Tex. Insurance Code § 1369.213: PROHIBITED CONDUCT.
Where this section sits in the code
- INSURANCE CODE
- TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
- SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
- CHAPTER 1369. BENEFITS RELATED TO PRESCRIPTION DRUGS AND DEVICES AND RELATED SERVICES
- 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