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HB 12 (Rose) Relating to the duration of services provided under Medicaid to women following a pregnancy

  • 12 months of Medicaid coverage for eligible pregnant women beginning on the last day of pregnancy
  • HB 12 passed both chambers and is now heading to the Governor’s desk

HB 25 (Talarico) Relating to wholesale importation of prescription drugs in this state; authorizing a fee

  • Would create the Wholesale Prescription Drug Importation Program in Texas, requiring the Texas State Board of Pharmacy to work with state drug wholesalers to import eligible prescription drugs from Canada
  • HHSC would be required to contract with one or more prescription drug wholesalers and Canadian suppliers with the goal of providing prescription cost savings to consumers
  • Plans, providers, and pharmacies would be subject to a registration process to dispense drugs under the program
  • HHSC is also required to develop a list of prescriptions under the program along with pricing info
  • Eligible drugs would not include controlled substances, biological products, infusions, intravenous drugs, drug inhaled during surgery, or parenteral drugs
  • HHSC can impose a fee on each prescription drug sold under the program
  • Annual reporting is required
  • HB 25 passed both chambers and is now heading to the Governor’s desk

HB 44 (Swanson) Relating to provider discrimination against a Medicaid recipient or child health plan program enrollee based on immunization status

  • Medicaid providers may not refuse to provide health care services to Medicaid recipients based solely on refusal or failure to vaccinate for a particular infectious or communicable disease
  • Providers can adopt policies requiring some or all patients to be vaccinated against a particular disease, but must accept conscience and medical exemptions
  • HHSC may not reimburse any individual physician who violates the provision; reimbursement is not stopped to physicians who are in a provider group or medical organization with another member physician who did violate the provision
  • Oncology and organ transplant services specialist providers are exempted
  • HB 44 passed both chambers and is now heading to the Governor’s desk

HB 109 (Johnson, Julie) Relating to health benefit coverage for hearing aids for children and adults

  • Prohibits plans from denying claims for a hearing aid solely on the basis that it costs more than the benefit is worth; plans would only pay up to the amount the benefit is worth for any hearing aid costing more than the benefit
  • HB 109 passed both chambers and is now heading to the Governor’s desk

HB 181 (Johnson, Jarvis) Relating to the establishment of the sickle cell disease registry

  • Creates the sickle cell disease registry including a record of cases that occur in the state; requires data reporting from health care facilities in a manner prescribed by DSHS
  • HB 181 passed both chambers and is now heading to the Governor’s desk

HB 400 (Klick) Relating to innovation grant programs to support residency training programs in psychiatric specialty fields and recruitment, training, and retention programs in behavioral health fields

  • Innovation Grant program under THECB to medical schools that administer innovative residency training programs designed to increase the number of physicians in this state who specialize in pediatric or adult psychiatric care
  • HB 400 passed both chambers and is now heading to the Governor’s desk

HB 617 (Darby) Relating to a pilot project to provide emergency telemedicine medical services and telehealth services in rural areas

  • Creates a pilot program for Next Gen 911 telehealth and telemedicine services in rural areas in concert with the Commission on State Emergency Communications (CSEC) and Texas Tech Health Services Center
  • CSEC is to report on finding of the pilot by Dec. 31, 2028
  • HB 617 passed both chambers and is now heading to the Governor’s desk

HB 711 (Frank) Relating to certain contract provisions and conduct affecting health care provider networks.

  • Prohibits certain clauses in provider network contracts including anti-steering clauses, anti-tiering clauses, gag clauses relating to price or quality info, and provisions restricting insurers and providers from giving better rates to other insurers and providers
  • HB 711 passed both chambers and is now heading to the Governor’s desk

HB 755 (Johnson, Julie) Relating to prior authorization for prescription drug benefits related to the treatment of autoimmune diseases and certain blood disorders.

