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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration of a prescription drug manufacturer |
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or third-party prescription assistance program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 65.002(b), Health and Safety Code, is |
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amended to read as follows: |
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(b) The purpose of this chapter is to authorize the |
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commission to establish a program to provide uninsured individuals |
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access to prescription drug benefits using money from the fund to |
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pay an amount equal to the value of a prescription drug rebate at |
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the point of sale and returning that rebate amount to the fund to |
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ensure the amounts credited to the fund equal the amounts paid from |
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the fund. |
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SECTION 2. Section 65.051(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) The commission may [shall] develop and design a |
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prescription drug savings program that partners with a pharmacy |
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benefit manager to offer prescription drugs at a discounted rate to |
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uninsured individuals. |
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SECTION 3. Section 65.204, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 65.204. ANNUAL PROGRAM REPORTS. Not later than |
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December 1 of each year following the first year in which the |
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program is established, the commission shall provide a written |
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report to the governor, lieutenant governor, speaker of the house |
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of representatives, and standing committees of the legislature with |
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primary jurisdiction over the program. The report must include: |
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(1) a line-item list of all program administrative |
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costs incurred by the commission; |
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(2) the amount of the pharmacy benefit manager and |
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third-party administrator fees; |
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(3) the aggregate amounts of rebates anticipated and |
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received for the program; and |
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(4) other program expenditures as the commission |
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determines appropriate. |
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SECTION 4. Subtitle C, Title 2, Health and Safety Code, is |
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amended by adding Chapter 66 to read as follows: |
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CHAPTER 66. PRESCRIPTION DRUG ASSISTANCE PROGRAM |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 66.001. DEFINITIONS. In this chapter: |
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(1) "Prescription drug" has the meaning assigned by |
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Section 551.003, Occupations Code. |
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(2) "Program" means the prescription drug assistance |
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program established under this chapter. |
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Sec. 66.002. CONSTRUCTION OF CHAPTER; PURPOSE. (a) This |
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chapter does not establish an entitlement to assistance in |
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obtaining benefits for certain individuals. |
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(b) The purpose of this chapter is to authorize the |
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commission to establish a program to provide certain individuals |
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access to prescription drug benefits using a prescription drug |
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manufacturer or third-party prescription assistance programs. |
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(c) This chapter does not expand the Medicaid program. |
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Sec. 66.003. RULES. The executive commissioner may adopt |
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the rules necessary to implement this chapter. |
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SUBCHAPTER B. ESTABLISHMENT AND ADMINISTRATION OF PRESCRIPTION |
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DRUG ASSISTANCE PROGRAM |
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Sec. 66.051. ESTABLISHMENT OF PROGRAM. (a) The commission |
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shall develop and design a prescription drug assistance program to |
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increase access to prescription drugs for certain individuals |
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through a prescription drug manufacturer or other third-party |
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patient assistance program. |
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(b) In developing and implementing the program, the |
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commission shall ensure the program benefits exclude prescription |
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drugs used for the elective termination of a pregnancy. |
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(c) The commission shall ensure the program is designed to |
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provide the greatest value to program enrollees by considering: |
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(1) the adequacy of prescription drugs available |
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through the program; |
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(2) the net costs of the drugs to enrollees; |
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(3) the cost to this state; and |
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(4) other important factors as determined by the |
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commission. |
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Sec. 66.052. GENERAL POWERS AND DUTIES OF COMMISSION. (a) |
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The commission shall oversee the implementation of the program and |
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develop procedures for accepting applications for program |
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enrollment. |
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(b) The commission shall list in a central location on the |
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commission's Internet website information that directs a patient to |
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the appropriate assistance available under the program. |
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(c) To the extent feasible, the commission shall integrate a |
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prescription drug manufacturer or third-party patient assistance |
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program into the prescription drug assistance program. A |
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prescription drug manufacturer or other third party may decline to |
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link the prescription drug manufacturer's or third party's patient |
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assistance program to the prescription drug assistance program. |
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Sec. 66.053. CONTRACT AND GRANT AUTHORITY. (a) The |
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commission may contract with a third-party administrator or other |
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entity to perform any or all of the commission's program duties |
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under this chapter. |
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(b) A third-party administrator or other entity under a |
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contract entered into under Subsection (a) may perform the actions |
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the commission would otherwise perform to implement the program. |
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(c) The commission may award grants to or enter into other |
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arrangements with a governmental entity or nonprofit organization |
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to implement this chapter. |
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Sec. 66.054. COMMUNITY OUTREACH AND EDUCATION CAMPAIGN. The |
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commission shall conduct a community outreach and education |
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campaign to provide information on the program's availability to |
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eligible individuals. |
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SUBCHAPTER C. FUNDING; PROGRAM SUSPENSION |
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Sec. 66.101. FUNDING. (a) The commission may accept and |
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use money to implement this chapter, including: |
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(1) gifts, grants, and donations; |
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(2) legislative appropriations; and |
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(3) federal money available under law. |
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(b) Money accepted under Subsection (a) may be used only to |
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administer the prescription drug assistance program and provide |
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program services. |
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Sec. 66.102. SUFFICIENT FUNDING REQUIRED. Notwithstanding |
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any other provision of this chapter, the commission is not required |
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to implement the program unless appropriated money is made |
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available for the program. |
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SUBCHAPTER D. PROGRAM ELIGIBILITY AND ENROLLEE REQUIREMENTS |
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Sec. 66.151. ELIGIBILITY CRITERIA. (a) Except as provided |
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by Subsection (b), an individual is eligible for benefits under the |
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program if the individual meets eligibility criteria as determined |
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by a prescription drug manufacturer or other third party's |
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prescription assistance program. |
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(b) The commission may identify additional factors the |
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program must consider for program eligibility. |
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SUBCHAPTER E. OPERATION OF PROGRAM |
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Sec. 66.201. PROGRAM BENEFITS. The commission must approve |
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program benefits offered under this chapter. The commission shall |
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ensure the benefits comply with all applicable federal and state |
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laws and rules. |
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Sec. 66.202. REPORT. (a) A third-party administrator or |
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other entity the commission contracts with under Section 66.053 |
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shall report to the commission in the form and manner prescribed by |
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the commission on the benefits and services provided under the |
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program. |
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(b) The commission shall establish a procedure to monitor |
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the provision of benefits and services under this chapter. |
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Sec. 66.203. ANNUAL PROGRAM REPORT. Not later than |
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December 1 of each year, the commission shall provide a written |
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report to the governor, lieutenant governor, speaker of the house |
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of representatives, and standing committees of the legislature with |
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primary jurisdiction over the program. The report must include: |
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(1) a line-item list of all program administrative |
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costs incurred by the commission, including costs incurred by a |
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third-party administrator or other entity; |
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(2) the aggregate amount of prescription drug cost |
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savings accrued under the program; and |
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(3) other program expenditures as the commission |
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determines appropriate. |
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SECTION 5. Section 65.102, Health and Safety Code, is |
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repealed. |
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SECTION 6. The Health and Human Services Commission is |
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required to implement a provision of this Act only if the |
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legislature appropriates money specifically for that purpose. If |
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the legislature does not appropriate money specifically for that |
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purpose, the Health and Human Services Commission may, but is not |
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required to, implement a provision of this Act using other |
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appropriations available for that purpose. |
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SECTION 7. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission and any other state agency designated by the |
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executive commissioner shall adopt rules necessary to implement |
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Chapter 65, Health and Safety Code, as amended by this Act, and |
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Chapter 66, Health and Safety Code, as added by this Act. |
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SECTION 8. This Act takes effect September 1, 2023. |