Texas 2019 - 86th Regular

Texas House Bill HB1455

Caption

Relating to the audit of wholesale invoices during certain audits of pharmacists and pharmacies.

Impact

If enacted, HB1455 would significantly impact existing laws related to pharmacy audits, creating a more structured approach to how health benefit plans and pharmacy benefit managers can conduct audits. It mandates that any discrepancies found in audits must be reversed if certain conditions regarding the dispensed drugs are met. This change seeks to protect pharmacists from unjust penalties and enhance the accountability of health benefit entities in their auditing processes.

Summary

House Bill 1455 aims to regulate the auditing practices of health benefit plan issuers and pharmacy benefit managers concerning wholesale invoices during pharmacy audits. The legislation specifically prohibits these entities from auditing claims submitted to another health benefit plan or pharmacy benefit manager. The intent is to provide clearer guidelines and protections for pharmacists during the audit process, reducing potential discrepancies and misunderstandings between pharmacies and health plans regarding dispensed medications.

Sentiment

The sentiment surrounding HB1455 appears to be largely supportive among pharmacists and pharmacy advocates, who view the bill as a necessary step toward ensuring fair treatment and improving transparency in the auditing process. There seems to be a recognition that the current auditing practices may place an undue burden on pharmacies, making this legislation a favorable development. However, there may be concerns among health benefit plans regarding how these changes could affect their operations and overall auditing efficacy.

Contention

Notable points of contention surrounding HB1455 include the potential limitation of audit powers for health benefit plan issuers and pharmacy benefit managers. Critics may argue that while the bill seeks to protect pharmacists, it could hinder necessary oversight of pharmacy practices. Furthermore, the nuances of compliance and enforcement of the new provisions may raise questions on whether the bill adequately addresses all potential audit scenarios while balancing the interests of both pharmacists and health benefit providers.

Companion Bills

TX SB692

Same As Relating to the audit of wholesale invoices during certain audits of pharmacists and pharmacies.

TX SB692

Same As Relating to the audit of wholesale invoices during certain audits of pharmacists and pharmacies.

Previously Filed As

TX HB235

Relating to the authority of pharmacists to furnish certain medications.

TX SB160

Relating to the furnishing by pharmacists and dispensing by physicians of certain medications.

TX HB2079

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

TX HB1050

Relating to the authority of pharmacists to dispense self-administered hormonal contraceptives.

TX HB3774

Relating to civil and criminal liability for pharmacists and pharmacies that dispense misoprostol.

TX HB25

Relating to wholesale importation of prescription drugs in this state; authorizing a fee.

TX HB4810

Relating to transactions involving dealer agreements under the Fair Practices of Equipment Manufacturers, Distributors, Wholesalers, and Dealers Act

TX SB749

Relating to the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

TX HB5129

Relating to the delegation to a pharmacy technician of a pharmacist's authority to administer an immunization or vaccine.

TX SB300

Relating to a pharmacist's authority to refuse to dispense a drug.

Similar Bills

CA AB913

Pharmacy benefit managers.

CA SB362

Chain community pharmacies: quotas.

LA HB432

Provides for the regulation of pharmacy services administrative organizations (OR +$88,000 SG EX See Note)

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

LA HB387

Provides for the regulation of pharmacy services administrative organizations

CA AB401

Pharmacy: remote dispensing site pharmacy: telepharmacy: shared clinic office space.

CA AB690

Pharmacies: relocation: remote dispensing site pharmacy: pharmacy technician: qualifications.

MS HB1119

Pharmacy benefit managers; revise provisions related to.