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A BILL TO BE ENTITLED
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AN ACT
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relating to the audit of retail and mail order pharmacy claims of |
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certain public employees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 1551, Insurance Code, is |
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amended by adding Section 1551.068 to read as follows: |
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Sec. 1551.068. AUDIT OF PHARMACY CLAIMS. The state auditor |
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shall conduct a biennial audit and submit to the board of trustees a |
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report on the claims data for prescriptions for a 90-day supply of |
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drugs to verify parity between retail and mail order pharmacies of |
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all factors of reimbursement, including average wholesale price and |
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maximum allowable cost. |
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SECTION 2. Subchapter C, Chapter 1575, Insurance Code, is |
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amended by adding Section 1575.111 to read as follows: |
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Sec. 1575.111. AUDIT OF PHARMACY CLAIMS. The state auditor |
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shall conduct a biennial audit and submit to the trustee a report on |
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the claims data for prescriptions for a 90-day supply of drugs to |
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verify parity between retail and mail order pharmacies of all |
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factors of reimbursement, including average wholesale price and |
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maximum allowable cost. |
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SECTION 3. The initial audit reports required by Sections |
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1551.068 and 1575.111, Insurance Code, as added by this Act, are due |
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not later than September 1, 2013. |
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SECTION 4. The changes in law made by this Act apply only to |
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health benefit plans provided under Chapters 1551 and 1575, |
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Insurance Code, beginning with the 2011-2012 plan year. A plan year |
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before 2011-2012 is governed by the law as it existed immediately |
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before September 1, 2011, and that law is continued in effect for |
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that purpose. |
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SECTION 5. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2011. |