Bill > HB709

This bill amends the Texas Insurance Code to require group health benefit plans to provide comprehensive coverage for serious emotional disturbance (SED) in children, which is defined as a diagnosable mental, behavioral, or emotional disorder that significantly impairs a child's functioning in family, school, or community settings. The bill mandates that health plans must cover at least 45 days of inpatient treatment and 60 outpatient visits per calendar year for SED, with no lifetime limitations, and require these mental health services to be covered under the same terms and cost-sharing structures as physical illness treatments. Additionally, the bill requires the department to conduct a study evaluating the claims and cost impacts of this new coverage, with a report to be submitted to state leadership by December 1, 2026. The provisions will apply to group health benefit plans delivered, issued, or renewed on or after January 1, 2026, and the act will take effect on September 1, 2025. A key innovation is the detailed definition of SED, which includes specific diagnostic criteria and functional impairment indicators, ensuring a comprehensive approach to identifying and treating children's mental health challenges.

Business and Industry

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB709