H.B. No. 3057         AN ACT   relating to health benefit plan coverage for chimeric antigen   receptor T-cell therapy.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 1369, Insurance Code, is amended by   adding Subchapter E-2 to read as follows:   SUBCHAPTER E-2. COVERAGE FOR CHIMERIC ANTIGEN RECEPTOR T-CELL   THERAPY          Sec. 1369.221.  APPLICABILITY OF SUBCHAPTER. (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 an individual or   group evidence of coverage or similar coverage document that is   issued by:                (1)  an insurance company;                (2)  a group hospital service corporation operating   under Chapter 842;                (3)  a health maintenance organization operating under   Chapter 843;                (4)  an approved nonprofit health corporation that   holds a certificate of authority under Chapter 844;                (5)  a multiple employer welfare arrangement that holds   a certificate of authority under Chapter 846;                (6)  a stipulated premium company operating under   Chapter 884;                (7)  a fraternal benefit society operating under   Chapter 885;                (8)  a Lloyd's plan operating under Chapter 941; or                (9)  an exchange operating under Chapter 942.          (b)  Notwithstanding any other law, this subchapter applies   to:                (1)  a small employer health benefit plan subject to   Chapter 1501, including coverage provided through a health group   cooperative under Subchapter B of that chapter;                (2)  a standard health benefit plan issued under   Chapter 1507;                (3)  a basic coverage plan under Chapter 1551;                (4)  a basic plan under Chapter 1575;                (5)  a primary care coverage plan under Chapter 1579;                (6)  a plan providing basic coverage under Chapter   1601; and                (7)  a self-funded health benefit plan sponsored by a   professional employer organization under Chapter 91, Labor Code.          Sec. 1369.222.  EXCEPTIONS TO APPLICABILITY OF SUBCHAPTER.   This subchapter does not apply to an issuer or provider of health   benefits under or a pharmacy benefit manager administering pharmacy   benefits under:                (1)  the state Medicaid program, including the Medicaid   managed care program under Chapter 540, Government Code; or                (2)  the child health plan program under Chapter 62,   Health and Safety Code.          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.          Sec. 1369.224.  RULES.  The commissioner shall adopt rules   as necessary to administer this subchapter.          SECTION 2.  This Act applies only to a health benefit plan   delivered, issued for delivery, or renewed on or after January 1,   2026.          SECTION 3.  This Act takes effect September 1, 2025.       ______________________________ ______________________________      President of the Senate Speaker of the House                   I certify that H.B. No. 3057 was passed by the House on May   10, 2025, by the following vote:  Yeas 109, Nays 22, 3 present, not   voting.     ______________________________   Chief Clerk of the House                 I certify that H.B. No. 3057 was passed by the Senate on May   27, 2025, by the following vote:  Yeas 30, Nays 1.     ______________________________   Secretary of the Senate       APPROVED:  _____________________                      Date                           _____________________                    Governor