CHAPTER 1361. DETECTION AND PREVENTION OF OSTEOPOROSIS

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES

CHAPTER 1361. DETECTION AND PREVENTION OF OSTEOPOROSIS

Sec. 1361.001. DEFINITION. In this chapter, "qualified

enrollee" means an individual entitled to coverage under a group

health benefit plan who is:

(1) a postmenopausal woman who is not receiving estrogen

replacement therapy;

(2) an individual with:

(A) vertebral abnormalities;

(B) primary hyperparathyroidism; or

(C) a history of bone fractures; or

(3) an individual who is:

(A) receiving long-term glucocorticoid therapy; or

(B) being monitored to assess the response to or efficacy of an

approved osteoporosis drug therapy.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1361.002. APPLICABILITY OF CHAPTER. This chapter applies

only to a group health benefit plan delivered, issued for

delivery, or renewed in this state that provides coverage for

medical or surgical expenses incurred as a result of accident or

sickness, including:

(1) a group insurance policy;

(2) a group contract issued by a group hospital service

corporation operating under Chapter 842; and

(3) a group contract issued by a health maintenance organization

operating under Chapter 843.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1361.003. COVERAGE REQUIRED. A group health benefit plan

must provide to a qualified enrollee coverage for medically

accepted bone mass measurement to detect low bone mass and to

determine the enrollee's risk of osteoporosis and fractures

associated with osteoporosis.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.