CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS
AND CERVICAL CANCER
Sec. 1370.001. APPLICABILITY OF CHAPTER. (a) This chapter
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, an individual or group evidence
of coverage, or a 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 company operating under Chapter 884;
(5) a health maintenance organization operating under Chapter
843;
(6) a reciprocal exchange operating under Chapter 942;
(7) a Lloyd's plan operating under Chapter 941;
(8) an approved nonprofit health corporation that holds a
certificate of authority under Chapter 844; or
(9) a multiple employer welfare arrangement that holds a
certificate of authority under Chapter 846.
(b) This chapter applies to a small employer health benefit plan
written under Chapter 1501.
Added by Acts 2005, 79th Leg., Ch.
577, Sec. 1, eff. September 1, 2005.
Sec. 1370.002. EXCEPTION. This chapter does not apply to:
(1) a plan that provides coverage:
(A) only for benefits for a specified disease or for another
limited benefit, other than a plan that provides benefits for
cancer treatment or similar services;
(B) only for accidental death or dismemberment;
(C) for wages or payments in lieu of wages for a period during
which an employee is absent from work because of sickness or
injury;
(D) as a supplement to a liability insurance policy;
(E) only for dental or vision care; or
(F) only for indemnity for hospital confinement;
(2) a Medicare supplemental policy as defined by Section
1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(3) a workers' compensation insurance policy;
(4) medical payment insurance coverage provided under an
automobile insurance policy;
(5) a credit insurance policy;
(6) a limited benefit policy that does not provide coverage for
physical examinations or wellness exams; or
(7) a long-term care insurance policy, including a nursing home
fixed indemnity policy, unless the commissioner determines that
the policy provides benefit coverage so comprehensive that the
policy is a health benefit plan as described by Section 1370.001.
Added by Acts 2005, 79th Leg., Ch.
577, Sec. 1, eff. September 1, 2005.
Sec. 1370.003. COVERAGE REQUIRED. (a) A health benefit plan
that provides coverage for diagnostic medical procedures must
provide to each woman 18 years of age or older enrolled in the
plan coverage for expenses for an annual medically recognized
diagnostic examination for the early detection of cervical
cancer.
(b) Coverage required under this section includes at a minimum a
conventional Pap smear screening or a screening using
liquid-based cytology methods, as approved by the United States
Food and Drug Administration, alone or in combination with a test
approved by the United States Food and Drug Administration for
the detection of the human papillomavirus.
(c) A screening test required under this section must be
performed in accordance with the guidelines adopted by:
(1) the American College of Obstetricians and Gynecologists; or
(2) another similar national organization of medical
professionals recognized by the commissioner.
Added by Acts 2005, 79th Leg., Ch.
577, Sec. 1, eff. September 1, 2005.
Sec. 1370.004. NOTICE OF COVERAGE. (a) A health benefit plan
issuer shall provide to each woman 18 years of age or older
enrolled in the plan written notice of the coverage required
under this chapter.
(b) The notice must be provided in accordance with rules adopted
by the commissioner.
Added by Acts 2005, 79th Leg., Ch.
577, Sec. 1, eff. September 1, 2005.