89R12354 TYPED
By: Landgraf H.B. No. 3057
A BILL TO BE ENTITLED
AN ACT
relating to network standards for Chimeric Antigen Receptor T-Cell
(CAR T) therapy.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Title 8, Subtitle E, Insurance Code, is amended
to create Chapter 1381 as follows:
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
CHAPTER 1381. NETWORK STANDARDS FOR CAR T THERAPY
Sec. 1381.001. PURPOSE. The purpose of this Chapter is to
expand access to Chimeric Antigen Receptor T-Cell (CAR T) therapy
by allowing the cancer treatment, if covered by a health benefit
plan, to be provided in any CAR T treatment center that qualifies as
a certified healthcare facility in accordance with the Food and
Drug Administration label governing safety certification, staff
training, adverse event management, patient monitoring, and data
collection.
Sec. 1381.002. APPLICABILITY OF CHAPTER. (a) This chapter
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 offered 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 chapter applies to:
(1) a small employer health benefit plan subject to Chapter
1501, including coverage provided through a health group
cooperative under Subchapter B of that chapter;
(2) a standard health benefit plan issued under Chapter
1507;
(3) a basic coverage plan under Chapter 1551;
(4) a basic plan under Chapter 1575;
(5) a primary care coverage plan under Chapter 1579;
(6) a plan providing basic coverage under Chapter 1601; and
(7) a self-funded health benefit plan sponsored by a
professional employer organization under Chapter 91, Labor Code.
Sec. 1381.003. NETWORK STANDARDS. (a) No health benefit
plan in the state that provides coverage for Chimeric Antigen
Receptor T-Cell (CAR T) therapy may refuse to contract for the
administration of any CAR T therapy by any provider that qualifies
as a certified healthcare facility in accordance with approved
procedure under the CAR-T product license by the FDA.
(b) No health benefit plan in the state that covers CAR T
therapy may deny coverage for the administration of any CAR T
therapy by any provider that qualifies as a certified healthcare
facility in accordance with approved procedure under the CAR-T
product license by the FDA.
(c) This section shall apply to any health benefit plan that
is delivered, issued for delivery, or renewed on or after January 1,
2026.
Sec. 1381.003. RULES. The commissioner shall adopt rules as
necessary to administer this chapter.
SECTION 2. This Act takes effect September 1, 2025.