1-1     By:  Madla                                             S.B. No. 804
 1-2           (In the Senate - Filed February 20, 2001; February 21, 2001,
 1-3     read first time and referred to Committee on Business and Commerce;
 1-4     March 26, 2001, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 6, Nays 0; March 26, 2001,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 804                By:  Shapleigh
 1-8                            A BILL TO BE ENTITLED
 1-9                                   AN ACT
1-10     relating to continuation of benefits for prescription drugs under
1-11     certain group health benefit plans.
1-12           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13           SECTION 1.  Section 3, Article 21.52J, Insurance Code, is
1-14     amended to read as follows:
1-15           Sec. 3.  DISCLOSURE OF DRUG FORMULARY REQUIRED. A group
1-16     health benefit plan that covers prescription drugs and that uses
1-17     one or more drug formularies to specify which prescription drugs
1-18     the plan will cover shall:
1-19                 (1)  provide to each enrollee in plain language in the
1-20     coverage documentation provided to the enrollee:
1-21                       (A)  notice that the plan uses one or more drug
1-22     formularies;
1-23                       (B)  an explanation of what a drug formulary is;
1-24                       (C)  a statement regarding the method the plan
1-25     uses to determine which prescription drugs are included in or
1-26     excluded from a drug formulary;
1-27                       (D)  a statement of how often the plan reviews
1-28     the contents of each drug formulary; [and]
1-29                       (E)  notice that the enrollee may contact the
1-30     plan to find out if a specific drug is on a particular drug
1-31     formulary; and
1-32                       (F)  a statement of the enrollee's right to
1-33     complain in a circumstance in which benefits for a drug are denied
1-34     because the drug is not included in the plan's drug formulary,
1-35     including the enrollee's rights under Section 4(c) of this article;
1-36                 (2)  disclose to any individual on request, not later
1-37     than the third business day after the date of the request, whether
1-38     a specific drug is on a particular drug formulary; and
1-39                 (3)  notify an enrollee or any other individual who
1-40     requests information about a drug formulary under this section that
1-41     the presence of a drug on a drug formulary does not guarantee that
1-42     an enrollee's health care provider will prescribe that drug for a
1-43     particular medical condition or mental illness.
1-44           SECTION 2.  Section 4, Article 21.52J, Insurance Code, is
1-45     amended by amending Subsection (a) and adding Subsections (c) and
1-46     (d) to read as follows:
1-47           (a)  Except as provided by Subsection (d), a [A] group health
1-48     benefit plan that offers prescription drug benefits shall make a
1-49     prescription drug that, at the beginning of the plan year, was
1-50     included on the health benefit plan's drug formulary [approved or
1-51     covered for a medical condition or mental illness] available to an
1-52     [each] enrollee at the contracted benefit level for that
1-53     prescription drug until the enrollee's plan renewal date,
1-54     regardless of whether the prescribed drug has been removed from the
1-55     health benefit plan's drug formulary, if:
1-56                 (1)  the drug was at any time previously prescribed to
1-57     the enrollee and provided under the plan, regardless of whether the
1-58     drug was prescribed during that plan year; or
1-59                 (2)  the enrollee can demonstrate, in accordance with
1-60     Subsection (c) of this section, that the drug was at any time
1-61     previously prescribed to the enrollee.
1-62           (c)  An enrollee who is denied benefits for a prescription
1-63     drug because the drug has been removed from the group health
1-64     benefit plan's drug formulary during a plan year and who believes
 2-1     the benefits are required under Subsection (a)(2) of this section
 2-2     may file a complaint in accordance with the complaint procedures of
 2-3     the group health benefit plan.  On an initial showing by the
 2-4     enrollee that the drug was previously prescribed at any time to the
 2-5     enrollee, the group health benefit plan shall provide the benefits
 2-6     at the contracted benefit level from the date the benefits were
 2-7     initially requested until the enrollee's plan renewal date.  An
 2-8     initial showing under this subsection may be made by any means that
 2-9     demonstrates that a prescription drug was previously prescribed to
2-10     an enrollee, including a copy of a prescription or a letter or
2-11     other appropriate documentation from the physician who prescribed
2-12     the drug or pharmacist who distributed the drug.
2-13           (d)  Subsection (a)  of this section does not require a group
2-14     health benefit plan to continue to provide prescription drug
2-15     benefits for a prescription drug if:
2-16                 (1)  the United States Food and Drug Administration
2-17     prohibits:
2-18                       (A)  the sale or use of the drug; or
2-19                       (B)  the use of the drug as prescribed to an
2-20     enrollee; or
2-21                 (2)  the United States Food and Drug Administration or
2-22     the drug's manufacturer identifies a side effect, adverse reaction,
2-23     or other health risk associated with the drug that:
2-24                       (A)  was unknown at the time the drug was
2-25     prescribed to the enrollee; or
2-26                       (B)  is substantially more severe, as determined
2-27     under rules adopted by the commissioner, than was believed at the
2-28     time the drug was prescribed to the enrollee.
2-29           SECTION 3.  Section 6, Article 21.52J, Insurance Code, is
2-30     amended to read as follows:
2-31           Sec. 6.  RULES.  The commissioner may adopt rules to
2-32     implement this article, including rules governing documents or
2-33     other evidence that must be accepted under Section 4(c) of this
2-34     article by a group health benefit plan as an initial showing that a
2-35     drug was at any time previously prescribed to an enrollee.
2-36           SECTION 4.  This Act takes effect September 1, 2001, and
2-37     applies only to a group health benefit plan that is delivered,
2-38     issued for delivery, or renewed on or after January 1, 2002.  A
2-39     group health benefit plan that is delivered, issued for delivery,
2-40     or renewed before January 1, 2002,  is governed by the law as it
2-41     existed immediately before the effective date of this Act, and that
2-42     law is continued in effect for this purpose.
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