{"data":{"id":"us-tx/tex.-insurance-code-1369.353","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1369.353","heading":"CRITERIA FOR DRUGS ON MAXIMUM ALLOWABLE COST LISTS.","body":"A health benefit plan issuer or pharmacy benefit manager may not include a drug on a maximum allowable cost list unless:\n(1) the drug:\n(A) has an \"A\" or \"B\" rating in the most recent version of the United States Food and Drug Administration's Approved Drug Products with Therapeutic Equivalence Evaluations, also known as the Orange Book; or\n(B) is rated \"NR\" or \"NA\" or has a similar rating by a nationally recognized reference; and\n(2) the drug is:\n(A) generally available for purchase by pharmacists and pharmacies in this state from a national or regional wholesaler; and\n(B) not obsolete.\nAdded by Acts 2015, 84th Leg., R.S., Ch. 596 (S.B. 332), Sec. 1, eff. January 1, 2016.","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 H. MAXIMUM ALLOWABLE COST"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.353","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"4030ee0dad1caecf693624798e328f5e6eb15b82934e1e3134072e7d5aca1c86","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1369.352","next":"us-tx/tex.-insurance-code-1369.354"},"notice":"GroundRules: Original legal text. Not legal advice."}