By: Talarico H.B. No. 40
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a cap on the monthly price of insulin and insulin
  supplies.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 1358, Insurance Code, is amended by
  adding Section 1358.058 to read as follows:
         Sec. 1358.058.  COST SHARING IN PRESCRIPTION INSULIN DRUGS -
  LIMITS CONFIDENTIALITY OF REBATE INFORMATION - DEFINITION -RULES.
               (1)  As used in this section, unless the context other
  requires, "prescription insulin drug" means a prescription drug, as
  defined in section 1358.051, that contains insulin and is used to
  treat diabetes.
               (2)  a carrier that provides coverage for prescription
  insulin drugs pursuant to the terms of a health coverage plan the
  carrier offers shall cap the total amount that a covered person is
  required to pay for a covered prescription insulin drug at an amount
  not to exceed one hundred dollars per thirty-day supply of insulin,
  regardless of the amount or type of insulin needed to fill the
  covered person's prescription.
               (3)  nothing in this section prevents a carrier from
  reducing a covered person's cost sharing by an amount greater than
  the amount specified in subsection (2) of this section.
               (4)  This section applies to health coverage plans
  offered by the Employees Retirement System of Texas and the Teacher
  Retirement System of Texas.
               (5)  the commissioner may use any of the commissioner's
  enforcement powers to obtain a carrier's compliance with this
  section.
               (6)  the commissioner may promulgate rules as necessary
  to implement and administer this section and to align with federal
  requirements.
         SECTION 2.  Chapter 1358, Insurance Code, is amended by
  adding Section 1358.059 to read as follows:
         Sec. 1358.059.  INVESTIGATION AND REPORTING OF PRESCRIPTION
  INSULIN DRUG PRICING. (a)  The Department of Health and Human
  Services shall investigate and report on the pricing of
  prescription insulin drugs
               (1)  made available to Texas consumers to ensure
  adequate consumer protections in pricing of prescription insulin
  drugs and whether additional consumer protections are needed.
               (2) (a)  as part of the investigation by the
  department, the department shall gather, compile, and analyze
  information concerning the organization, business practices,
  pricing information, data, reports, or other information that the
  department finds necessary to fulfill the requirements of this
  section from companies engaged in the manufacture or sale of
  prescription insulin drugs. The department shall also consider any
  publicly available information related to drug pricing.
                     (b)  if necessary to fulfill the reporting
  requirements of this section, the attorney general may issue a
  civil investigative demand requiring a state department; carrier;
  pharmacy benefit management firm; or manufacturer of prescription
  insulin drugs that are made available in Texas, to furnish
  material, answers, data, or other relevant information.
               (3)  a person or business shall not be compelled to
  provide trade secrets.
               (4)  by September 1, 2022, the department shall issue
  and make available to the public a report detailing its findings
  from the investigation conducted pursuant to this section. The
  department shall present the report to the Governor, the Lieutenant
  Governor, the Speaker of the House, and the Senate Committee on
  Business and Commerce and the House Committee on Insurance or their
  successor committees. The report must include:
                     (a)  a summary of insulin pricing practices and
  variables that contribute to pricing of health coverage plans;
                     (b)  public policy recommendations to control and
  prevent overpricing of prescription insulin drugs made available to
  Texas consumers;
                     (c)  any recommendations to improve consumer
  protections, to prevent deceptive sales practices related to the
  sale of prescription insulin drugs, including the pricing of those
  drugs; and
                     (d)  any other information the department finds
  necessary.
               (5)  this section is repealed, effective December 1,
  2022.
         SECTION 3.  This Act applies only to a health benefit plan
  that is delivered, issued for delivery, or renewed on or after
  January 1, 2022. A health benefit plan that is delivered, issued for
  delivery, or renewed before January 1, 2022, is governed by the law
  as it existed immediately before the effective date of this Act, and
  that law is continued in effect for that purpose.
         SECTION 7.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution. If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2021.