BILL ANALYSIS

H.B. 1680

By: Jones, Venton

Insurance

Committee Report (Unamended)

BACKGROUND AND PURPOSE

In the 2022 Texas HIV Program Annual Report, the Texas Health and Human Services Commission reports that over 100,000 individuals lived with HIV in 2022, with approximately 5,000 new cases being diagnosed in that year, and that HIV prevention through access to proven intervention, including pre-exposure prophylaxis (PrEP), is a pillar of the federal initiative to end the HIV epidemic. The bill author has informed the committee that prior authorization creates unnecessary delays and obstacles, compelling patients to prove their need for HIV prevention, thus discouraging PrEP use and contributing to the continued spread of the virus. H.B. 1680 seeks to streamline access to PrEP and facilitate a more effective public health response to end the HIV epidemic in Texas by prohibiting prior authorization requirements for prescription drugs prescribed to prevent HIV infection.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 1680 amends the Insurance Code to prohibit a health benefit plan issuer that provides prescription drug benefits from requiring an enrollee to receive a prior authorization of the prescription drug benefit for a prescription drug prescribed to prevent human immunodeficiency virus (HIV) infection. For this purpose, "prescription drug" has the meaning assigned to that term under the Texas Pharmacy Act.

H.B. 1680 specifies the types of plans to which its provisions apply and establishes that its provisions apply to coverage under a group health benefit plan provided to a Texas resident regardless of whether the group policy, agreement, or contract is delivered, issued for delivery, or renewed in Texas. The bill's provisions do not apply to an individual health benefit plan issued on or before March 23, 2010, that has not had any significant changes since that date that reduce benefits or increase costs to the individual.

H.B. 1680 applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2026. If before implementing any of the bill's provisions a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision must request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

EFFECTIVE DATE

September 1, 2025.