Texas House Bill HB839

Texas 2023 - 88th Regular

• Filed: 12/1/22

Caption

Relating to prior authorization for prescription drug benefits related to the treatment or prevention of infectious diseases.

Impact

If enacted, HB 839 would amend the Insurance Code, specifically adding provisions that apply to a wide range of health benefit plans. This change aims to foster a more equitable healthcare environment by ensuring that individuals receiving treatment for infectious diseases can obtain their prescribed medications without facing additional hurdles through prior authorization requirements. Such a shift is anticipated to have significant implications for both health insurance providers and policyholders, emphasizing the urgency of addressing public health needs.

Summary

House Bill 839 aims to modify existing regulations concerning prior authorization for prescription drug benefits specifically related to the treatment or prevention of infectious diseases. The bill seeks to eliminate the necessity for prior authorization, which can delay access to critical medications for individuals with such diseases. By doing so, the legislation intends to improve patient access to timely treatment and enhance overall public health outcomes.

Sentiment

The sentiment surrounding HB 839 appears positive among healthcare advocates and practitioners who argue that reducing barriers to medication access is critical, especially for vulnerable populations affected by infectious diseases. However, there may be concerns from insurance companies regarding the potential for increased costs and overuse of prescribed medications without prior checks, indicating a nuanced discourse about the balance between patient access and cost management in healthcare.

Contention

Noteworthy points of contention may arise regarding the implications of the bill on insurance practices and the role of prior authorization in controlling medication costs. Proponents of HB 839 will likely argue that removing prior authorization is a necessary reform, whereas critics might caution that it could lead to skyrocketing costs and potential misuse of prescription drugs. This debate highlights the tension between enhancing patient access and ensuring responsible healthcare spending.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 1369. Benefits Related To Prescription Drugs And Devices And Related Services
  • Section: New Section

• Chapter 1501. Health Insurance Portability And Availability Act
  • Section: 004

• Chapter 1507. Consumer Choice Of Benefits Plans
  • Section: 004

• Chapter 1551. Texas Employees Group Benefits Act
  • Section: 004

• Chapter 1575. Texas Public School Employees Group Benefits Program
  • Section: 004

• Chapter 1579. Texas School Employees Uniform Group Health Coverage
  • Section: 004

• Chapter 1601. Uniform Insurance Benefits Act For Employees Of The University Of Texas System And The Texas A&m University System
  • Section: 004

Business Organizations Code

• Chapter 22. Nonprofit Corporations
  • Section: New Section

Government Code

• Chapter 533. Medicaid Managed Care Program
  • Section: New Section

Health And Safety Code

• Chapter 62. Child Health Plan For Certain Low-income Children
  • Section: New Section

• Chapter 75. Regional Or Local Health Care Programs For Employees Of Small Employers
  • Section: 104

Labor Code

• Chapter 91. Professional Employer Organizations
  • Section: New Section

Local Government Code

• Chapter 157. Assistance, Benefits, And Working Conditions Of County Officers And Employees
  • Section: New Section

• Chapter 172. Texas Political Subdivisions Uniform Group Benefits Program
  • Section: 004