Texas 2023 - 88th Regular

Texas Senate Bill SB622

Filed
1/26/23  
Out of Senate Committee
4/17/23  
Voted on by Senate
4/27/23  
Out of House Committee
5/3/23  
Voted on by House
5/10/23  
Governor Action
5/29/23  

Caption

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

Impact

The bill's enactment is set to facilitate patients' partnerships with their healthcare providers in identifying cost-effective and clinically appropriate medication options. By standardizing the disclosure of essential drug pricing information, SB622 aims to alleviate confusion and potential barriers faced by patients when navigating their health benefit plans. Importantly, it is expected that this legislative change could lead to improved health outcomes by supporting patient adherence to prescribed treatments.

Summary

Senate Bill 622, authored by Senator Parker, focuses on enhancing the transparency of prescription drug pricing by requiring health benefit plan issuers to disclose specific information to enrollees and their prescribing providers upon request. This bill mandates that health plans provide details such as their drug formulary, the enrollee's eligibility for specific drugs, and comprehensive cost-sharing information, including copayments, deductibles, and coinsurance. These provisions are aimed at empowering patients with the necessary information to make informed decisions regarding their prescriptions at manageable costs.

Sentiment

The sentiment surrounding Senate Bill 622 has generally been positive among supporters who advocate for greater patient empowerment and transparency in healthcare. Notably, stakeholders in the pharmacy and healthcare sectors, including organizations and individual testimonies during hearings, have endorsed the bill as a necessary step towards a more equitable healthcare system. However, concerns have been raised about the potential administrative burdens placed on smaller health plans and the timeline for compliance, highlighting a need for careful implementation.

Contention

Despite broad support, notable contention arose regarding the implementation timeline and compliance requirements, especially from smaller health benefit plan issuers. The bill allows for extended compliance deadlines and discretionary flexibility for smaller plans, which some argue could impact the overall effectiveness of the legislation. Moreover, discussions also highlighted the inherent challenges in ensuring that the information disclosed is both timely and accurate, essential for truly supporting informed patient decision-making.

Texas Constitutional Statutes Affected

Insurance Code

  • Chapter 1369. Benefits Related To Prescription Drugs And Devices And Related Services
    • Section: New Section
    • Section: New Section
    • Section: New Section
    • Section: New Section
    • Section: New Section
  • Chapter 1501. Health Insurance Portability And Availability Act
    • Section: New Section
  • Chapter 1507. Consumer Choice Of Benefits Plans
    • Section: New Section
  • Chapter 1551. Texas Employees Group Benefits Act
    • Section: New Section
  • Chapter 1575. Texas Public School Employees Group Benefits Program
    • Section: New Section
  • Chapter 1579. Texas School Employees Uniform Group Health Coverage
    • Section: New Section
  • Chapter 1601. Uniform Insurance Benefits Act For Employees Of The University Of Texas System And The Texas A&m University System
    • Section: New Section
  • Chapter 2054. Texas Mutual Insurance Company
    • Section: New Section

Health And Safety Code

  • Chapter 75. Regional Or Local Health Care Programs For Employees Of Small Employers
    • Section: 104
  • Chapter 62. Child Health Plan For Certain Low-income Children
    • Section: New Section

Labor Code

  • Chapter 91. Professional Employer Organizations
    • Section: New Section

Government Code

  • Chapter 533. Medicaid Managed Care Program
    • Section: New Section

Companion Bills

TX HB1754

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

Previously Filed As

TX HB1754

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

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