Insights

TX State Updates - 2015 Jan 02 No.01


On May 18, 2015, the Texas Department of Insurance (TDI) filed an adopted rule concerning changes to coverage for acquired brain injuries and updating Texas Insurance Code 1352 to conform to HB 2929 which was passed during the 2013 legislative session. The Insurance Code previously required health benefit plans to provide coverage for treatment of an acquired brain injury, but HB 2929 made substantial changes, including: Prohibiting a health benefit plan from including any post-acute-care treatment covered under the plan in any annual limitation on the number of days of acute-care treatment covered; removing a provision requiring any limitation on post-acute-care treatment to be separately stated in the plan; prohibiting a plan from limiting the number of days of covered post-acute care or the number of days of covered inpatient care for medically necessary treatment of acquired brain injury; and clarifying that a plan must include the same amount of limitations, deductibles, copayments and coinsurance factors for required coverage for an acquired brain injury as are applicable to other medical conditions for which coverage is provided under the plan. TDI has now adopted the rule amending Insurance Code 1352 to reflect the required changes. The adopted rule is effective June 7, 2015.

Adopted Rule »