The committee met to take up new and pending business. This report focuses only on the bills listed below.
HB 3986 – Simmons, Relating to coverage by certain health benefit plans for certain services prescribed to treat autism spectrum disorder
- Texas has become the national leader in insurance coverage for children with autism but coverage does not include recreational therapy as a generally recognized service for autism treatment
- Rep. Guerra applauded the bill and asked if this was considered hippotherapy
- Horses can be involved with this therapy – recreational therapy will provide children the opportunity to learn how to play
John Kokkinos, Self
- Support the bill
- Autism is a medical condition – abnormality in the neurological system
- 47% of children with autism will get better with therapeutic intervention
Jessica Dupree, Recreational Therapist
- Support the bill
- Recreational therapy is an evidence-based therapy that can be effective for children with autism
- Certified on a national level with a minimum of obtaining a bachelor’s degree, passing the national exam and participating in continuing education
- Rep. Guerra asked if recreational therapy is associated with hippotherapy
- Two distinct forms of therapy but can be used together if certified in both areas
Jerrell Nelson, Holistic Healthcare Services
- Support the bill
- Physician must sign off for a child to participate in recreational therapy – helps individuals develop life skills
- Rep. Sheets asked about the time frame and costs associated with this therapy
- Therapy ranges from sixth months to up to three years depending on the child. Costs are based on an hourly basis; average of $70-80 and hour
Anne Heart, Self
- Support the bill
- Son received ten years of recreational therapy through Medicare
Jamie Dudensing, Texas Association of Health Plans
- On the bill
- Concern with the terminology of recreational therapy – no definition or scope of practice in statute
- Rep. Meyer asked if there was a concern with the essential health benefits in terms of the Affordable Care Act
- No one has assessed the penalty of exceeding the cost of benefit – additional protection language is recommended
Jan Graeber, Texas Department of Insurance
- On the bill
- Rep. Sheets asked what concerns are present in relation to the Affordable Care Act
- State is protected by language passed in previous statutes
Bill left pending.
HB 449—Alonzo, Relating to the coverage by certain health benefit plans of mammograms performed by certain health care providers
- Passed the bill out of insurance committee last session
Bill left pending.
HB 694 – Hernandez, Relating to coverage for supplemental breast cancer screening under certain health benefit plans
- Passed the first part of this bill in 2011 – woman must be notified if it has been discovered she has dense breast tissue after receiving a mammogram
- Health plan would cover supplemental breast cancer screenings if deemed necessary by a physician
Bill left pending.
HB 2979—Anderson/Rodney, Relating to health benefit plan coverage of hearing aids for certain individuals
- $400,000 can be saved in special education costs per child by the time a child graduates from high school if a child is identified early and given appropriate care
- Health benefit plans cover medically necessary hearing aids for a child who is 18 or under
Chelsea Murphy, Self
- Support the bill
- Son diagnosed with hearing loss at two months old – received appropriate care and was able to discontinue special education by kindergarten
- Early intervention and amplification led to his current success
Jamie Klingman, Self
- Support the bill
- Hearing aids and support services are not covered by any insurance plans – costs over $5,000 per year
- Rep. Meyer asked to expand on the cost and services in addition to hearing aids
- $1-4,000 for hearing aids per year; $250 hearing molds every six months; $250 hearing tests every six months
Michael Wax, Self
- Support the bill
- Newborn daughter has recently been diagnosed as hard of hearing – family received a hearing aid through a grant and daughter is ahead of normal learning patterns
- Rep. Guerra asked what happens to old hearing aids over time and wondered if they are reusable
- Technology breaks and is no longer usable
Dr. Audra Stuart, Self
- Support the bill
- Newborn daughter failed hearing diagnostic test – moderate hearing loss
- Children will lose auditory pathways by the age of three if they do not receive aids
- $5,000 of hearing aids were considered cosmetic appliances by insurance companies
- Rep. Meyer questioned if there were any additional costs associated with having a child with hearing loss – wants to make sure bill is as comprehensive as possible
- Newborn received new hearing molds every 6 weeks to lessen feedback
Kelly Berger, Self
- Support the bill
- Faced difficulties in being able to afford hearing aids for two children – money taken away from college fund
- Insurance companies provided $500 per year every five years that hardly covered total costs
- Speech therapy was a large additional cost for the family
Jennifer Petersen, Self
- Support the bill
- Insurance companies in Texas are not required to cover hearing aid services for children
- Hearing aid batteries, wax traps, speech therapy and occupational therapy are all additional costs
- Estimated $20-25,000 in additional costs in caring for her son until he turns 18
Madison Wright, Self
- Support the bill
- Diagnosed with a hearing loss at birth – received early childhood intervention and speech therapy at age 3
- Insurance company helped pay for her hearing aids
- Recommended for insurance companies to treat hearing loss similar to vision loss (e.g. contacts and glasses)
Dr. Karen Ditty, Texas Academy of Audiology
- Support the bill
- Hearing aids are practically as fragile as an iPhone – sensitive to wind, rain, dogs, etc. – and cannot be passed down from one person to the next
- BlueCross BlueShield covers $1,000/year per hearing aid but is minimal compared to the total associated costs
- Other states have distributed $2-3,000 per child per year to cover bundled hearing services for children
- Rep. Guerra asked about the costs associated with cochlear implant surgery
- Parts of cochlear implant surgery are covered – only the surgery but not the parts
- $30,000 for the surgery and $9,000 for the parts
- Hearing aid trial is required before having a cochlear implant surgery
Sandra, Texas Association for Parents and Educators of the Deaf
- Support the bill
- Deaf educator since 1989
- Children without hearing aid and therapy are seriously delayed – in both social and educational skill
- Amplification at an early age makes all of the difference
- Schools are required to provide assistive technology while the child is at school – only six hours of the day
Rep. Meyer recommended for the bill to be expanded including additional costs associated with hearing loss in addition to hearing aids. Rep. Anderson intends to reach out to industry. Texas Association of Business is the only group that has submitted opposition to the bill considering it is a mandate. Rep. Sheets encouraged for an amendment to be drafted protecting the state from incurring associated costs.
Bill left pending.
Pending Business
HB 2467 – King, Phil, Relating to the exclusion from the premium and maintenance tax base of federal fees imposed on insurers and other providers under the Patient Protection and Affordable Care Act, and recouped from policyholders.
- Voted favorably
HB 3028 – Frullo, John, Relating to regulation of discount drug card program operators.
- Voted favorably
SB 94 – Hinojosa, Chuy, Relating to certain fees charged for the adjudication of pharmacy benefit claims.
- Voted favorably
SB 979 – Creighton, Brandon, Relating to individual indemnity health insurance.
- Voted favorably
SB 65 – Eltife, Kevin, Relating to own risk and solvency assessment by insurers and insurance groups.
- Voted favorably