PRIOR AUTHORIZATION AND CERTAIN PROTOCOL REQUIREMENTS PROHIBITED FOR CERTAIN ANTIRETROVIRAL DRUGS.
Tex. GOV'T Code § 549.0252.
in effect(a) In this section, "antiretroviral drug" means a drug that treats human immunodeficiency virus infection or prevents acquired immune deficiency syndrome. The term includes:
(1) protease inhibitors;
(2) non-nucleoside reverse transcriptase inhibitors;
(3) nucleoside reverse transcriptase inhibitors;
(4) integrase inhibitors;
(5) fusion inhibitors;
(6) attachment inhibitors;
(7) CD4 post-attachment inhibitors;
(8) CCR5 receptor antagonists; and
(9) other antiretroviral drugs used to treat human immunodeficiency virus infection or prevent acquired immune deficiency syndrome.
(b) The executive commissioner, in the rules and standards governing the Medicaid vendor drug program, may not require a clinical, nonpreferred, or other prior authorization for an antiretroviral drug, or a step therapy or other protocol, that could restrict or delay the dispensing of the drug except to minimize fraud, waste, or abuse.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.