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86th TX Lege

Texas Bill Would Eliminate Prior Authorizations Requirements for HIV Meds

Texas HB 3058, authored by Rep. Julie Johnson (D-Irving), would prohibit health plan providers from requiring prior authorizations for medications prescribed to treat AIDS or HIV.

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Antiviral pills used to treat HIV and AIDS often require prior authorization

The Texas House Committee on Insurance held a hearing on House Bill 3058, a bill that would remove bureaucratic barriers between people living with HIV and the lifesaving medications they need. The bill, authored by Rep. Julie Johnson (D-Irving), would eliminate a requirement for prior authorization of prescription medicines that treat AIDS and HIV.

Patients living with HIV who are not on these treatments are able to transmit HIV more easily, which impacts not only the patient themselves but also public health. Timely treatment upon diagnosis and continuity of care is essential for people living with HIV; delays in treatment, however brief, can lead to viral resistance. Once the virus develops resistance, the medication, and often the entire class of medication, are no longer viable treatment options.

“Requiring prior authorization in treatment drugs for HIV & AIDS is a serious barrier to timely treatment for patents and is an adversary of Texas public health overall,” Rep. Johnson said in introducing the bill. “Eighty-five percent of physicians across the U.S. report that the prior authorization requirement is an interference in their continuity of care.”

Health plan providers requiring prior authorization for these medicines, not only put patients at risk but also dramatically increase public health risks and overall cost of treatment. Prior authorization requirements were designed to limit costs, but in the case of HIV & AIDS, the potential cost as a result of inability to access treatment promptly far exceeds the price of the medicines.

Dr. John Carlo, CEO of Prism Health North Texas, which runs three non-profit health centers specializing in HIV treatment and prevention in North Texas, worked with Rep. Johnson to draft the legislation with the goal of expanding access to these medicines and ultimately saving lives.

If passed, the bill would go in to effect on September 1, 2019, and be applied to health benefit plans that are delivered, issued for delivery, or renewed on or after January 1, 2020.

The bill was left pending in committee, with a vote expected in the coming weeks.

Chase is the founder and Creative Director of therepubliq.com, former host and Executive Producer of OutCast Austin, an award-winning LGBT weekly radio program on KOOP 91.7 FM in Austin. In 2011, he was named the Critics Pick for 'Most Gaybiquitous' in the Austin Chronicle's Best of Austin. In 2012, CultureMap Austin named him one of Austin's Top LGBT bloggers and he received the AGLCC's Chamber Award for Social Media Diva.

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october 2020

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