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 | |
|
|
||
|
|
||
| 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 [ |
||
| 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 | ||
| [ |
||
| 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. | ||
