Bill > SB527

This bill adds a new subchapter to the Texas Insurance Code that requires health benefit plans to provide coverage for medically necessary general anesthesia for pediatric dental services under specific conditions. Specifically, the bill mandates that health benefit plans cannot exclude coverage for general anesthesia when the patient is under 13 years old and unable to undergo dental services without anesthesia due to documented physical, mental, or medical reasons, and when the anesthesia is performed by a qualified provider. The bill applies to a wide range of health insurance providers, including insurance companies, health maintenance organizations, and self-funded health benefit plans. Importantly, the bill does not require health benefit plans to cover dental care or procedures themselves, only the general anesthesia services. The new provisions will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, and the act itself will take effect on September 1, 2025. This legislation aims to ensure that young children with specific 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=SB527