Texas Insurance Code Title 8, Chapter 1357 - Mastectomy
SUBCHAPTER A RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMY
- Texas Section 1357.001 - Definitions
In this subchapter: (1) "Breast reconstruction" means reconstruction of a breast incident to mastectomy to restore or achieve breast symmetry. The term includes surgical reconstruction...
- Texas Section 1357.002 - Applicability Of Subchapter
This subchapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition,...
- Texas Section 1357.003 - Exception
This subchapter does not apply to: (1) a plan that provides coverage: (A) only for a specified disease or another limited benefit, other than benefits...
- Texas Section 1357.004 - Coverage Required
(a) A health benefit plan that provides coverage for mastectomy must provide coverage for: (1) reconstruction of the breast on which the mastectomy has been...
- Texas Section 1357.005 - Prohibited Conduct
(a) An issuer of a health benefit plan may not: (1) offer a financial incentive for an enrollee to not receive breast reconstruction or to...
- Texas Section 1357.006 - Notice Of Coverage
(a) An issuer of a health benefit plan that provides coverage under this subchapter shall provide to each enrollee notice of the availability of the...
SUBCHAPTER B HOSPITAL STAY FOLLOWING MASTECTOMY AND CERTAIN RELATED PROCEDURES
- Texas Section 1357.007 - Rules
The commissioner may adopt rules to implement this subchapter and to meet the minimum requirements of federal law. Added by Acts 2003, 78th Leg., ch....
- Texas Section 1357.051 - Definition
In this subchapter, "enrollee" means an individual entitled to coverage under a health benefit plan. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3,...
- Texas Section 1357.052 - Applicability Of Subchapter
This subchapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health...
- Texas Section 1357.053 - Exception
This subchapter does not apply to: (1) a plan that provides coverage: (A) only for accidental death or dismemberment; (B) for wages or payments in...
- Texas Section 1357.054 - Coverage Required
(a) A health benefit plan that provides coverage for the treatment of breast cancer must provide to each enrollee coverage for inpatient care for a...
- Texas Section 1357.055 - Prohibited Conduct
An issuer of a health benefit plan may not: (1) deny the eligibility or continued eligibility of an individual to enroll in the plan or...
- Texas Section 1357.056 - Notice Of Coverage
(a) An issuer of a health benefit plan shall provide to each enrollee written notice of the coverage required under this subchapter. (b) The notice...
- Texas Section 1357.057 - Rules
The commissioner shall adopt rules necessary to administer this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Last modified: September 28, 2016