CHAPTER 1359. FORMULAS FOR INDIVIDUALS WITH PHENYLKETONURIA OR OTHER HERITABLE DISEASES
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
CHAPTER 1359. FORMULAS FOR INDIVIDUALS WITH PHENYLKETONURIA OR
OTHER HERITABLE DISEASES
Sec. 1359.001. DEFINITIONS. In this chapter:
(1) "Heritable disease" means an inherited disease that may
result in mental or physical retardation or death.
(2) "Phenylketonuria" means an inherited condition that, if not
treated, may cause severe mental retardation.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1359.002. APPLICABILITY OF CHAPTER. This chapter applies
only to a group health benefit plan that is a group policy,
contract, or certificate of health insurance or an evidence of
coverage delivered, issued for delivery, or renewed in this state
by:
(1) an insurance company;
(2) a group hospital service corporation operating under Chapter
842; or
(3) a health maintenance organization operating under Chapter
843.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1359.003. COVERAGE REQUIRED. (a) A group health benefit
plan must provide coverage for formulas necessary to treat
phenylketonuria or a heritable disease.
(b) The group health benefit plan must provide the coverage to
the same extent that the plan provides coverage for drugs that
are available only on the orders of a physician.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.