Bill Text: TX SB1076 | 2017-2018 | 85th Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to amounts charged to an enrollee in a health benefit plan for prescription drugs covered by the plan.
Spectrum: Moderate Partisan Bill (Republican 18-2)
Status: (Passed) 2017-06-12 - Effective on 9/1/17 [SB1076 Detail]
Download: Texas-2017-SB1076-Comm_Sub.html
Bill Title: Relating to amounts charged to an enrollee in a health benefit plan for prescription drugs covered by the plan.
Spectrum: Moderate Partisan Bill (Republican 18-2)
Status: (Passed) 2017-06-12 - Effective on 9/1/17 [SB1076 Detail]
Download: Texas-2017-SB1076-Comm_Sub.html
By: Schwertner | S.B. No. 1076 | |
(In the Senate - Filed February 23, 2017; March 7, 2017, | ||
read first time and referred to Committee on Business & Commerce; | ||
April 10, 2017, reported adversely, with favorable Committee | ||
Substitute by the following vote: Yeas 9, Nays 0; April 10, 2017, | ||
sent to printer.) | ||
COMMITTEE SUBSTITUTE FOR S.B. No. 1076 | By: Schwertner |
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relating to amounts charged to an enrollee in a health benefit plan | ||
for prescription drugs covered by the plan. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1369.001, Insurance Code, is amended by | ||
adding Subdivision (2-a) to read as follows: | ||
(2-a) "Enrollee" means an individual who is covered | ||
under a health benefit plan, including a covered dependent. | ||
SECTION 2. Subchapter A, Chapter 1369, Insurance Code, is | ||
amended by adding Section 1369.0041 to read as follows: | ||
Sec. 1369.0041. LIMIT ON PAYMENT REQUIRED UNDER PLAN. A | ||
health benefit plan issuer that covers prescription drugs may not | ||
require an enrollee to make a payment for a prescription drug at the | ||
point of sale in an amount greater than the lesser of: | ||
(1) the applicable copayment; or | ||
(2) the negotiated or allowable claim amount for the | ||
prescription drug specified by the agreement between the health | ||
benefit plan issuer or its pharmacy benefit manager and the | ||
pharmacist or pharmacy providing the prescription drug. | ||
SECTION 3. Section 1369.0041, Insurance Code, as added by | ||
this Act, applies only to a health benefit plan that is delivered, | ||
issued for delivery, or renewed on or after January 1, 2018. A plan | ||
delivered, issued for delivery, or renewed before January 1, 2018, | ||
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 4. This Act takes effect September 1, 2017. | ||
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