HB2412 - Relating to health benefit plan coverage for certain obesity medications.

  89R11882 SCF-D     By: Bucy H.B. No. 2412       A BILL TO BE ENTITLED   AN ACT   relating to health benefit plan coverage for certain obesity   medications.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 1369, Insurance Code, is amended by   adding Subchapter R to read as follows:   SUBCHAPTER R.   COVERAGE FOR CERTAIN OBESITY MEDICATIONS           Sec.   1369.781.     APPLICABILITY OF SUBCHAPTER. (a) This   subchapter applies only to a health benefit plan that provides   benefits for medical or surgical expenses incurred as a result of a   health condition, accident, or sickness, including an individual,   group, blanket, or franchise insurance policy or insurance   agreement, a group hospital service contract, or an individual or   group evidence of coverage or similar coverage document that is   issued by:                 (1)  an insurance company;                 (2)     a group hospital service corporation operating   under Chapter 842;                 (3)     a health maintenance organization operating under   Chapter 843;                 (4)     an approved nonprofit health corporation that   holds a certificate of authority under Chapter 844;                 (5)     a multiple employer welfare arrangement that holds   a certificate of authority under Chapter 846;                 (6)     a stipulated premium company operating under   Chapter 884;                 (7)     a fraternal benefit society operating under   Chapter 885;                 (8)  a Lloyd's plan operating under Chapter 941; or                 (9)  an exchange operating under Chapter 942.           (b)     Notwithstanding any other law, this subchapter applies   to:                 (1)  a basic coverage plan under Chapter 1551;                 (2)  a basic plan under Chapter 1575;                 (3)     a primary care coverage plan under Chapter 1579;   and                 (4)     the state Medicaid program, including the Medicaid   managed care program operated under Chapter 540, Government Code.           Sec.   1369.782.     COVERAGE REQUIRED FOR CERTAIN OBESITY   MEDICATIONS. A health benefit plan that provides prescription drug   benefits must provide coverage for a prescription drug that is a   glucagon-like peptide-1 receptor agonist to treat obesity.          SECTION 2.  If before implementing any provision of this Act   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 shall request the waiver or   authorization and may delay implementing that provision until the   waiver or authorization is granted.          SECTION 3.  Subchapter R, Chapter 1369, Insurance Code, as   added by this Act, applies only to a health benefit plan delivered,   issued for delivery, or renewed on or after January 1, 2026.          SECTION 4.  This Act takes effect September 1, 2025.