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A BILL TO BE ENTITLED
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AN ACT
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relating to network standards for Chimeric Antigen Receptor T-Cell |
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(CAR T) therapy. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Title 8, Subtitle E, Insurance Code, is amended |
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to create Chapter 1381 as follows: |
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TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES |
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CHAPTER 1381. NETWORK STANDARDS FOR CAR T THERAPY |
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Sec. 1381.001. PURPOSE. The purpose of this Chapter is to |
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expand access to Chimeric Antigen Receptor T-Cell (CAR T) therapy |
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by allowing the cancer treatment, if covered by a health benefit |
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plan, to be provided in any CAR T treatment center that qualifies as |
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a certified healthcare facility in accordance with the Food and |
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Drug Administration label governing safety certification, staff |
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training, adverse event management, patient monitoring, and data |
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collection. |
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Sec. 1381.002. APPLICABILITY OF CHAPTER. (a) This chapter |
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applies only to a health benefit plan that provides benefits for |
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medical or surgical expenses incurred as a result of a health |
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condition, accident, or sickness, including an individual, group, |
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blanket, or franchise insurance policy or insurance agreement, a |
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group hospital service contract, or an individual or group evidence |
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of coverage or similar coverage document that is offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating under |
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Chapter 842; |
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(3) a health maintenance organization operating under |
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Chapter 843; |
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(4) an approved nonprofit health corporation that holds a |
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certificate of authority under Chapter 844; |
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(5) a multiple employer welfare arrangement that holds a |
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certificate of authority under Chapter 846; |
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(6) a stipulated premium company operating under Chapter |
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884; |
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(7) a fraternal benefit society operating under Chapter |
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885; |
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(8) a Lloyd's plan operating under Chapter 941; or |
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(9) an exchange operating under Chapter 942. |
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(b) Notwithstanding any other law, this chapter applies to: |
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(1) a small employer health benefit plan subject to Chapter |
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1501, including coverage provided through a health group |
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cooperative under Subchapter B of that chapter; |
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(2) a standard health benefit plan issued under Chapter |
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1507; |
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(3) a basic coverage plan under Chapter 1551; |
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(4) a basic plan under Chapter 1575; |
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(5) a primary care coverage plan under Chapter 1579; |
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(6) a plan providing basic coverage under Chapter 1601; and |
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(7) a self-funded health benefit plan sponsored by a |
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professional employer organization under Chapter 91, Labor Code. |
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Sec. 1381.003. NETWORK STANDARDS. (a) No health benefit |
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plan in the state that provides coverage for Chimeric Antigen |
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Receptor T-Cell (CAR T) therapy may refuse to contract for the |
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administration of any CAR T therapy by any provider that qualifies |
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as a certified healthcare facility in accordance with approved |
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procedure under the CAR-T product license by the FDA. |
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(b) No health benefit plan in the state that covers CAR T |
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therapy may deny coverage for the administration of any CAR T |
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therapy by any provider that qualifies as a certified healthcare |
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facility in accordance with approved procedure under the CAR-T |
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product license by the FDA. |
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(c) This section shall apply to any health benefit plan that |
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is delivered, issued for delivery, or renewed on or after January 1, |
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2026. |
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Sec. 1381.003. RULES. The commissioner shall adopt rules as |
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necessary to administer this chapter. |
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SECTION 2. This Act takes effect September 1, 2025. |