H.B. No. 3286
  relating to prescription drug benefits under Medicaid and the child
  health plan program.
         SECTION 1.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.0691 to read as follows:
         Sec. 531.0691.  VENDOR DRUG PROGRAM INCLUSION. (a)  The
  commission shall ensure that the vendor drug program includes all
  drugs and national drug codes made available under the federal
  Medicaid Drug Rebate Program if a certificate of information form
  to request the drug's inclusion in the vendor drug program has been
  submitted to the commission and:
               (1)  approved by the commission; or
               (2)  subject to Subsection (b), is pending review by
  the commission.
         (b)  On receipt of a certificate of information form to
  request the addition to the Texas Drug Code Index of a drug that is
  available under the federal Medicaid Drug Rebate Program, the
  commission shall, if the commission determines that the drug is
  appropriate for dispensing through an outpatient pharmacy,
  provisionally make the drug available under the vendor drug program
  for a period that expires on the earlier of:
               (1)  the 90th day after the date the form was submitted;
               (2)  the date the commission makes a determination
  regarding whether to approve or deny the drug's inclusion on the
  vendor drug program formulary.
         (c)  The commission shall:
               (1)  denote the provisional availability of a drug
  under this section; and
               (2)  remove a drug made provisionally available under
  the vendor drug program:
                     (A)  on the expiration of the 90-day period
  prescribed by Subsection (b)(1); or
                     (B)  if applicable, on the date the commission
  denies the drug's inclusion on the vendor drug program formulary.
         SECTION 2.  Chapter 533, Government Code, is amended by
  adding Subchapter C to read as follows:
         Sec. 533.071.  PREFERRED DRUG LIST EXCEPTIONS.  (a)  The
  commission shall adopt rules allowing exceptions to the preferred
  drug list if:
               (1)  the drug required under the preferred drug list:
                     (A)  is contraindicated;
                     (B)  will likely cause an adverse reaction in or
  physical or mental harm to the recipient; or
                     (C)  is expected to be ineffective based on the
  known clinical characteristics of the recipient and the known
  characteristics of the prescription drug regimen;
               (2)  the recipient previously discontinued taking the
  preferred drug at any point in the recipient's clinical history and
  for any length of time because the drug:
                     (A)  was not effective;
                     (B)  had a diminished effect; or
                     (C)  resulted in an adverse event;
               (3)  the recipient was prescribed and is taking a
  nonpreferred drug in the antidepressant or antipsychotic drug class
  and the recipient:
                     (A)  was prescribed the nonpreferred drug before
  being discharged from an inpatient facility;
                     (B)  is stable on the nonpreferred drug; and
                     (C)  is at risk of experiencing complications from
  switching from the nonpreferred drug to another drug; or
               (4)  the preferred drug is not available for reasons
  outside of the Medicaid managed care organization's control,
  including because:
                     (A)  the drug is in short supply according to the
  Food and Drug Administration Drug Shortages Database; or
                     (B)  the drug's manufacturer has placed the drug
  on backorder or allocation.
         (b)  An exception provided under this section does not
  subject the Medicaid managed care plan to liquidated damages for
  failing to comply with the preferred drug list.
         SECTION 3.  Section 531.072, Government Code, is amended by
  adding Subsections (b-3), (g), and (h) to read as follows:
         (b-3)  Notwithstanding Subsection (b), the preferred drug
  lists must contain all therapeutic equivalents for a generic drug
  on the preferred drug list.
         (g)  The commission shall develop an expedited review
  process to consider requests from managed care organizations and
  providers to add drugs to the preferred drug list.
         (h)  The commission shall grant temporary non-preferred
  status to new drugs that are available but have not yet been
  reviewed by the drug utilization review board and establish
  criteria for authorizing drugs with temporary non-preferred
         SECTION 4.  Section 531.073(b), Government Code, is amended
  to read as follows:
         (b)  The commission shall establish procedures for the prior
  authorization requirement under the Medicaid vendor drug program to
  ensure that the requirements of 42 U.S.C. Section 1396r-8(d)(5) and
  its subsequent amendments are met.  Specifically, the procedures
  must ensure that:
               (1)  [a prior authorization requirement is not imposed
  for a drug before the drug has been considered at a meeting of the
  Drug Utilization Review Board under Section 531.0736;
               [(2)]  there will be a response to a request for prior
  authorization by telephone or other telecommunications device
  within 24 hours after receipt of a request for prior authorization;
               (2) [(3)]  a 72-hour supply of the drug prescribed will
  be provided in an emergency or if the commission does not provide a
  response within the time required by Subdivision (1) [(2)].
         SECTION 5.  Sections 531.0736(c) and (d), Government Code,
  are amended to read as follows:
         (c)  The executive commissioner shall determine the
  composition of the board, which must:
               (1)  comply with applicable federal law, including 42
  C.F.R. Section 456.716;
               (2)  include three [two] representatives of managed
  care organizations [as nonvoting members], all [one] of whom must
  be physicians or pharmacists [a physician and one of whom must be a
               (3)  include at least 17 physicians and pharmacists
                     (A)  provide services across the entire
  population of Medicaid recipients and represent different
  specialties, including at least one of each of the following types
  of physicians:
                           (i)  a pediatrician;
                           (ii)  a primary care physician;
                           (iii)  an obstetrician and gynecologist;
                           (iv)  a child and adolescent psychiatrist;
                           (v)  an adult psychiatrist; and
                     (B)  have experience in either developing or
  practicing under a preferred drug list; and
               (4)  include a consumer advocate who represents
  Medicaid recipients.
         (d)  Notwithstanding any other law, members [Members]
  appointed under Subsection (c)(2) may attend quarterly and other
  regularly scheduled meetings, but may not:
               (1)  attend portions of the executive sessions in which
  confidential drug pricing information is shared; or
               (2)  access confidential drug pricing information.
         SECTION 6.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 7.  This Act takes effect September 1, 2023.
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
         I certify that H.B. No. 3286 was passed by the House on May 5,
  2023, by the following vote:  Yeas 142, Nays 0, 1 present, not
  voting; and that the House concurred in Senate amendments to H.B.
  No. 3286 on May 25, 2023, by the following vote:  Yeas 139, Nays 0,
  1 present, not voting.
  Chief Clerk of the House   
         I certify that H.B. No. 3286 was passed by the Senate, with
  amendments, on May 21, 2023, by the following vote:  Yeas 31, Nays
  Secretary of the Senate   
  APPROVED: __________________