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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for certain tests for the |
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early detection of cardiovascular disease in certain children. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Section 1376.003, Insurance Code, |
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is amended to read as follows: |
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Sec. 1376.003. MINIMUM COVERAGE REQUIRED: CERTAIN ADULTS. |
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SECTION 2. Chapter 1376, Insurance Code, is amended by |
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adding Section 1376.004 to read as follows: |
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Sec. 1376.004. MINIMUM COVERAGE REQUIRED: CERTAIN |
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CHILDREN. (a) A health benefit plan that provides coverage for |
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screening medical procedures must provide the minimum coverage |
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required by this section to each covered individual who is older |
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than 10 years of age and younger than 18 years of age and who: |
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(1) is a student at a middle school in Texas; or |
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(2) has not been diagnosed with heart disease and has |
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not undergone an electrocardiogram or echocardiogram within the |
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past two years. |
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(b) The minimum coverage required to be provided under this |
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section is coverage of up to $150 for the following series of |
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examinations once every five years, performed by a physician and a |
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laboratory certified by a national organization recognized by the |
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commissioner by rule for the purposes of this section, and intended |
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to detect asymptomatic underlying congenital cardiovascular |
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conditions that are associated with sudden cardiac arrest in |
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children, including abnormal structure or function of the heart, |
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the arteries, or the electrical pathways in the heart: |
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(1) history documenting personal or family history |
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associated with sudden cardiac arrest; |
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(2) focused cardiovascular physical examination for |
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clues to underlying conditions associated with sudden cardiac |
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arrest, such as abnormal murmurs and body habitus; |
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(3) electrocardiogram measuring cardiac electrical |
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activity and for the detection of those conditions associated with |
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sudden cardiac arrest; and |
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(4) limited five-minute echocardiography to detect |
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those structural cardiovascular conditions associated with sudden |
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cardiac arrest in children. |
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SECTION 3. The change in law made by this Act applies only |
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to a health benefit plan delivered, issued for delivery, or renewed |
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on or after January 1, 2012. A health benefit plan delivered, |
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issued for delivery, or renewed before January 1, 2012, is governed |
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by the law in effect immediately before the effective date of this |
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Act, and that law is continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2011. |