{"data":{"id":"us-tx/tex.-insurance-code-1369.453","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1369.453","heading":"APPLICABILITY TO CERTAIN MEDICATIONS.","body":"This subchapter applies with respect to only a medication that:\n(1) is covered by the enrollee's health benefit plan;\n(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;\n(3) is used for treatment and management of a chronic illness, as that term is defined by Section 1369.456;\n(4) may be prescribed with refills;\n(5) is a formulation that can be effectively dispensed in accordance with the medication synchronization plan described by Section 1369.456; and\n(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:\n(A) a Schedule II controlled substance; or\n(B) a Schedule III controlled substance containing hydrocodone.\nAdded by Acts 2017, 85th Leg., R.S., Ch. 1007 (H.B. 1296), Sec. 1, eff. September 1, 2017.","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 J. COVERAGE RELATED TO PRESCRIPTION DRUG SYNCHRONIZATION"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.453","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"2b60fa84f625e1e08d42621def5e40443ccde1c2403c885e134aaaf09991c8ab","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1369.452","next":"us-tx/tex.-insurance-code-1369.454"},"notice":"GroundRules: Original legal text. Not legal advice."}