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A BILL TO BE ENTITLED
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AN ACT
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relating to protection of certain disclosures and communications by |
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pharmacists and pharmacies regarding prescription drug benefits. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 4151, Insurance Code, is |
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amended by adding Section 4151.155 to read as follows: |
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Sec. 4151.155. CERTAIN DISCLOSURES AND COMMUNICATIONS BY |
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PHARMACIST OR PHARMACY PROTECTED. (a) A pharmacy benefit manager |
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may not, by contract or otherwise, prohibit or restrict a |
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pharmacist or pharmacy from informing an enrollee of any difference |
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between the enrollee's out-of-pocket cost for a prescription drug |
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under the enrollee's prescription drug benefit and the |
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out-of-pocket cost without submitting a claim under the enrollee's |
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prescription drug benefit. |
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(b) A provision in a pharmacy benefit manager's pharmacy |
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benefit network contract is void and unenforceable if the provision |
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prohibits or restricts a pharmacist or pharmacy from: |
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(1) informing an enrollee of any difference between |
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the enrollee's out-of-pocket cost for a prescription drug under the |
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enrollee's prescription drug benefit and the out-of-pocket cost |
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without submitting a claim under the enrollee's prescription drug |
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benefit; or |
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(2) communicating with plan sponsors or |
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administrators regarding member services with respect to |
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prescription drug benefits, pharmacy services and benefits, |
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network access and adequacy with respect to prescription drug |
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benefits, partnership opportunities, or prescription claim |
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reimbursement. |
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SECTION 2. The change in law made by this Act applies only |
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to a contract or agreement entered into, amended, or renewed on or |
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after the effective date of this Act. |
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SECTION 3. This Act takes effect September 1, 2025. |