Bill > HB261

This bill requires health benefit plans in Texas to cover medically necessary general anesthesia for pediatric dental services under specific conditions. The bill applies to a wide range of health insurance providers, including insurance companies, hospital service corporations, health maintenance organizations, and self-funded plans. Specifically, the coverage is mandatory for children under 13 years old who cannot undergo dental services without general anesthesia due to documented physical, mental, or medical reasons, and when the anesthesia is performed by a qualified provider. The bill importantly does not require health benefit plans to cover dental care or procedures themselves, only the general anesthesia services. The new requirements will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with the act taking effect on September 1, 2025. This legislation aims to ensure that children with special medical needs can access necessary dental treatments by removing potential financial barriers related to anesthesia services.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB261