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TX HB412
Bill
Status
11/12/2024
Primary Sponsor
Ray Lopez
Click for details
AI Summary
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Requires health benefit plan issuers to provide (rather than merely offer) coverage for early childhood intervention services for children with developmental delays under individualized family service plans
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Expands the definition of covered rehabilitative and habilitative therapies to include specialized skills training by certified early intervention specialists, applied behavior analysis treatment by licensed behavior analysts or psychologists, and case management services
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Allows health plans to impose an annual limit of $9,000 per child for specialized skills training and case management costs, but prohibits applying this limit to other therapies like occupational, physical, or speech therapy
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Eliminates prior authorization and utilization management requirements for services specified in a child's individualized family service plan
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Prohibits health plans from counting early childhood intervention therapy visits toward annual visit limits or using therapy costs as sole justification for premium increases or coverage termination; applies to plans delivered or renewed on or after January 1, 2026
Legislative Description
Relating to health benefit plan coverage for early childhood intervention services.
Health
Last Action
Referred to Insurance
2/28/2025