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Amend CSHB 2145, Senate committee printing, as follows:
(1) After the SECTION of the bill adding Section 1551.2197,
Insurance Code, insert a new SECTION, appropriately numbered, to
read as follows:
SECTION ___. Subchapter E, Chapter 1551, Insurance Code, is
amended by adding Section 1551.2198 to read as follows:
Sec. 1551.2198. REQUIREMENTS FOR PHARMACY BENEFIT
MANAGERS. (a) A pharmacy benefit manager who contracts with the
board of trustees to provide prescription drug benefits for a
participant in the group benefits program may not use, or contract
to use, extrapolation calculations in an audit of a pharmacy.
(b) A pharmacy benefit manager who contracts with the board
of trustees to provide prescription drug benefits for a participant
in the group benefits program shall comply with the requirements
for payment of claims to health care providers adopted under
Subchapter J, Chapter 843 and Subchapter C, Chapter 1301.
(2) After the SECTION of the bill adding Section 1575.171,
Insurance Code, insert a new SECTION, appropriately numbered, to
read as follows:
SECTION ___. Subchapter D, Chapter 1575, Insurance Code, is
amended by adding Section 1575.172 to read as follows:
Sec. 1575.172. REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
(a) A pharmacy benefit manager who contracts with the trustee to
provide prescription drug benefits for a participant in the group
program may not use, or contract to use, extrapolation calculations
in an audit of a pharmacy.
(b) A pharmacy benefit manager who contracts with the
trustee to provide prescription drug benefits for a participant in
the group program shall comply with the requirements for payment of
claims to health care providers adopted under Subchapter J, Chapter
843 and Subchapter C, Chapter 1301.
(3) After the SECTION of the bill adding Section 1579.109,
Insurance Code, insert a new SECTION, appropriately numbered, to
read as follows:
SECTION ___. Subchapter C, Chapter 1579, Insurance Code, is
amended by adding Section 1579.110 to read as follows:
Sec. 1579.110. REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
(a) A pharmacy benefit manager who contracts with the trustee to
provide prescription drug benefits for a participant in the program
may not use, or contract to use, extrapolation calculations in an
audit of a pharmacy.
(b) A pharmacy benefit manager who contracts with the
trustee to provide prescription drug benefits for a participant in
the program shall comply with the requirements for payment of
claims to health care providers adopted under Subchapter J, Chapter
843 and Subchapter C, Chapter 1301.
(4) After the SECTION of the bill adding Section 1601.156,
Insurance Code, insert a new SECTION, appropriately numbered, to
read as follows:
SECTION ___. Subchapter D, Chapter 1601, Insurance Code, is
amended by adding Section 1601.157 to read as follows:
Sec. 1601.157. REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS.
(a) A pharmacy benefit manager who contracts with a system to
provide prescription drug benefits for a participant in the uniform
program may not use, or contract to use, extrapolation calculations
in an audit of a pharmacy.
(b) A pharmacy benefit manager who contracts with a system
to provide prescription drug benefits for a participant in the
uniform program shall comply with the requirements for payment of
claims to health care providers adopted under Subchapter J, Chapter
843 and Subchapter C, Chapter 1301.
(5) Renumber the SECTIONS of the bill appropriately.