{"data":{"id":"us-tx/tex.-insurance-code-1369.213","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1369.213","heading":"PROHIBITED CONDUCT.","body":"(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:\n(1) fail to successfully respond to a different drug; or\n(2) prove a history of failure of a different drug.\n(b) This section applies only to a drug the use of which is:\n(1) consistent with best practices for the treatment of stage-four advanced, metastatic cancer or an associated condition;\n(2) supported by peer-reviewed, evidence-based literature; and\n(3) approved by the United States Food and Drug Administration.\nAdded by Acts 2019, 86th Leg., R.S., Ch. 1350 (H.B. 1584), Sec. 1, eff. September 1, 2019.","path":["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"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.213","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"383947846c7b24e89546bb58a4fd8c53eda3875f8c7911fe07783e40a14fe61f","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1369.212","next":"us-tx/tex.-insurance-code-1369.221"},"notice":"GroundRules: Original legal text. Not legal advice."}