  • No more than one prior authorization annually for an enrollee with a prescription to treat an autoimmune disease, hemophilia, or Von Willebrand disease
  • Exceptions for opioids, benzodiazepines, barbiturates, or carisoprodol, drugs with a typical treatment period of less than 12 months, drugs with a box warning, or off label use
  • HB 755 passed both chambers and is now heading to the Governor’s desk

HB 999 (Price) Relating to the effect of certain reductions in a health benefit plan enrollee’s out-of-pocket expenses for certain prescription drugs on enrollee cost-sharing requirements

  • Requires plans and PBMs to apply coupons or other reductions made on behalf of an enrollee to the enrollee’s copay, cost sharing, or out-of-pocket
  • Applies on to covered drugs where a generic doesn’t exist, a biosimilar doesn’t exist, or where they do exist and the enrollee obtained access via PA, step therapy, or the exceptions and appeals process
  • HB 999 passed both chambers and is now heading to the Governor’s desk

HB 1283 (Oliverson) Relating to prescription drug formularies applicable to the Medicaid managed care program

  • Extends the single state formulary to August 31, 2033
  • HB 1283 passed both chambers and is now heading to the Governor’s desk

HB 1337 (Hull) Relating to step therapy protocols required by health benefit plans for coverage of prescription drugs for serious mental illnesses

  • Prohibits step therapy for drugs prescribed to treat serious mental illness in enrollees 18 or older 
  • Step therapy using generics or equivalents can only be required once in a plan year and if that generic or equivalent is on the plan’s drug formulary
  • HB 1337 passed both chambers and is now heading to the Governor’s desk

HB 1488 (Rose) Relating to sickle cell disease health care improvement and the sickle cell task force

  • Requires HHSC, in collaboration with the Sickle Cell Task Force, to support initiatives to promote health care services for plan enrollees diagnosed with sickle cell disease and bolster sickle cell education for providers
  • HHSC is also directed to identify opportunities for improving health outcomes of those diagnosed with sickle cell via reducing hospital admissions and connecting those diagnosed to a health home or expert
  • Sickle Cell Task Force membership is modified to include TEA representative, health care professional with research experience, etc.
  • Sickle cell info to be included in certain medical school and graduate medical education curriculums
  • TEA is directed to distribute info on sickle cell disease to schools
  • HB 1488 passed both chambers and is now heading to the Governor’s desk

HB 1527 (Oliverson) Relating to the relationship between dentists and certain employee benefit plans and health insurers

  • Limits recovery of overpayments and requires plans to allow for challenges by dentists
  • Prevents disallowable clauses in contracts with dentists
  • Plans are required to allow dentists to elect not to participate in third party access to contracts or elect not to enter into contracts directly with the third party
  • HB 1527 passed both chambers and is now heading to the Governor’s desk

HB 1647 (Harris, Cody) Relating to health benefit plan coverage of clinician-administered drugs

  • For clinician-administered drugs for enrollees with complex, rare, or life-threatening medical conditions, plans would be prohibited from requiring exclusive use of certain pharmacies or in-network pharmacies, limiting coverage based on choice of pharmacy, requiring billing or reimbursement under the pharmacy benefit without consent, or require higher fees, copay, etc. based on choice of pharmacy
  • These requirements are only prohibited when delay or barriers would impact that care or health of the enrollee with complex, rare, or life-threatening medical conditions
  • HB 1647 passed both chambers and is now heading to the Governor’s desk

HB 2478 (Klick) Relating to newborn and infant screening tests

  • Annual newborn screening report that identifies any additional resources needed and summarize a plan for DSHS to implement additional newborn screening tests
  • Requires congenital cytomegalovirus testing if a newborn fails a hearing screening under the Newborn Hearing, Screening, Tracking, and Intervention Program
  • HB 2478 passed both chambers and is now heading to the Governor’s desk

HB 3286 (Klick) Relating to prescription drug benefits under Medicaid and the child health plan program

  • Directs HHSC to adopt rules allowing exceptions to the Preferred Drug List; exceptions include:
    • For drugs on the PDL when 1) the preferred drug is contraindicated, 2) they will likely cause an adverse reaction, or 3) the drug is expected to be ineffective
    • For drugs previously taken by the recipient if the drug 1) was not effective 2) had diminished effect or 3) resulted in an adverse events
    • When the recipient is taking an antidepressant or antipsychotic non-preferred drug and 1) the non-preferred drug was prescribed before being discharged 2) is stable on the non-preferred drug or 3) is at risk of complications from switching medicine
    • For drugs not available for reasons outside the MCO’s control because 1) the drug is in short supply or 2) the manufacturer has placed it on backorder or allocation
  • The bill would also require HHSC to ensure that the vendor drug program includes all drugs and national drug codes made available on the federal Medicaid Drug Rebate Program
  •  According to the Health and Human Services Commission, the bill could result in a reduction of federal and supplemental rebates due to a shift towards higher net cost nonpreferred drugs
  • HB 3286 passed both chambers and is now heading to the Governor’s desk

HB 3359 (Bonnen) Relating to network adequacy standards and other requirements for preferred provider benefit plans

