Tex. Insurance Code § 1369.453: APPLICABILITY TO CERTAIN MEDICATIONS.
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 J. COVERAGE RELATED TO PRESCRIPTION DRUG SYNCHRONIZATION
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.
Added by Acts 2017, 85th Leg., R.S., Ch. 1007 (H.B. 1296), Sec. 1, eff. September 1, 2017.
Collected 2026-08-27T01:47:21Z. Source file · JSON