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A BILL TO BE ENTITLED
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AN ACT
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relating to applicability of certain prescription drug insurance |
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laws to health benefit plans and pharmacy benefit managers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter L, Chapter 1369, Insurance Code, is |
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amended by adding Section 1369.5515 to read as follows: |
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Sec. 1369.5515. APPLICABILITY OF SUBCHAPTER. (a) Except |
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as provided by this subsection, a pharmacy benefit manager must |
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comply with the provisions of this subchapter with respect to each |
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health benefit plan administered by the pharmacy benefit manager, |
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regardless of whether a provision of this subchapter is |
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specifically made applicable to the plan. A pharmacy benefit |
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manager is not required to comply with a provision of this |
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subchapter with respect to a plan expressly excluded by this |
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subchapter from the applicability of the provision. |
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(b) This subchapter applies to a health benefit plan |
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provided to a resident of this state, regardless of whether the |
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plan, policy, agreement, or contract is delivered, issued for |
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delivery, or renewed within or outside this state and to the |
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pharmacy benefit manager for that plan. |
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SECTION 2. Section 1369.602, Insurance Code, is amended by |
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adding Subsections (d) and (e) to read as follows: |
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(d) Except as provided by this subsection, a pharmacy |
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benefit manager must comply with the provisions of this subchapter |
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with respect to each health benefit plan administered by the |
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pharmacy benefit manager, regardless of whether a provision of this |
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subchapter is specifically made applicable to the plan. A pharmacy |
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benefit manager is not required to comply with a provision of this |
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subchapter with respect to a plan expressly excluded by this |
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subchapter from the applicability of the provision. |
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(e) This subchapter applies to a health benefit plan |
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provided to a resident of this state, regardless of whether the |
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plan, policy, agreement, or contract is delivered, issued for |
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delivery, or renewed within or outside this state and to the |
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pharmacy benefit manager for that plan. |
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SECTION 3. As soon as practicable after the effective date |
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of this Act, the commissioner of insurance shall repeal all rules |
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that are inconsistent with the changes in law made by this Act. |
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SECTION 4. The changes in law made by this Act apply only to |
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a health benefit plan that is delivered, issued for delivery, or |
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renewed on or after January 1, 2026. A health benefit plan |
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delivered, issued for delivery, or renewed before January 1, 2026, |
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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 5. This Act takes effect September 1, 2025. |