Bill Text: TX HB1337 | 2023-2024 | 88th Legislature | Enrolled
Bill Title: Relating to step therapy protocols required by health benefit plans for coverage of prescription drugs for serious mental illnesses.
Spectrum: Slight Partisan Bill (Democrat 7-4)
Status: (Passed) 2023-06-12 - Effective on 9/1/23 [HB1337 Detail]
Download: Texas-2023-HB1337-Enrolled.html
| H.B. No. 1337 | ||
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| relating to step therapy protocols required by health benefit plans | ||
| for coverage of prescription drugs for serious mental illnesses. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter B, Chapter 1369, Insurance Code, is | ||
| amended by adding Section 1369.0547 to read as follows: | ||
| Sec. 1369.0547. STEP THERAPY PROTOCOLS FOR PRESCRIPTION | ||
| DRUGS TO TREAT SERIOUS MENTAL ILLNESSES. (a) In this section, | ||
| "serious mental illness" has the meaning assigned by Section | ||
| 1355.001. | ||
| (b) This section applies only to a drug prescribed to an | ||
| enrollee who is 18 years of age or older to treat a diagnosis of a | ||
| serious mental illness. | ||
| (c) A health benefit plan that provides coverage for | ||
| prescription drugs to treat a serious mental illness may not | ||
| require, before the health benefit plan provides coverage of a | ||
| prescription drug approved by the United States Food and Drug | ||
| Administration, that the enrollee: | ||
| (1) fail to successfully respond to more than one | ||
| different drug for each drug prescribed, excluding the generic or | ||
| pharmaceutical equivalent of the prescribed drug; or | ||
| (2) prove a history of failure of more than one | ||
| different drug for each drug prescribed, excluding the generic or | ||
| pharmaceutical equivalent of the prescribed drug. | ||
| (d) Subject to Section 1369.0546, a health benefit plan | ||
| issuer may implement a step therapy protocol to require a trial of a | ||
| generic or pharmaceutical equivalent of a prescribed prescription | ||
| drug as a condition of continued coverage of the prescribed drug | ||
| only: | ||
| (1) once in a plan year; and | ||
| (2) if the generic or pharmaceutical equivalent drug | ||
| is added to the plan's drug formulary. | ||
| SECTION 2. This Act applies only to a health benefit plan | ||
| delivered, issued for delivery, or renewed on or after January 1, | ||
| 2024. A health benefit plan delivered, issued for delivery, or | ||
| renewed before January 1, 2024, is governed by the law as it existed | ||
| immediately before the effective date of this Act, and that law is | ||
| continued in effect for that purpose. | ||
| SECTION 3. This Act takes effect September 1, 2023. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I certify that H.B. No. 1337 was passed by the House on April | ||
| 12, 2023, by the following vote: Yeas 146, Nays 1, 2 present, not | ||
| voting. | ||
| ______________________________ | ||
| Chief Clerk of the House | ||
| I certify that H.B. No. 1337 was passed by the Senate on May | ||
| 23, 2023, by the following vote: Yeas 31, Nays 0. | ||
| ______________________________ | ||
| Secretary of the Senate | ||
| APPROVED: _____________________ | ||
| Date | ||
| _____________________ | ||
| Governor | ||
