HBA-MSH H.B. 1982 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1982 By: Farabee Insurance 4/1/2001 Introduced BACKGROUND AND PURPOSE Current law requires a group health benefit plan that offers prescription drug benefits to make a prescription drug that was approved or covered for a medical condition or mental illness available to each enrollee at the contracted benefit level until the enrollee's plan renewal date, regardless of whether the prescribed drug has been removed from the health benefit plan's drug formulary. This requirement has necessitated the development of multiple formularies by the health plans and has created administrative problems. House Bill 1982 requires a health plan to make available a prescription drug that was prescribed for an enrollee during the plan year and sets forth certain exceptions. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the commissioner of insurance in SECTION 1 (Article 21.52J, Insurance Code) of this bill. ANALYSIS House Bill 1982 amends the Insurance Code to require a group health benefit plan that offers prescription drug benefits to make a prescription drug that was prescribed for an enrollee during the plan year available to the enrollee at the contracted benefit level until the enrollee's plan renewal date, regardless of whether the prescribed drug has been removed from the health benefit plan's drug formulary. The bill provides that this does not require a group health benefit plan to continue to provide prescription drug benefits for a prescription drug if the United States Food and Drug Administration (FDA) prohibits the sale or use of the drug or the use of the drug as prescribed to an enrollee, or the FDA or the drug's manufacturer identifies a side effect, adverse reaction, or other health risk associated with the drug that was unknown at the time the drug was prescribed to the enrollee or is substantially more severe as determined under rules adopted by the commissioner of insurance than was believed at the time the drug was prescribed to the enrollee. EFFECTIVE DATE September 1, 2001. The Act applies only to a group health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2002.