The following information provides a high-level understanding of Texas House Bill 1919 and the impact to the corporate policies and procedures of Blue Cross and Blue Shield of Texas (BCBSTX).

Additional information may be obtained from the State of Texas Legislative Web site.

The Texas Department of Insurance has not released final rules regarding the Texas House Bill 1919 requirements. Blue Cross Blue Shield of Texas has evaluated and adjusted policies and procedures to be in compliance with the latest understanding of the legislative requirements.

House Bill 1919 (HB 1919), passed by the 80th Texas Legislature – Regular Session, applies to fully-insured accounts (and portions of the bill apply to certain self-funded government accounts) and mandates

1. additional coverage for Acquired Brain Injury (ABI),
2. modified time frames for Utilization Review decisions related to ABI,
3. added coverage for Autism Spectrum Disorder (ASD), and
4. modified definition of Serious Mental Illness (SMI) to remove Pervasive Development Disorders (PDD) from the list of conditions that are considered Serious Mental Illness (SMI). Treatment of certain PDD diagnoses are covered under the ASD mandate.

HB 1919 legislation is effective September 1, 2007, and is applicable only to health insurance plans delivered, issued for delivery, or renewed on and after January 1, 2008.

For example:

The legislation is effective for new groups upon their enrollment date, beginning or after January 1, 2008.

For renewing groups, the legislation will go into effect upon each group’s anniversary (renewal) date, beginning and after January 1, 2008.

Operational changes have been implemented to allow BCBSTX to administer the requirements of HB 1919. See BCBSTX Compliance Policy.