Relating to the delivery of prescription drugs for certain state health plans by mail order; providing an administrative penalty.
Impact
The implications of HB2293 are significant for state health plans, particularly those administered by the Teacher Retirement System of Texas and the Employees Retirement System of Texas. The bill mandates that these plans allow enrollees to obtain prescription drugs from their local pharmacies and only pay the same rates as if they had utilized a mail order pharmacy. By doing so, it attempts to balance the playing field between community pharmacies and larger mail order operations, potentially benefiting local businesses while ensuring that patients have better access to their medications.
Summary
House Bill 2293 aims to regulate the delivery of prescription drugs for certain state health plans by mail order. Specifically, it amends the Texas Insurance Code by adding Chapter 1560, which outlines provisions for obtaining medication through both community retail pharmacies and mail order pharmacies. The bill ensures that individuals enrolled in state health plans can acquire a multiple-month supply of prescription drugs from local pharmacies under the same terms as if they were obtained through mail order services. This is intended to enhance access to necessary medications, particularly for those who may face difficulties with mail order services.
Contention
While the bill appears to promote accessibility, there may be contentions surrounding the reimbursement structures and the impact on mail order pharmacies. There's potential pushback from mail order pharmacy advocates who might argue that the requirements could diminish their business and affect cost structures. Moreover, the bill includes provisions for administrative penalties for noncompliance, specifically targeting health benefit plans that fail to adhere to the established rules, which could raise concerns about fair practices and the administrative burden on insurers.
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.