| (a) Global substitution of terms. This subchapter substitutes
the following terms for terms used in 45 CFR §146.136 (concerning
Parity in Mental Health and Substance Use Disorder Benefits) with
no change in meaning:
(1) the term "enrollees" is substituted for the term
"participants and beneficiaries";
(2) the term "health benefit plan" is substituted for
the terms "group health plan" (or health insurance coverage offered
in connection with such plans) and "plan or coverage"; and
(3) the terms "requirement" or "requirements" are substituted
for the terms "rule" or "rules."
(b) Omission of federal provisions. The following federal
provisions are not duplicated in this division either because they
were superseded by a later federal rule or there is no analogous Texas
law, or because they are otherwise captured in this subchapter:
(1) 45 CFR §146.136(b)(1)(ii), which addresses
exemptions;
(2) 45 CFR §146.136(c)(5), which addresses exemptions;
(3) 45 CFR §146.136(f), which addresses small
employer exemption; and
(4) 45 CFR §146.136(g), which addresses increased
cost exemption.
(c) Substitutions for federal provisions. Where a state
requirement exists, a corresponding but incongruent federal provision
has been omitted. Specifically, §21.2411 of this title (relating
to Availability of Plan Information) replaces the federal provision
at 45 CFR §146.136(d)(2), which addresses reason for any denial.
In addition, a portion of 45 CFR §146.136(d)(3), which addresses
provisions of other law, has been omitted.
|
