Tex. Ins. Code § 1575.170

PRIOR AUTHORIZATION FOR CERTAIN DRUGS

Known as the Texas Public School Retired Employees Group Benefits Act

The act spans §§ 1575.001 to 1575.506 (105 sections).

Added by Acts 2003, 78th Leg., ch. 213, Sec. 3, eff

(a) In this section, "drug formulary" means a list of drugs preferred for use and eligible for coverage under a health benefit plan.

(b) A health benefit plan provided under this chapter, other than a Medicare Advantage plan or a Medicare prescription drug plan, that uses a drug formulary in providing a prescription drug benefit must require prior authorization for coverage of the following categories of prescribed drugs if the specific drug prescribed is not included in the formulary:

(1) a gastrointestinal drug;

(2) a cholesterol-lowering drug;

(3) an anti-inflammatory drug;

(4) an antihistamine; and

(5) an antidepressant drug.

Official source: Texas Constitution and Statutes. Reproduced from public-domain Texas statutes; confirm against the official source for the current text. Not legal advice.