GroundRules
← Search the law
Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1369.213: PROHIBITED CONDUCT.

Read at publisher ↗
Where this section sits in the code
  1. INSURANCE CODE
  2. TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
  3. SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
  4. CHAPTER 1369. BENEFITS RELATED TO PRESCRIPTION DRUGS AND DEVICES AND RELATED SERVICES
  5. SUBCHAPTER E-1. COVERAGE OF PRESCRIPTION DRUGS FOR STAGE-FOUR ADVANCED, METASTATIC CANCER

(a) A health benefit plan that provides coverage for stage-four advanced, metastatic cancer and associated conditions 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 a different drug; or

(2) prove a history of failure of a different drug.

(b) This section applies only to a drug the use of which is:

(1) consistent with best practices for the treatment of stage-four advanced, metastatic cancer or an associated condition;

(2) supported by peer-reviewed, evidence-based literature; and

(3) approved by the United States Food and Drug Administration.

Added by Acts 2019, 86th Leg., R.S., Ch. 1350 (H.B. 1584), Sec. 1, eff. September 1, 2019.

Collected 2026-08-27T01:47:21Z. Source file · JSON

Browse this collection