SRC-TBR S.B. 804 77(R)   BILL ANALYSIS


Senate Research Center   S.B. 804
77R6976 DLF-DBy: Madla
Business & Commerce
3/16/2001
As Filed


DIGEST AND PURPOSE 

Current Texas law requires health benefit plans to provide enrollees with
continuous access to prescribed formulary drugs at the same benefit level
until the enrollee's plan renewal date, even if the drug has been removed
from the formulary.  As proposed, S.B. 804 narrows the scope of current law
and requires health plans to provide enrollees with access to prescription
drugs that were prescribed for an enrollee during the plan year.  Such
prescriptions would have to be available at the contracted benefit level
until the enrollee's plan renewal date, whether or not the prescribed drug
has been removed from the health benefit plan's drug formulary. 
 
RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a
state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 4, Article 21.52J, Insurance Code, by amending
Subsection (a) and adding Subsection (c) as follows, 

(a)  Requires, except as provided by Subsection (c), a group health benefit
plan that offers prescription drug benefits to make a prescription drug
that was prescribed for an enrollee during the plan year available to the
enrollee at the contracted benefit level until the enrollee's plan renewal
date, regardless of whether the prescribed drug has been removed from the
health benefit plan's drug formulary. 

(c)  Provides that Subsection (a) of this section does not require a group
health benefit plan to continue to provide prescription drug benefits for a
prescription drug if certain requirements are met. 

SECTION 2.  Effective date:September 1, 2001.
    Makes application of this Act prospective.