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A BILL TO BE ENTITLED
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AN ACT
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relating to information required on pharmacy benefit cards. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1369.151, Insurance Code, is amended to |
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read as follows: |
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Sec. 1369.151. APPLICABILITY OF SUBCHAPTER. (a) This |
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subchapter applies only to a health benefit plan that provides |
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benefits for medical or surgical expenses incurred as a result of a |
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health condition, accident, or sickness, including an individual, |
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group, blanket, or franchise insurance policy or insurance |
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agreement, a group hospital service contract, or an individual or |
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group evidence of coverage or similar coverage document that is |
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offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating |
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under Chapter 842; |
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(3) a fraternal benefit society operating under |
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Chapter 885; |
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(4) a stipulated premium company operating under |
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Chapter 884; |
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(5) a reciprocal exchange operating under Chapter 942; |
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(6) a health maintenance organization operating under |
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Chapter 843; |
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(7) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; or |
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(8) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844. |
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(b) Notwithstanding any other law, this subchapter applies |
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to coverage under: |
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(1) the basic coverage plan under Chapter 1551; |
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(2) the basic plan under Chapter 1575; |
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(3) the primary care coverage plan under Chapter 1579; |
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(4) the basic coverage plan under Chapter 1601; |
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(5) the child health plan program under Chapter 62, |
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Health and Safety Code; and |
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(6) the medical assistance program under Chapter 32, |
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Human Resources Code. |
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SECTION 2. Section 1369.153, Insurance Code, is amended to |
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read as follows: |
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Sec. 1369.153. INFORMATION REQUIRED ON IDENTIFICATION |
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CARD. (a) An issuer of a health benefit plan that provides |
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pharmacy benefits to enrollees shall include on the front of the |
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identification card of each enrollee: |
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(1) the name [or logo] of the entity administering the |
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pharmacy benefits if the entity is different from the health |
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benefit plan issuer; |
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(2) the group number applicable to the enrollee; |
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(3) the identification number of the enrollee, which |
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may not be the enrollee's social security number; |
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(4) the bank identification number necessary for |
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electronic billing; |
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(5) [(3)] the effective date of the coverage evidenced |
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by the card; and |
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(6) [(4)
a telephone number for contacting an
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appropriate person to obtain information relating to the pharmacy
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benefits provided under the plan; and
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[(5)] copayment information for generic and |
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brand-name prescription drugs. |
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(b) In addition to the information required under |
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Subsection (a), the issuer of a health benefit plan shall include on |
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the identification card of each enrollee: |
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(1) the logo of the entity administering the pharmacy |
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benefits if the entity is different from the health benefit plan |
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issuer; and |
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(2) a telephone number for contacting an appropriate |
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person to obtain information relating to the pharmacy benefits |
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provided under the plan. |
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(c) In addition to complying with Subsections (a) and (b), |
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an issuer of a health benefit plan may provide the information |
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required under Subsections (a) and (b) in electronically readable |
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form on the back of the identification card. |
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(d) This section does not require a health benefit plan |
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issuer that administers its own pharmacy benefits to issue an |
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identification card separate from any identification card issued to |
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an enrollee to evidence coverage under the plan if the |
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identification card issued to evidence coverage contains the |
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information required by Subsections [Subsection] (a) and (b). |
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SECTION 3. This Act applies only to an insurance policy or |
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contract or evidence of coverage that is delivered, issued for |
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delivery, or renewed on or after January 1, 2010. An insurance |
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policy or contract or evidence of coverage delivered, issued for |
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delivery, or renewed before January 1, 2010, is governed by the law |
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as it existed immediately before the effective date of this Act, and |
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that law is continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2009. |