| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to a study regarding insurance coverage of prescription |
|
|
drugs provided under a health benefit plan. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter B, Chapter 1369, Insurance Code, is |
|
|
amended by adding Section 1369.0551 to read as follows: |
|
|
Sec. 1369.0551. STUDY. (a) The department shall conduct a |
|
|
study to evaluate the ways in which pharmacy benefit managers use |
|
|
prescription drug information to manage therapeutic drug |
|
|
interchange programs and other drug substitution recommendations |
|
|
made by pharmacy benefit managers or other similar entities. The |
|
|
study must include information regarding pharmacy benefit |
|
|
managers: |
|
|
(1) intervening in the delivery or transmission of a |
|
|
prescription from a prescribing health care practitioner to a |
|
|
pharmacist for purposes of influencing the prescribing health care |
|
|
practitioner's choice of therapy; |
|
|
(2) recommending that a prescribing health care |
|
|
practitioner change from the originally prescribed medication to |
|
|
another medication, including generic substitutions and |
|
|
therapeutic interchanges; |
|
|
(3) changing a drug or device prescribed by a health |
|
|
care practitioner without the consent of the prescribing health |
|
|
care practitioner; |
|
|
(4) changing a patient cost-sharing obligation for the |
|
|
cost of a prescription drug or device, including placing a drug or |
|
|
device on a higher formulary tier than the initial contracted |
|
|
benefit level; and |
|
|
(5) removing a drug or device from a group health |
|
|
benefit plan formulary without providing proper enrollee notice. |
|
|
(b) Not later than August 1, 2010, the department shall |
|
|
submit to the governor, the lieutenant governor, the speaker of the |
|
|
house of representatives, and the appropriate standing committees |
|
|
of the legislature a report regarding the results of the study |
|
|
required by Subsection (a), together with any recommendations for |
|
|
legislation. |
|
|
(c) This section expires September 1, 2010. |
|
|
SECTION 2. This Act takes effect September 1, 2009. |