TO: | Honorable Robert Duncan, Chair, Senate Committee on State Affairs |
FROM: | John S. O'Brien, Director, Legislative Budget Board |
IN RE: | SB1106 by Van de Putte (Relating to payment of claims to pharmacies and pharmacists.), As Introduced |
Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
---|---|
2010 | $0 |
2011 | $0 |
2012 | $0 |
2013 | $0 |
2014 | $0 |
Fiscal Year | Probable (Cost) from Insurance Maint Tax Fees 8042 |
Probable Revenue Gain from Insurance Maint Tax Fees 8042 |
Change in Number of State Employees from FY 2009 |
---|---|---|---|
2010 | ($237,619) | $237,619 | 3.0 |
2011 | ($223,795) | $223,795 | 3.0 |
2012 | ($223,795) | $223,795 | 3.0 |
2013 | ($223,795) | $223,795 | 3.0 |
2014 | ($223,795) | $223,795 | 3.0 |
The bill would amend the Insurance Code to change the requirements of a pharmacy audit and to decrease the time frame for insurance companies to pay pharmacies for claims. Additionally, the bill would create a dispute resolution process for the Texas Department of Insurance (TDI) to resolve disputes regarding claim payments by health maintenance organizations or insurers under preferred provider benefit plans. The bill would require that a complainant may appeal TDI's written order by requesting a hearing on the matter before the State Office of Administrative Hearings (SOAH).
The bill would only apply to claims submitted on or after September 1, 2009 and to contracts between a pharmacy benefit manager and an insurer or health maintenance organization entered into or renewed on or after January 1, 2010. The bill would take effect on September 1, 2009.
Source Agencies: | 323 Teacher Retirement System, 360 State Office of Administrative Hearings, 454 Department of Insurance, 720 The University of Texas System Administration, 327 Employees Retirement System, 710 Texas A&M University System Administrative and General Offices
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LBB Staff: | JOB, KJG, MW, CH
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