The bill, H.B. No. 3542, introduces new provisions under Chapter 1369 of the Insurance Code, specifically adding Subchapter A-1, which establishes continuous coverage requirements for prescription drugs. It defines "prescription drug" in accordance with existing law and outlines the applicability of the subchapter to various health benefit plans, including those offered by insurance companies, health maintenance organizations, and other entities. The bill ensures that a health benefit plan cannot deny or limit an enrollee's coverage of a prescription drug solely due to a change in the plan's pharmacy benefit manager.

Additionally, the bill stipulates that if a state agency determines that a federal waiver or authorization is necessary for implementing any provision, the agency may delay implementation until such waiver or authorization is granted. The changes made by this Act will apply to health benefit plans that are delivered, issued for delivery, or renewed on or after January 1, 2026, and the Act is set to take effect on September 1, 2025.

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