By: Menéndez S.B. No. 1525

(In the Senate - Filed February 21, 2025; March 6, 2025, read first time and referred to Committee on Health & Human Services; May 5, 2025, reported adversely, with favorable Committee Substitute by the following vote: Yeas 9, Nays 0; May 5, 2025, sent to printer.) Click here to see the committee vote

COMMITTEE SUBSTITUTE FOR S.B. No. 1525 By: Perry

A BILL TO BE ENTITLED

AN ACT

relating to prior authorization for prescription drug benefits related to the treatment of neurodegenerative diseases.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. The heading to Subchapter N, Chapter 1369, Insurance Code, is amended to read as follows:

SUBCHAPTER N. COVERAGE OF PRESCRIPTION DRUGS FOR AUTOIMMUNE AND

NEURODEGENERATIVE DISEASES AND CERTAIN BLOOD DISORDERS

SECTION 2. Section 1369.654, Insurance Code, is amended by amending Subsection (a) and adding Subsection (c) to read as follows:

(a) A health benefit plan issuer that provides prescription drug benefits may not require an enrollee to receive more than one prior authorization annually of the prescription drug benefit for a prescription drug prescribed to treat an autoimmune disease, a neurodegenerative disease, hemophilia, or Von Willebrand disease.

(c) Notwithstanding Subsection (a), a health benefit plan issuer may require an enrollee who is prescribed a new prescription drug to treat a neurodegenerative disease to obtain a prior authorization for the prescription drug.

SECTION 3. The change in law made by this Act applies only to a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2026. A health benefit plan delivered, issued for delivery, or renewed before January 1, 2026, is governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose.

SECTION 4. This Act takes effect September 1, 2025.

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