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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) A health benefit plan that provides coverage for stage-four advanced, metastatic cancer and associated conditions may not require, before the health benefit plan provides coverage of a prescription drug approved by the United States Food and Drug Administration, that the enrollee:
(1) fail to successfully respond to a different drug; or
(2) prove a history of failure of a different drug.
(b) This section applies only to a drug the use of which is:
(1) consistent with best practices for the treatment of stage-four advanced, metastatic cancer or an associated condition;
(2) supported by peer-reviewed, evidence-based literature; and
(3) approved by the United States Food and Drug Administration.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 1369.213. Prohibited Conduct - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1369-213/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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