Texas HB4674 modifies prescription drug benefits and coverage for certain health benefit plans.

Texas HB4674 amends the Insurance Code to modify prescription drug benefits and coverage for certain health benefit plans. The bill prohibits health benefit plan issuers from modifying certain prescription drug benefits and coverage on renewal, unless specific conditions are met. Modifications that require notice include removing a drug from a formulary, adding prior authorization requirements, altering quantity limits, imposing step-therapy restrictions, moving a drug to a higher cost-sharing tier, increasing out-of-pocket expenses, and reducing the maximum drug coverage amount.

Texas HB4674 modifies prescription drug benefits and coverage for certain health benefit plans.

Texas HB4674 amends the Insurance Code to modify prescription drug benefits and coverage for certain health benefit plans. The bill prohibits health benefit plan issuers from modifying certain prescription drug benefits and coverage on renewal, unless specific conditions are met. Modifications that require notice include removing a drug from a formulary, adding prior authorization requirements, altering quantity limits, imposing step-therapy restrictions, moving a drug to a higher cost-sharing tier, increasing out-of-pocket expenses, and reducing the maximum drug coverage amount.