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Relating to step therapy protocols required by health benefit plans for coverage of prescription drugs for serious mental illnesses.
No significant fiscal implication to the State is anticipated.
SB 2051 would prohibit a health benefit plan that provides coverage for a serious mental illness from requiring that an enrollee fail to successfully respond to a different drug or prove a history of failure of a different drug before the health benefit plan provides coverage of a prescription drug.
SB 2051 would allow a health benefit plan issuer to require an enrollee to try a generic or pharmaceutical equivalent of the prescribed drug as a condition of continued coverage for the prescribed drug only once in a plan year.
Texas Action opposes SB 2051 because it violates the limited-government principle. The state should not prohibit an insurance company from requiring this form of step therapy.
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