81R21490 PMO-D
 
  By: Shelton, Hopson, Hunter, Zerwas H.B. No. 1138
 
  Substitute the following for H.B. No. 1138:
 
  By:  Thompson C.S.H.B. No. 1138
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to information required on pharmacy benefit cards.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1369.151, Insurance Code, is amended to
  read as follows:
         Sec. 1369.151.  APPLICABILITY OF SUBCHAPTER.  (a) This
  subchapter 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, including an individual,
  group, blanket, or franchise insurance policy or insurance
  agreement, a group hospital service contract, or an individual or
  group evidence of coverage or similar coverage document that is
  offered by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a fraternal benefit society operating under
  Chapter 885;
               (4)  a stipulated premium company operating under
  Chapter 884;
               (5)  a reciprocal exchange operating under Chapter 942;
               (6)  a health maintenance organization operating under
  Chapter 843;
               (7)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846; or
               (8)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844.
         (b)  Notwithstanding any other law, this subchapter applies
  to coverage under:
               (1)  the basic coverage plan under Chapter 1551;
               (2)  the basic plan under Chapter 1575;
               (3)  the primary care coverage plan under Chapter 1579;
               (4)  the basic coverage plan under Chapter 1601;
               (5)  the child health plan program under Chapter 62,
  Health and Safety Code; and
               (6)  the medical assistance program under Chapter 32,
  Human Resources Code.
         SECTION 2.  Section 1369.153, Insurance Code, is amended to
  read as follows:
         Sec. 1369.153.  INFORMATION REQUIRED ON IDENTIFICATION
  CARD.  (a)  An issuer of a health benefit plan that provides
  pharmacy benefits to enrollees shall include on the front of the
  identification card of each enrollee:
               (1)  the name [or logo] of the entity administering the
  pharmacy benefits if the entity is different from the health
  benefit plan issuer;
               (2)  the group number applicable to the enrollee;
               (3)  the identification number of the enrollee, which
  may not be the enrollee's social security number;
               (4)  the bank identification number necessary for
  electronic billing;
               (5) [(3)]  the effective date of the coverage evidenced
  by the card; and
               (6) [(4)     a telephone number for contacting an
  appropriate person to obtain information relating to the pharmacy
  benefits provided under the plan; and
               [(5)]  copayment information for generic and
  brand-name prescription drugs.
         (b)  In addition to the information required under
  Subsection (a), the issuer of a health benefit plan shall include on
  the identification card of each enrollee:
               (1)  the logo of the entity administering the pharmacy
  benefits if the entity is different from the health benefit plan
  issuer; and
               (2)  a telephone number for contacting an appropriate
  person to obtain information relating to the pharmacy benefits
  provided under the plan.
         (c)  In addition to complying with Subsections (a) and (b),
  an issuer of a health benefit plan may provide the information
  required under Subsections (a) and (b) in electronically readable
  form on the back of the identification card.
         (d)  This section does not require a health benefit plan
  issuer 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 plan if the
  identification card issued to evidence coverage contains the
  information required by Subsections [Subsection] (a) and (b).
         SECTION 3.  This Act applies only to an insurance policy or
  contract or evidence of coverage that is delivered, issued for
  delivery, or renewed on or after January 1, 2010. An insurance
  policy or contract or evidence of coverage delivered, issued for
  delivery, or renewed before January 1, 2010, is governed by the law
  as it existed immediately before the effective date of this Act, and
  that law is continued in effect for that purpose.
         SECTION 4.  This Act takes effect September 1, 2009.