Tex.
Ins. Code Section 1367.205
Coverage of Certain Therapies
(a)
A health benefit plan that provides coverage for rehabilitative and habilitative therapies under this subchapter may not prohibit or restrict payment for covered services provided to a child and determined to be necessary to and provided in accordance with an individualized family service plan issued by the Interagency Council on Early Childhood Intervention under Chapter 73 (Early Childhood Intervention Services), Human Resources Code.(b)
Rehabilitative and habilitative therapies described by Subsection (a) must be covered in the amount, duration, scope, and service setting established in the child’s individualized family service plan.(c)
A child is entitled to benefits under this subchapter if the child, as a result of the child’s relationship to an insured or enrollee in a health benefit plan, would be entitled to coverage under an accident and health insurance policy under Section 1201.061 (Coverage for Adopted Child), 1201.062 (Coverage for Certain Children in Individual or Group Policy or in Plan or Program), 1201.063 (Prohibition of Certain Criteria Relating to Child’s Coverage in Individual or Group Policy), or 1201.064 (Coverage for Child of Spouse in Individual or Group Policy).
Source:
Section 1367.205 — Coverage of Certain Therapies, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1367.htm#1367.205 (accessed Jun. 5, 2024).
