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Senate Bill 332 |
Senate Author: Schwertner et al. |
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Effective: 1-1-16 |
House Sponsor: Hunter |
Senate Bill 332 amends the Insurance Code to establish criteria for a health benefit plan issuer's or pharmacy benefit manager's inclusion of a drug on a maximum allowable cost list. The bill also sets restrictions on the formulation of maximum allowable cost prices by a health benefit plan issuer or pharmacy benefit manager and requires the sources of the pricing data used in formulating maximum allowable cost prices to be disclosed to a pharmacist or pharmacy under contract with the health benefit plan issuer or pharmacy benefit manager. Among other provisions, the bill requires maximum allowable cost price information to be updated weekly to reflect price changes, requires a contracted pharmacist or pharmacy to be provided access to maximum allowable cost lists, sets out provisions governing a pharmacy's or pharmacist's appeal of a maximum allowable cost price determination, and provides for the confidentiality of a maximum allowable cost list.