Tex. Ins. Code § 1369.453

Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.

Section 1369.453 - Applicability to Certain Medications

This subchapter applies with respect to only a medication that:

(1) is covered by the enrollee's health benefit plan;

(2) meets the prior authorization criteria specifically applicable to the medication under the health benefit plan on the date the request for synchronization is made;

(3) is used for treatment and management of a chronic illness, as that term is defined by Section 1369.456;

(4) may be prescribed with refills;

(5) is a formulation that can be effectively dispensed in accordance with the medication synchronization plan described by Section 1369.456; and

(6) is not, according to the schedules established by the commissioner of the Department of State Health Services under Chapter 481, Health and Safety Code:

(A) a Schedule II controlled substance; or

(B) a Schedule III controlled substance containing hydrocodone.

Tex. Ins. Code § 1369.453

Added by Acts 2017, Texas Acts of the 85th Leg. - Regular Session, ch. 1007,Sec. 1, eff. 9/1/2017.