87R2815 RDS-F
 
  By: Buckingham S.B. No. 523
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the effect of certain reductions in a health benefit
  plan enrollee's out-of-pocket expenses for prescription drugs on
  enrollee cost-sharing requirements.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Subchapter B, Chapter 1369,
  Insurance Code, is amended to read as follows:
  SUBCHAPTER B. REQUIREMENTS AFFECTING COVERAGE OF SPECIFIC
  PRESCRIPTION DRUGS OR COST SHARING [SPECIFIED BY DRUG FORMULARY]
         SECTION 2.  Subchapter B, Chapter 1369, Insurance Code, is
  amended by adding Section 1369.0542 to read as follows:
         Sec. 1369.0542.  EFFECT OF REDUCTIONS IN OUT-OF-POCKET
  EXPENSES ON COST SHARING. An issuer of a health benefit plan that
  covers prescription drugs or a pharmacy benefit manager shall apply
  any third-party payment, financial assistance, discount, product
  voucher, or other reduction in out-of-pocket expenses made by or on
  behalf of an enrollee for a prescription drug to the enrollee's
  deductible, copayment, cost-sharing responsibility, or
  out-of-pocket maximum applicable to prescription drug benefits
  under the enrollee's plan.
         SECTION 3.  Section 1369.0542, Insurance Code, as added by
  this Act, applies only to a health benefit plan that is delivered,
  issued for delivery, or renewed on or after January 1, 2022. A
  health benefit plan delivered, issued for delivery, or renewed
  before January 1, 2022, is governed by the law as it existed
  immediately before the effective date of this Act, and that law is
  continued in effect for that purpose.
         SECTION 4.  This Act takes effect September 1, 2021.