Bill Text: TX HB3413 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to limitations on use of certain pharmacy benefit managers.
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2023-04-18 - Withdrawn from schedule [HB3413 Detail]
Download: Texas-2023-HB3413-Introduced.html
| By: Frank | H.B. No. 3413 | |
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| relating to limitations on use of certain pharmacy benefit | ||
| managers. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter D, Chapter 4151, Insurance Code, is | ||
| amended by adding Section 4151.155 to read as follows: | ||
| Sec. 4151.155. PROHIBITION ON REQUIRING THE USE OF CERTAIN | ||
| PHARMACY BENEFIT MANAGERS. (a) If a health benefit plan has an | ||
| ownership or investment interest (which may be through equity, | ||
| debt, or other means) in a pharmacy benefit manager, then the health | ||
| benefit plan may not require the use of such pharmacy benefit | ||
| manager for the administering of pharmacy benefit services offered | ||
| under, or in conjunction with, the health benefit plan. | ||
| SECTION 2. Subchapter D, Chapter 4151, Insurance Code is | ||
| amended by adding Sec. 4151.156, Insurance Code, to read as | ||
| follows: | ||
| Sec. 4151.156. APPLICABILITY OF SECTION. (a) Section | ||
| 4151.155 of this subchapter applies only to a health benefit plan | ||
| that provides benefits for medical or surgical expenses incurred as | ||
| a result of a health condition, accident, or sickness, including | ||
| individual, group, blanket, or group hospital service contract, or | ||
| an individual or group evidence of coverage or similar coverage | ||
| document that is offered by: | ||
| (1) an insurance company; | ||
| (2) a group hospital service corporation operating | ||
| under Chapter 842; | ||
| (3) a health maintenance organization operating under | ||
| Chapter 843; | ||
| (4) an approved nonprofit health corporation that | ||
| holds a certificate of authority under Chapter 844; | ||
| (5) a multiple employer welfare arrangement that holds | ||
| a certificate of authority under Chapter 846; | ||
| (6) a stipulated premium company operation under | ||
| Chapter 884; | ||
| (7) a fraternal benefit society operating under | ||
| Chapter 885; | ||
| (8) a Lloyd's plan operating under Chapter 941; or | ||
| (9) an exchange operating under Chapter 942. | ||
| (b) Notwithstanding any other law, the subchapter applies | ||
| to: | ||
| (1) a small employer health benefit plan subject to | ||
| Chapter 1501, including coverage through a health group cooperative | ||
| under Subchapter B of that chapter; | ||
| (2) a standard health benefit plan issued under | ||
| Chapter 1507; | ||
| (3) group health coverage made available by a school | ||
| district in accordance with Section 22.004, Education Code; | ||
| (4) a regional or local health care program operating | ||
| under Section 75.104, Health and Safety Code; | ||
| (5) a self-funded health benefit plan sponsored by a | ||
| professional employer organization under Chapter 91, Labor Code; | ||
| (6) a basic coverage plan under Chapter 1551; | ||
| (7) a basic plan under Chapter 1575; | ||
| (8) a coverage plan under Chapter 1579; and | ||
| (9) a plan providing basic coverage under Chapter | ||
| 1601. | ||
| SECTION 3. Sections 4151.155 and 4151.156, Subchapter D, | ||
| Chapter 4151, Insurance Code as added by this Act, apply only to a | ||
| health benefit plan that is delivered, issued for delivery, or | ||
| renewed on or after January 1, 2024. | ||
| SECTION 4. This Act takes effect September 1, 2023. | ||
