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A BILL TO BE ENTITLED
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AN ACT
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relating to amounts charged to an enrollee in a health benefit plan |
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for prescription drugs covered by the plan. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1369.001, Insurance Code, is amended by |
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adding Subdivision (2-a) to read as follows: |
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(2-a) "Enrollee" means an individual who is covered |
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under a health benefit plan, including a covered dependent. |
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SECTION 2. Subchapter A, Chapter 1369, Insurance Code, is |
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amended by adding Section 1369.0041 to read as follows: |
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Sec. 1369.0041. LIMIT ON PAYMENT REQUIRED UNDER PLAN. A |
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health benefit plan that covers prescription drugs may not include |
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a provision that requires an enrollee to make a payment for a |
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prescription drug at the point of sale in an amount greater than an |
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amount that the pharmacist or pharmacy providing the prescription |
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drug may retain from: |
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(1) the health benefit plan issuer; or |
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(2) the health benefit plan issuer's pharmacy benefit |
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manager. |
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SECTION 3. Section 1369.0041, Insurance Code, as added by |
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this Act, applies only to a health benefit plan that is delivered, |
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issued for delivery, or renewed on or after January 1, 2018. A plan |
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delivered, issued for delivery, or renewed before January 1, 2018, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 4. This Act takes effect September 1, 2017. |