Coverage Requirements

Sec. 1369.223. COVERAGE REQUIREMENTS. A health benefit plan that provides coverage for chimeric antigen receptor T-cell therapy must provide coverage for chimeric antigen receptor T-cell therapy that is: (1) medically necessary; and (2) administered by a health care provider that is: (A) qualified as a certified health care facility in accordance with the procedure for the chimeric antigen receptor T-cell therapy product license approved by the United States Food and Drug Administration; and (B) participating in the health benefit plan's network with respect to any other service. Added by Acts 2025, 89th Leg., R.S., Ch. 608 (H.B. 3057), Sec. 1, eff. September 1, 2025.