TEXAS SUMMARY OF EXISTING LAW

A health benefit plan issuer may not, for a patient with a cancer or cancer-related diagnosis: (1) require a clinician-administered drug to be dispensed by a pharmacy selected by the health benefit plan issuer; (2) require that a clinician-administered drug or the administration of a clinician-administered drug be covered as a pharmacy benefit rather than a medical benefit; (3) if a clinician-administered drug is otherwise covered, limit or exclude coverage for the clinician-administered drug when not dispensed by a pharmacy selected by the health benefit plan issuer; or (4) prohibit a physician or health care provider from obtaining or administering a clinician-administered drug that the physician or provider is otherwise permitted to obtain or administer by law.

Links to Proposed Laws: HB 1586

PRACTICAL NOTE FOR EXISTING LAW

This is a very strong bill aimed at prohibiting mandatory white bagging of any kind, or even moving the drug from a medical benefit to a pharmacy benefit. It may serve as a good model for other states’ laws.