By Van de Putte                                       H.B. No. 1455
       74R4395 PB-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to access to pharmaceutical services through certain
    1-3  managed care health plans.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 1, Article 21.52B, Insurance Code, is
    1-6  amended by adding Subdivision (6) to read as follows:
    1-7              (6)  "Managed care plan" means a health maintenance
    1-8  organization, a preferred provider organization, or another
    1-9  organization that, under a contract or other agreement entered into
   1-10  with a participant in the plan:
   1-11                    (A)  provides health care benefits, or arranges
   1-12  for health care benefits to be provided, to a participant in the
   1-13  plan; and
   1-14                    (B)  requires or encourages those participants to
   1-15  use health care providers designated by the plan.
   1-16        SECTION 2.  Section 2, Article 21.52B, Insurance Code, is
   1-17  amended to read as follows:
   1-18        Sec. 2.  PROHIBITED CONTRACTUAL PROVISIONS.  (a)  A health
   1-19  insurance policy or managed care plan that is delivered, issued for
   1-20  delivery, or renewed or for which a contract or other agreement is
   1-21  executed may not:
   1-22              (1)  prohibit or limit a person who is a beneficiary of
   1-23  the policy or a participant in the plan from selecting a pharmacy
   1-24  or pharmacist of the person's choice to be a provider under the
    2-1  policy or plan to furnish pharmaceutical services offered or
    2-2  provided by that policy or plan, or interfere with that person's
    2-3  selection of a pharmacy or pharmacist;
    2-4              (2)  deny a pharmacy or pharmacist the right to
    2-5  participate as a contract provider under the policy or plan if the
    2-6  pharmacy or pharmacist agrees to provide pharmaceutical services
    2-7  that meet all terms and requirements and to include the same
    2-8  administrative, financial, and professional conditions that apply
    2-9  to pharmacies and pharmacists who have been designated as providers
   2-10  under the policy or plan; or
   2-11              (3)  require a beneficiary of a policy or a participant
   2-12  in a plan to obtain or request a specific quantity or dosage supply
   2-13  of pharmaceutical products.
   2-14        (b)  Notwithstanding Subsection (a)(3) of this section, a
   2-15  health insurance <, but the> policy or managed care plan may allow
   2-16  the <beneficiary's> physician of a beneficiary or participant to
   2-17  prescribe drugs in a quantity or dosage supply the physician
   2-18  determines appropriate and that is in compliance with state and
   2-19  federal statutes.
   2-20        (c) <(b)>  This section does not prohibit:
   2-21              (1)  a provision of a policy or plan from limiting the
   2-22  quantity or dosage supply of pharmaceutical products for which
   2-23  coverage is provided or providing financial incentives to encourage
   2-24  the beneficiary or participant and the prescribing physician to use
   2-25  a program that provides pharmaceutical products in quantities that
   2-26  result in cost savings to the insurance program or managed care
   2-27  plan and the beneficiary or participant if the provision applies
    3-1  equally to all designated providers of pharmaceutical services
    3-2  under the policy or plan; or
    3-3              (2)  a pharmacy card program that provides a means of
    3-4  obtaining pharmaceutical services offered by the policy or plan
    3-5  through all designated providers of pharmaceutical services.
    3-6        SECTION 3.  Section 3, Article 21.52B, Insurance Code, is
    3-7  amended to read as follows:
    3-8        Sec. 3.  PROVISION VOID. A provision of a health insurance
    3-9  policy or managed care plan that is delivered, issued for delivery,
   3-10  entered into, or renewed in this state that conflicts with Section
   3-11  2 of this article is void to the extent of the conflict.
   3-12        SECTION 4.  Section 4, Article 21.52B, Insurance Code, is
   3-13  amended to read as follows:
   3-14        Sec. 4.  CONSTRUCTION OF ARTICLE. This article does not
   3-15  require a health insurance policy or managed care plan to provide
   3-16  pharmaceutical services.
   3-17        SECTION 5.  Section 14(g), Texas Health Maintenance
   3-18  Organization Act (Article 20A.14, Vernon's Texas Insurance Code),
   3-19  is amended to read as follows:
   3-20        (g)  No type of provider licensed or otherwise authorized to
   3-21  practice in this state may be denied participation to provide
   3-22  health care services which are delivered by the health maintenance
   3-23  organization and which are within the scope of licensure or
   3-24  authorization of the type of provider on the sole basis of type of
   3-25  license or authorization.  This section may not be construed to (1)
   3-26  require a health maintenance organization to utilize a particular
   3-27  type of provider in its operation; (2) require, except as provided
    4-1  by Article 21.52B of this code, that a health maintenance
    4-2  organization accept each provider of a category or type; or (3)
    4-3  require that health maintenance organizations contract directly
    4-4  with such providers.  Notwithstanding any other provision nothing
    4-5  herein shall be construed to limit the health maintenance
    4-6  organization's authority to set the terms and conditions under
    4-7  which health care services will be rendered by providers.  All
    4-8  providers must comply with the terms and conditions established by
    4-9  the health maintenance organization for the provision of health
   4-10  services and for designation as a provider.
   4-11        SECTION 6.  This Act takes effect September 1, 1995, and
   4-12  applies only to an insurance policy or evidence of coverage under a
   4-13  managed care plan that is delivered, issued for delivery, or
   4-14  renewed on or after January 1, 1996.  A policy or evidence of
   4-15  coverage that is delivered, issued for delivery, or renewed before
   4-16  January 1, 1996, is governed by the law as it existed immediately
   4-17  before the effective date of this Act, and that law is continued in
   4-18  effect for that purpose.
   4-19        SECTION 7.  The importance of this legislation and the
   4-20  crowded condition of the calendars in both houses create an
   4-21  emergency and an imperative public necessity that the
   4-22  constitutional rule requiring bills to be read on three several
   4-23  days in each house be suspended, and this rule is hereby suspended.