Bill Text: TX HB3456 | 2013-2014 | 83rd Legislature | Introduced


Bill Title: Relating to reimbursement rates paid to certain pharmacies in connection with health benefit plans.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2013-03-20 - Referred to Insurance [HB3456 Detail]

Download: Texas-2013-HB3456-Introduced.html
 
 
  By: Eiland H.B. No. 3456
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to reimbursement rates paid to certain pharmacies in
  connection with health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1560.004, Insurance Code, is amended to
  read as follows:
         Sec. 1560.004.  PRESCRIPTION DRUG REIMBURSEMENT RATES. (a)
  Except as provided by Subsection (c), an [An] issuer of a health
  benefit plan that provides pharmacy benefits to enrollees shall
  reimburse pharmacies participating in the health plan using
  prescription drug reimbursement rates, for both brand name and
  generic prescription drugs, that are based on a current and
  nationally recognized benchmark index that includes average
  wholesale price and maximum allowable cost.
         (b)  Except as provided by Subsection (c), regardless
  [Regardless] of whether a pharmacy is a mail order pharmacy or a
  community retail pharmacy, an issuer of a health benefit plan shall
  use the same benchmark index, including the same average wholesale
  price, maximum allowable cost, and national prescription drug
  codes, to reimburse all pharmacies participating in the health
  benefit plan.
         (c)  An issuer of a health benefit plan shall incorporate
  into the calculation under Subsection (b) any monetary or
  nonmonetary benefit that a mail order pharmacy receives and that a
  community retail pharmacy does not receive in connection with
  providing a prescription drug to enrollees.
 
         SECTION 2.  Section 1560.004, Insurance Code, as amended by
  this Act, applies only to a health benefit plan provided under
  Chapter 1551, 1575, or 1579, Insurance Code, beginning with the
  2014-2015 plan year. A plan year before 2014-2015 is governed by
  the law as it existed immediately before September 1, 2014, and that
  law is continued in effect for that purpose.
         SECTION 3.  This Act takes effect September 1, 2013.
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