Bill Text: TX HB255 | 2015-2016 | 84th Legislature | Comm Sub
Bill Title: Relating to certain fees charged for the adjudication of pharmacy benefit claims.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2015-04-30 - Laid on the table subject to call [HB255 Detail]
Download: Texas-2015-HB255-Comm_Sub.html
| 84R1569 PMO-F | ||
| By: Guerra, Raney, Muñoz, Jr., Sheffield | H.B. No. 255 | |
|
|
||
|
|
||
| relating to certain fees charged for the adjudication of pharmacy | ||
| benefit claims. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1369, Insurance Code, is amended by | ||
| adding Subchapter I to read as follows: | ||
| SUBCHAPTER I. PHARMACY BENEFIT CLAIM ADJUDICATION | ||
| Sec. 1369.401. DEFINITION. In this subchapter, "pharmacy | ||
| benefit manager" has the meaning assigned by Section 4151.151. | ||
| Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit | ||
| plan issuer or a pharmacy benefit manager may not directly or | ||
| indirectly charge or hold a pharmacist or pharmacy responsible for | ||
| a fee for any step of or component or mechanism related to the claim | ||
| adjudication process, including: | ||
| (1) the adjudication of a pharmacy benefit claim; | ||
| (2) the processing or transmission of a pharmacy | ||
| benefit claim; | ||
| (3) the development or management of a claim | ||
| processing or adjudication network; or | ||
| (4) participation in a claim processing or | ||
| adjudication network. | ||
| SECTION 2. The change in law made by this Act does not | ||
| affect the terms of a contract, if any, entered into or renewed | ||
| before the effective date of this Act until a renewal of the | ||
| contract that occurs on or after the effective date of this Act. | ||
| SECTION 3. This Act takes effect September 1, 2015. | ||
