Texas 2019 - 86th Regular

Texas House Bill HB698

Caption

Relating to certain protected practices of pharmacists and pharmacies regarding amounts charged for prescription drugs.

Impact

The enactment of HB 698 is expected to have significant implications for state laws governing healthcare and pharmacy practices. By creating legal protections for transparency, the bill empowers pharmacists to openly discuss prices with enrollees, thereby fostering a consumer-friendly environment. Moreover, the legislation aims to mitigate practices where PBMs may otherwise suppress price information to maintain higher profits, which can adversely affect both pharmacists and consumers. The bill is viewed as a step toward ensuring that patients are not only informed about their medication costs but can also potentially save money by opting for more affordable options.

Summary

House Bill 698 addresses the practices of pharmacists and pharmacies concerning the amounts charged for prescription medications. The bill aims to protect certain practices that pharmacists can engage in without penalty from health benefit plan issuers or pharmacy benefit managers (PBMs). Specifically, it prohibits these entities from restricting or penalizing pharmacists who inform enrollees that the pharmacy's price for a prescription drug may be lower than their copayment, deductible, or coinsurance under their health plan. This encourages cost transparency within the pharmacy sector, potentially benefiting consumers financially by enabling them to be informed about the best pricing options for their medications.

Sentiment

The sentiment surrounding HB 698 was generally positive among advocates for consumer rights and healthcare transparency. Supporters, including various healthcare organizations, emphasized the importance of enabling pharmacists to communicate openly with patients about prescription costs. This measure has been framed as an essential reform aimed at reducing out-of-pocket expenses for patients. However, some healthcare industry stakeholders may express concern over how these changes could impact the profitability of health benefit plans and the overall dynamics within the pharmacy benefit management sector.

Contention

Notable points of contention surrounding HB 698 include the balance between consumer protection and the interests of health benefit plan issuers. Critics may argue that mandated transparency could disrupt existing relationships and business models between pharmacists, PBMs, and health insurers, leading to unintended consequences within the healthcare marketplace. There is also concern among some regarding how this transparency will influence prescription drug pricing strategies and negotiate outcomes, which could place additional pressure on pharmacy benefit managers to adapt to new regulatory frameworks. Ultimately, the bill proponents and opponents will need to address these potential ripple effects as the new regulations take effect.

Companion Bills

TX SB469

Similar To Relating to certain protected disclosures by pharmacists and pharmacies regarding amounts charged for prescription drugs.

Previously Filed As

TX HB1754

Relating to the disclosure of certain prescription drug information by a health benefit plan.

TX SB622

Relating to the disclosure of certain prescription drug information by a health benefit plan.

TX HB2079

Relating to the authority of pharmacists to order and furnish certain prescription drugs.

TX HB826

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

TX SB1221

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

TX HB2180

Relating to the application of prescription drug price rebates to reduce health benefit plan enrollee cost sharing.

TX HB916

Relating to health benefit plan coverage of prescription contraceptive drugs.

TX SB807

Relating to health benefit plan coverage of prescription contraceptive drugs.

TX HB5230

Relating to health benefit plan coverage of prescription drugs for serious mental illnesses and opioid and substance use disorders.

TX HB4347

Relating to the application of prescription drug price reductions; imposing a civil penalty.

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