House Bill No. 2557 aims to amend the Insurance Code regarding prior authorization for prescription drug benefits specifically related to chronic health conditions. The bill updates the heading of Subchapter N, Chapter 1369, to focus on "Coverage of Prescription Drugs for Chronic Health Conditions," removing the previous reference to autoimmune diseases and certain blood disorders. It introduces a definition for "chronic health condition," which encompasses illnesses or impairments expected to last at least one year and that require ongoing medical attention or limit daily living activities. Additionally, the term "prescription drug" is clarified to align with existing definitions in the Occupations Code.

Furthermore, the bill stipulates that health benefit plan issuers cannot require more than one prior authorization annually for prescription drugs prescribed to treat chronic health conditions, which now explicitly includes autoimmune diseases, hemophilia, neurodegenerative diseases, and Von Willebrand disease. The changes will take effect for health benefit plans delivered, issued, or renewed on or after January 1, 2026, while plans prior to this date will continue to follow the existing law. The overall intent of the bill is to streamline the process for obtaining necessary medications for individuals with chronic health conditions.

Statutes affected:
Introduced: Insurance Code 1369.651, Insurance Code 551.003 (Insurance Code 551, Insurance Code 1369)