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A BILL TO BE ENTITLED
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AN ACT
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relating to certain fees charged for the adjudication of pharmacy |
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benefit claims. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 1369, Insurance Code, is amended by |
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adding Subchapter I to read as follows: |
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SUBCHAPTER I. PHARMACY BENEFIT CLAIM ADJUDICATION |
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Sec. 1369.401. DEFINITION. In this subchapter, "pharmacy |
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benefit manager" has the meaning assigned by Section 4151.151. |
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Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit |
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plan issuer or a pharmacy benefit manager may not directly or |
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indirectly charge or hold a pharmacist or pharmacy responsible for |
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a fee for any step of or component or mechanism related to the claim |
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adjudication process, including: |
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(1) the adjudication of a pharmacy benefit claim; |
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(2) the processing or transmission of a pharmacy |
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benefit claim; |
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(3) the development or management of a claim |
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processing or adjudication network; or |
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(4) participation in a claim processing or |
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adjudication network. |
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SECTION 2. The change in law made by this Act does not |
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affect the terms of a contract, if any, entered into or renewed |
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before the effective date of this Act until a renewal of the |
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contract that occurs on or after the effective date of this Act. |
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SECTION 3. This Act takes effect September 1, 2015. |