SRC-SLL, PNG S.B. 1237 76(R)BILL ANALYSIS Senate Research CenterS.B. 1237 By: Nelson Economic Development 8/5/1999 Enrolled DIGEST Currently, under Texas law, insurers are not required to include standardized information on enrollees' pharmacy identification cards. This bill requires health benefit plans to provide uniform pharmacy identification cards for each enrollee, to include certain standardized information. PURPOSE As enrolled, S.B. 1237 requires health benefit plans to provide to each enrollee uniform pharmacy identification cards, which shall include certain standardized information. RULEMAKING AUTHORITY Rulemaking authority is granted to the insurance commissioner in SECTIONS 2 and 4 (Section 19A(a) and (b), Article 21.07-6, and Section 4, Article 21.53L, Insurance Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 1, Article 21.07-6, Insurance Code, by amending Subdivision (1) and adding Subdivision (9), to redefine "administrator" and to define "pharmacy benefit manager." SECTION 2. Amends Article 21.07-6, Insurance Code, by adding Section 19A, as follows: Sec. 19A. IDENTIFICATION CARDS FOR CERTAIN PLANS. Requires an administrator for a plan that provides pharmacy benefits to issue an identification card to each individual covered by the plan, except as provided by rules adopted by the insurance commissioner (commissioner). Requires the commissioner, by rule, to adopt standard information to be included on the identification card. Requires the standard form to include certain information. Requires an administrator for a plan that provides pharmacy benefits to issue to an individual an identification card by a certain date. SECTION 3. Amends Article 21.07-6, Insurance Code, by adding Section 19B, as follows: Sec. 19B. DISCLOSURE OF CERTAIN PATIENT INFORMATION PROHIBITED. Prohibits a pharmacy benefit manager (manager) from selling a list of patients that contains information through which the identity of individual patients is disclosed. Requires all data that identifies a patient maintained by the manager to be maintained in a confidential manner that prevents disclosure to third parties, unless the disclosure is otherwise authorized by law or by the patient. Provides that this section does not prohibit certain actions. SECTION 4. Amends Chapter 21E, Insurance Code, by adding Article 21.53L, as follows: Art. 21.53L. PHARMACY BENEFIT CARDS Sec. 1. DEFINITION. Defines "health benefit plan." Sec. 2. SCOPE OF ARTICLE. Provides that this article applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness. Provides that this article does not apply to certain plans and policies. Sec. 3. IDENTIFICATION CARD; PHARMACY BENEFITS. Sets forth required information to be included on the identification cards issued by a health benefit plan that provides pharmacy benefits. Provides that this section does not require a health benefit plan that administers its own pharmacy benefits to issue an identification card separate from any identification card issued to an enrollee to evidence coverage under the health benefit plan, if the identification card contains the information required by Subsection (a) of this section. Makes conforming changes. Sec. 4. RULES. Requires the commissioner to adopt rules as necessary to implement this article. SECTION 5. Effective date: September 1, 1999. SECTION 6. Makes application of this Act prospective to January 1, 2000. Provides that an administrator is not required to issue a new identification card to an individual, as required by Section 19A, Article 21.07-6, Insurance Code, if the identification card held by the individual on the effective date of this Act contains the required information, described by Sections 19A(b)(2)-(5), Article 21.07-6, Insurance Code. Requires a new card complying with Section 19A, Article 21.07-6, Insurance Code, to be issued at the time the individual's coverage is modified. Provides that a health benefit plan is not required to issue a new identification card to an enrollee, as required by Section 3, Article 21.53L, Insurance Code, if the identification card held by the enrollee on the effective date of this Act contains the information required by Sections 3(a)(2)-(5), Article 21.53L, Insurance Code. Requires a new card complying with Article 21.53L, Insurance Code, to be issued at the time the enrollee's coverage is modified. SECTION 7. Emergency clause.