TX HB3542

Prohibits health benefit plans from denying or limiting an enrollee's prescription drug coverage solely because the plan changed its pharmacy benefit manager

Applies broadly to virtually all health coverage in Texas, including private insurance, HMOs, state employee plans, teacher retirement plans, Medicaid managed care, CHIP, county employee benefits, and self-funded plans

Covers individual, group, blanket, and franchise insurance policies offered by insurance companies, group hospital service corporations, health maintenance organizations, nonprofit health corporations, and multiple employer welfare arrangements

Requires state agencies to seek federal waivers or authorizations if necessary to implement provisions affecting federally-regulated programs

Takes effect September 1, 2025, and applies to health benefit plans delivered, issued, or renewed on or after January 1, 2026