Tex. Ins. Code § 1369.302 · Subchapter G. STANDARD REQUEST FORM FOR PRIOR AUTHORIZATION OF PRESCRIPTION DRUG BENEFITS
APPLICABILITY OF SUBCHAPTER.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) This subchapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or a small or large employer group contract or similar coverage document that is offered by:
(1) an insurance company;
(2) a group hospital service corporation operating under Chapter 842;
(3) a fraternal benefit society operating under Chapter 885;
(4) a stipulated premium company operating under Chapter 884;
(5) a reciprocal exchange operating under Chapter 942;
(6) a health maintenance organization operating under Chapter 843;
(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.
(b) This subchapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.
(c) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this subchapter applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579; and
(4) basic coverage under Chapter 1601.
(d) Notwithstanding any other law, this subchapter applies to coverage under:
(1) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; and
(2) the medical assistance program under Chapter 32, Human Resources Code.
Notes and commentary — not statutory text
History
Added by Acts 2013, 83rd Leg., R.S., Ch. 1328 (S.B. 644), Sec. 1, eff. September 1, 2013.
Redesignated from Insurance Code, Section 1369.252 by Acts 2015, 84th Leg., R.S., Ch. 1236 (S.B. 1296), Sec. 21.001(38), eff. September 1, 2015.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm
- Text hash
- sha256 5a67daaef528d7e1fd8fc3b0b58e4db8e87824e0d2de76fc19cf3775444d2588
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Education Code
Health and Safety Code
Human Resources Code
Insurance Code
- Tex. Ins. Code ch. 842GROUP HOSPITAL SERVICE CORPORATIONSPrinted as Chapter 842
- Tex. Ins. Code ch. 843HEALTH MAINTENANCE ORGANIZATIONSPrinted as Chapter 843
- Tex. Ins. Code ch. 846MULTIPLE EMPLOYER WELFARE ARRANGEMENTSPrinted as Chapter 846
- Tex. Ins. Code ch. 884STIPULATED PREMIUM INSURANCE COMPANIESPrinted as Chapter 884
- Tex. Ins. Code ch. 885FRATERNAL BENEFIT SOCIETIESPrinted as Chapter 885
- Tex. Ins. Code ch. 942RECIPROCAL AND INTERINSURANCE EXCHANGESPrinted as Chapter 942
- Tex. Ins. Code ch. 1551TEXAS EMPLOYEES GROUP BENEFITS ACTPrinted as Chapter 1551
- Tex. Ins. Code ch. 1575TEXAS PUBLIC SCHOOL EMPLOYEES GROUP BENEFITS PROGRAMPrinted as Chapter 1575
- Tex. Ins. Code ch. 1579TEXAS SCHOOL EMPLOYEES UNIFORM GROUP HEALTH COVERAGEPrinted as Chapter 1579
Cited by 1 provision
Provisions in this library whose text cites Tex. Ins. Code § 1369.302. Each shows the citation as that text prints it.
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