By Maxey H.B. No. 478
74R2378 PB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the adoption of a mail-order prescription drug benefit
1-3 option under the uniform group insurance program for certain state
1-4 employees.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. The Texas Employees Uniform Group Insurance
1-7 Benefits Act (Article 3.50-2, Vernon's Texas Insurance Code) is
1-8 amended by adding Section 5B to read as follows:
1-9 Sec. 5B. MAIL-ORDER OPTION FOR CERTAIN PRESCRIPTION DRUG
1-10 BENEFITS. (a) In this section:
1-11 (1) "Chronic medical condition" includes:
1-12 (A) arthritis;
1-13 (B) hypertension;
1-14 (C) cardiovascular disease;
1-15 (D) diabetes;
1-16 (E) cancer;
1-17 (F) pulmonary disease;
1-18 (G) digestive tract disease; or
1-19 (H) another chronic, physically debilitating
1-20 condition that requires the use of medication.
1-21 (2) "Maintenance drug" means a medication that is
1-22 routinely prescribed on an ongoing basis for a chronic medical
1-23 condition.
1-24 (b) In providing coverage for prescription drugs under a
2-1 group health benefits plan, the trustee shall adopt a system that
2-2 combines a mail-order option for maintenance drugs with a retail
2-3 purchase option for those drugs. The trustee by rule shall specify
2-4 the maintenance drugs that may be obtained through the mail-order
2-5 service.
2-6 (c) The trustee may not require an employee or dependent to
2-7 use the mail-order option to obtain prescription drugs covered
2-8 under the health benefits plan.
2-9 (d) The mail-order option must include the ability to order
2-10 a 90-day supply of drugs prescribed by a physician at a cost to the
2-11 employee or dependent lower than the cost charged for the same
2-12 medications at a local retail outlet.
2-13 (e) A pharmacy licensed in this state may bid to provide the
2-14 mail-order service. A pharmacy located outside this state may
2-15 participate in the bidding process if that pharmacy registers with
2-16 the trustee and the Texas State Board of Pharmacy. A bidding
2-17 pharmacy must include verification satisfactory to the trustee of
2-18 its ability to mail each prescription not later than 48 hours after
2-19 the time that the pharmacy receives the prescription drug order
2-20 request. The trustee shall adopt rules relating to:
2-21 (1) eligibility requirements for pharmacies
2-22 participating in the mail-order service under this section; and
2-23 (2) the bidding process under this subsection.
2-24 (f) The trustee shall monitor the savings to the state
2-25 associated with the use of the mail-order service and shall report
2-26 information related to the savings in the trustee's annual report
2-27 to the commissioner under Section 7 of this article.
3-1 SECTION 2. The trustee of the Employees Retirement System of
3-2 Texas shall adopt rules to implement Section 5B, Texas Employees
3-3 Uniform Group Insurance Benefits Act (Article 3.50-2, Vernon's
3-4 Texas Insurance Code), as added by this Act, not later than
3-5 September 1, 1995.
3-6 SECTION 3. The importance of this legislation and the
3-7 crowded condition of the calendars in both houses create an
3-8 emergency and an imperative public necessity that the
3-9 constitutional rule requiring bills to be read on three several
3-10 days in each house be suspended, and this rule is hereby suspended,
3-11 and that this Act take effect and be in force from and after its
3-12 passage, and it is so enacted.