SRC-JEC H.B. 833 78(R)   BILL ANALYSIS


Senate Research Center   H.B. 833
78R11321 JMM-FBy: Hochberg (Jackson)
State Affairs
5/21/2003
Engrossed


DIGEST AND PURPOSE 

Currently, the Texas Pharmacy Act requires a pharmacist to either inform
patients of their right to refuse generic equivalent substitution or
display a sign that informs patients of their right to refuse a generic
substitution.  Although in many non-workers' compensation insurance plans
the patient is required or permitted to pay a co-payment and may refuse a
generic substitution, the Texas Workers Compensation Commission's position
is that a claimant may not do so in the workers' compensation system.  The
Pharmacy Board has taken the position that the workers' compensation
patient does have the right to refuse a generic substitution.  H.B. 833
amends the Labor Code to clarify that a workers compensation claimant has
the right to refuse a generic drug substitution, but may not seek
reimbursement for any additional cost over the cost of the generic drug.

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the Texas Workers'
Compensation Commission in SECTION 1 (Section 408.028, Labor Code) of this
bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 408.028, Labor Code, by adding Subsection (e),
as follows: 

(e)  Requires the Texas Workers' Compensation Commission (TWCC),
notwithstanding Subsection (b), by rule to allow an employee to purchase a
brand name drug rather than a generic pharmaceutical medication or
over-the-counter alternative to a prescription medication if a health care
provider prescribes a generic pharmaceutical medication or an
over-the-counter alternative to a prescription medication.  Requires the
employee to be responsible for paying the difference between the cost of
the brand name drug and the cost of the generic pharmaceutical medication
or of an over-the-counter alternative to a prescription medication.
Prohibits the employee from seeking reimbursement for the difference in
cost from an insurance carrier and provides that the employee is not
entitled to use the medical dispute resolution provisions of Chapter 413
with regard to the prescription.  Provides that a payment described by
this subsection by an employee to a health care provider does not violate
Section 413.042 (Private Claims; Administrative Violation).  Provides that
this subsection does not affect the duty of a health care provider to
comply with the requirements of Subsection (b) when prescribing
medications or ordering over-the-counter alternatives to prescription
medications. 

SECTION 2.   (a)  Effective date:  September 1, 2003.

(b)  Requires TWCC to adopt rules under Section 408.028(e), Labor Code, as
added by this Act, not later than March 1, 2004.