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Senate Bill 644 |
Senate Author: Huffman |
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Effective: 9-1-13 |
House Sponsor: Zerwas |
Senate Bill 644 amends the Insurance Code to require the commissioner of insurance by rule to prescribe a single, standard form not later than January 1, 2015, for requesting prior authorization of prescription drug benefits and, in prescribing the form, to take into consideration certain existing forms and standards. The bill requires the commissioner by rule to require a health benefit plan issuer or the issuer's agent that manages or administers prescription drug benefits to use the form for any prior authorization of prescription drug benefits required by the plan and to require that the Texas Department of Insurance and a health benefit plan issuer or the issuer's agent that manages or administers prescription drug benefits make the form available electronically on their respective websites. The bill requires the commissioner by rule to establish penalties for failure to accept the form and acknowledge receipt of the form as required by commissioner rule.
Senate Bill 644 requires a health benefit plan issuer or the issuer's agent that manages or administers prescription drug benefits, not later than the second anniversary of the date national standards for electronic prior authorization of benefits are adopted, to exchange prior authorization requests electronically with a prescribing provider who has e-prescribing capability and who initiates a request electronically.
Senate Bill 644 requires the commissioner to appoint a committee to advise the commissioner on the technical, operational, and practical aspects of developing the standard prior authorization form. The bill sets out provisions relating to the duties, composition, and operation of the advisory committee. The bill also requires the commissioner to convene the advisory committee, not later than the second anniversary of the final approval of the standard prior authorization form, to review the standard prior authorization form, examine the form's effectiveness and impact on patient safety, and determine whether changes are needed. The bill specifies the types of health benefit plans and programs to which the bill's provisions apply and makes such provisions applicable only to a request for prior authorization of prescription drug benefits made on or after September 1, 2015.