for medical or surgical expenses incurred as a result of a   health condition, accident, or sickness, including an individual,   group, blanket, or franchise insurance policy or insurance   agreement, a group hospital service contract, or an individual or   group evidence of coverage or similar coverage document that is   offered by:                (1)  an insurance company;                (2)  a group hospital service corporation operating   under Chapter 842;                (3)  a fraternal benefit society operating under   Chapter 885;                (4)  a stipulated premium insurance company operating   under Chapter 884;                (5)  a health maintenance organization operating under   Chapter 843;                (6)  a multiple employer welfare arrangement that holds   a certificate of authority under Chapter 846; or                (7)  an approved nonprofit health corporation that   holds a certificate of authority under Chapter 844.          (b)  Notwithstanding any provision in Chapter 1551, 1575,   1579, or 1601 or any other law, this subchapter applies to:                (1)  a basic coverage plan under Chapter 1551;                (2)  a basic plan under Chapter 1575;                (3)  a primary care coverage plan under Chapter 1579;   and                (4)  basic coverage under Chapter 1601.          (c)  This subchapter does not apply to a qualified health   plan if a determination is made under 45 C.F.R. Section 155.170   that:                (1)  this chapter requires the plan to offer benefits   in addition to the essential health benefits required under 42   U.S.C. Section 18022(b); and                (2)  this state is required to defray the cost of the   benefits mandated under this chapter.          Sec. 1366.103.  COVERAGE FOR CERTAIN SERVICES REQUIRED. (a)   A health benefit plan that provides maternity benefits must provide   to a woman who gives birth to a child coverage for screening and   treatment for postpartum depression for the 12-month period after   the date the woman gives birth to the child.          (b)  The coverage for postpartum depression provided under   Subsection (a):                (1)  must provide mental health services to a woman   regardless of whether the woman has been found to be a danger to   herself or others; and                (2)  may not place an arbitrary or artificial limit on   the amount of services that may be provided.          SECTION 4.  As soon as practicable after the effective date   of this Act, the executive commissioner of the Health and Human   Services Commission shall develop and seek a waiver or other   appropriate authorization from the Centers for Medicare and   Medicaid Services to extend the number of postpartum visits a woman   may receive under the CHIP perinatal program in order to implement   Section 62.202, Health and Safety Code, as added by this Act.          SECTION 5.  If before implementing any provision of this Act   a state agency determines that an additional waiver or additional   authorization from a federal agency is necessary for implementation   of that provision, the agency affected by the provision shall   request the waiver or authorization and may delay implementing that   provision until the waiver or authorization is granted.          SECTION 6.  Subchapter C, Chapter 1366, Insurance Code, as   added by this Act, applies only to a health benefit plan that is   delivered, issued for delivery, or renewed on or after January 1,   2018. A health benefit plan that is 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 7.  This Act takes effect September 1, 2017.