| 1 | 1 | | 88R15189 CJD-D |
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| 2 | 2 | | By: Talarico H.B. No. 4798 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to governmental health benefit plan coverage for opioid |
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| 8 | 8 | | antagonists and associated devices. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subtitle E, Title 8, Insurance Code, is amended |
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| 11 | 11 | | by adding Chapter 1372 to read as follows: |
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| 12 | 12 | | CHAPTER 1372. COVERAGE FOR OPIOID ANTAGONISTS |
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| 13 | 13 | | Sec. 1372.001. DEFINITION. In this chapter, "opioid |
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| 14 | 14 | | antagonist" means any drug that binds to opioid receptors and |
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| 15 | 15 | | blocks or otherwise inhibits the effects of opioids acting on those |
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| 16 | 16 | | receptors. |
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| 17 | 17 | | Sec. 1372.002. APPLICABILITY OF CHAPTER. Notwithstanding |
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| 18 | 18 | | any other law, this chapter applies only to: |
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| 19 | 19 | | (1) a basic coverage plan under Chapter 1551; |
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| 20 | 20 | | (2) a basic plan under Chapter 1575; |
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| 21 | 21 | | (3) a primary care coverage plan under Chapter 1579; |
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| 22 | 22 | | (4) a plan providing basic coverage under Chapter |
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| 23 | 23 | | 1601; |
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| 24 | 24 | | (5) the state Medicaid program, including the Medicaid |
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| 25 | 25 | | managed care program operated under Chapter 533, Government Code; |
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| 26 | 26 | | and |
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| 27 | 27 | | (6) the child health plan program under Chapter 62, |
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| 28 | 28 | | Health and Safety Code. |
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| 29 | 29 | | Sec. 1372.003. REQUIRED COVERAGE FOR OPIOID ANTAGONISTS. A |
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| 30 | 30 | | health benefit plan must provide coverage for an opioid antagonist |
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| 31 | 31 | | and an associated device used in the administration of an opioid |
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| 32 | 32 | | antagonist. |
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| 33 | 33 | | SECTION 2. If before implementing any provision of this Act |
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| 34 | 34 | | a state agency determines that a waiver or authorization from a |
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| 35 | 35 | | federal agency is necessary for implementation of that provision, |
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| 36 | 36 | | the agency affected by the provision shall request the waiver or |
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| 37 | 37 | | authorization and may delay implementing that provision until the |
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| 38 | 38 | | waiver or authorization is granted. |
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| 39 | 39 | | SECTION 3. The change in law made by this Act applies only |
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| 40 | 40 | | to a health benefit plan delivered, issued for delivery, or renewed |
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| 41 | 41 | | on or after January 1, 2024. |
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| 42 | 42 | | SECTION 4. This Act takes effect September 1, 2023. |
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