  • Seeks to codify measurable network adequacy standards for preferred provider benefit plans and require carriers to meet these standards prior to offering the networks
  • Requires public hearings for waiver requests and limits the number of waivers allowed by TDI
  • HB 3359 passed both chambers and is now heading to the Governor’s desk

HB 4166 (Klick) Relating to the redistribution of donated prepackaged prescription drugs

  • Expands drug donations to include original, unopened, sealed, and tamper-evident bottles or containers; previously only unit-dose packaging was allowed
  • HB 4166 passed both chambers and is now heading to the Governor’s desk

HB 4331 (Klick) Relating to the donors of certain unused prescription drugs

  • Expands drug donations to include manufacturers, health care facilities, and pharmacies
  • HB 4331 passed both chambers and is now heading to the Governor’s desk

HB 4332 (Klick) Relating to the redistribution of donated prepackaged prescription drugs

  • Allows for redistribution of donated prepackaged drugs by participating providers
  • HB 4332 passed both chambers and is now heading to the Governor’s desk

HB 4500 (Harris, Caroline) Relating to electronic verification of health benefits by health benefit plan issuers for certain physicians and health care providers.

  • Requires plans to maintain a secure system accessible by physicians and providers detailing whether a patient is covered under the plan and any deductible, copay, or coinsurance for the patient
  • Plans can provide the system through existing websites or through contracted 3rd party portals
  • HB 4500 passed both chambers and is now heading to the Governor’s desk

HB 4990 (Bonnen) Relating to the Texas Pharmaceutical Initiative and a governing board and advisory council for the initiative.

  • Establishes the Texas Pharmacy Initiative with the goal of developing a business plan detailing, among other administrative matters, establishing or contracting for statewide PBM services, operation of or contracting for a distribution network, manufacturing generic drugs and biosimilars, providing gene therapies, and providing advanced labs for drug research
  • HB 4990 passed both chambers and is now heading to the Governor’s desk

SB 24 (Kolkhorst) Relating to the powers and duties of the Health and Human Services Commission and the transfer to the commission of certain powers and duties from the Department of Family and Protective Services

  • Transfers Early Childhood Intervention Services, Child Abuse Neglect Prevention Trust Fund, Community Youth Development Grant Program, the Nurse-Family Partnership Competitive Grant Program, and the Texas Home Visiting Program from DFPS to HHSC
  • Codifies the Alternatives to Abortion program and renames it the Thriving Texas Families Program
  • SB 24 passed both chambers and is now heading to the Governor’s desk

SB 622 (Parker) Relating to the disclosure of certain prescription drug information by a health benefit plan

  • Requires health plans covering prescription drugs to provide certain cost info to an enrollee or enrollee’s providers upon request; the info provided must include the issuer’s drug formulary and, for the prescription drug and any formulary alternative, the enrollee’s eligibility, applicable utilization management requirements, and cost-sharing information, including any deductible, copayment, or coinsurance
  • Carries timeline and expediency requirements
  • A House amendment removed nonprofit agricultural organization health benefits from the bill
  • SB 622 passed both chambers and is now heading to the Governor’s desk

SB 773 (Parker) Relating to access to certain investigational drugs, biological products, and devices used in clinical trials by patients with severe chronic diseases

  • Permits use of investigational drugs, biological products, and devices for patients with severe chronic illness; does not include low-THC cannabis
  • SB 773 passed both chambers and is now heading to the Governor’s desk

SB 833 (King) Relating to consideration by insurers of certain prohibited criteria for ratemaking

  • Prohibits insurance companies doing business in Texas from using an environmental, social, or governance model, score, factor, or standard to charge a rate different than the rate charged to another business or risk in the same class for essentially the same hazard
  • SB 833 passed both chambers and is now heading to the Governor’s desk

SB 2289/SJR 87 (Huffman) Relating to the exemption from ad valorem taxation of equipment or inventory held by a manufacturer of medical or biomedical products to protect the Texas healthcare network and strengthen our medical supply chain

  • Exempts medical or biomedical property located in a medical or biomedical manufacturing facility from property taxation
  • Medical or biomedical property includes devices, therapeutics, pharmaceuticals, personal protective equipment, manufacturing items, component parts, etc.
  • SJR 87 would be submitted to voters at the November 7, 2023 election
  • SB 2289 passed both chambers and is now heading to the Governor’s desk; the bill will be effective upon passage of its constitutional amendment