By: Kolkhorst S.B. No. 493

(In the Senate - Filed November 22, 2024; February 3, 2025, read first time and referred to Committee on Health & Human Services; March 31, 2025, reported adversely, with favorable Committee Substitute by the following vote: Yeas 7, Nays 0; March 31, 2025, sent to printer.) Click here to see the committee vote

COMMITTEE SUBSTITUTE FOR S.B. No. 493 By: Kolkhorst

A BILL TO BE ENTITLED

AN ACT

relating to certain protected disclosures or communications by pharmacists and pharmacies regarding prescription drug benefits.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter A, Chapter 562, Occupations Code, is amended by adding Section 562.0035 to read as follows:

Sec. 562.0035. PROTECTED DISCLOSURES AND COMMUNICATIONS BY PHARMACISTS AND PHARMACIES REGARDING PRESCRIPTION DRUG BENEFITS. (a) In this section, "enrollee" means an individual who is covered under a health benefit plan, including a covered dependent.

(b) A pharmacist or pharmacy may not enter into a contract or agreement or implement or effectuate a policy that prohibits or restricts the pharmacist or pharmacy from:

(1) informing an enrollee of any difference between the enrollee's out-of-pocket cost for a prescription drug under the enrollee's health benefit plan and the out-of-pocket cost without submitting a claim under the enrollee's health benefit plan; or

(2) communicating with sponsors of an enrollee's health benefit plan regarding member services with respect to prescription drug benefits, pharmacy services and benefits, network access and adequacy with respect to prescription drug benefits, partnership opportunities, or prescription claim reimbursement.

SECTION 2. The change in law made by this Act applies only to a contract or agreement entered into or amended on or after the effective date of this Act.

SECTION 3. This Act takes effect September 1, 2025.

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