Texas § 1369.453 APPLICABILITY TO CERTAIN MEDICATIONS.

Texas Statutes

§ 1369.453 — APPLICABILITY TO CERTAIN MEDICATIONS.

Texas § 1369.453

Code INInsurance Code

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Bluebook

Tex. Insurance Code Code Ann. § 1369.453 (2026).

Text

Sec. 1369.453. APPLICABILITY TO CERTAIN MEDICATIONS. This subchapter applies with respect to only a medication that:

(1)is covered by the enrollee's health benefit plan;

(2)meets the prior authorization criteria specifically applicable to the medication under the health benefit plan on the date the request for synchronization is made;

(3)is used for treatment and management of a chronic illness, as that term is defined by Section 1369.456 ;

(4)may be prescribed with refills;

(5)is a formulation that can be effectively dispensed in accordance with the medication synchronization plan described by Section 1369.456 ; and

(6)is not, according to the schedules established by the commissioner of the Department of State Health Services under Chapter 481 , Health and Safety Code:

(A)a Schedu

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Sec. 1369.453. APPLICABILITY TO CERTAIN MEDICATIONS. This subchapter applies with respect to only a medication that:
(1) is covered by the enrollee's health benefit plan;
(2) meets the prior authorization criteria specifically applicable to the medication under the health benefit plan on the date the request for synchronization is made;
(3) is used for treatment and management of a chronic illness, as that term is defined by Section 1369.456 ;
(4) may be prescribed with refills;
(5) is a formulation that can be effectively dispensed in accordance with the medication synchronization plan described by Section 1369.456 ; and
(6) is not, according to the schedules established by the commissioner of the Department of State Health Services under Chapter 481 , Health and Safety Code:
(A) a Schedule II controlled substance; or
(B) a Schedule III controlled substance containing hydrocodone.