Bill > HB3057

This bill mandates that health benefit plans in Texas provide coverage for chimeric antigen receptor (CAR) T-cell therapy, a cutting-edge cancer treatment where a patient's own immune cells are genetically modified to target and destroy cancer cells. The bill applies to a wide range of health insurance providers, including insurance companies, hospital service corporations, health maintenance organizations, and self-funded health benefit plans. The coverage requirements stipulate that the CAR T-cell therapy must be medically necessary and administered by a healthcare provider who is both certified by the FDA for the specific therapy product and is participating in the health plan's network. The bill specifically excludes state Medicaid programs and the child health plan program from these requirements. Health benefit plans will be required to implement this coverage for plans delivered, issued, or renewed on or after January 1, 2026, with the act taking effect on September 1, 2025. The Texas insurance commissioner is tasked with adopting rules to implement this subchapter, ensuring that patients have access to this advanced and potentially life-saving treatment through their health insurance plans.

Business and Industry, Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB3057