Texas House Bill HB5102

Texas 2025 - 89th Regular

• Filed: 3/13/25

Caption

Relating to applicability of certain prescription drug insurance laws to health benefit plans and pharmacy benefit managers.

Impact

One of the significant impacts of HB5102 is its implication on regulations governing pharmacy benefit managers, who play a crucial role in the administration of prescription drug benefits. By clarifying that these managers must comply with state laws regardless of where a plan is issued or renewed, the bill intends to strengthen consumer protections and ensure that residents of Texas have access to necessary prescription medications under their health benefit plans. Importantly, the law applies to plans renewed on or after January 1, 2026, setting a clear timeline for compliance.

Summary

House Bill 5102 addresses the applicability of certain prescription drug insurance laws specifically concerning health benefit plans and pharmacy benefit managers in Texas. The bill mandates that pharmacy benefit managers must adhere to provisions outlined in the Insurance Code with respect to each health benefit plan they administer, irrespective of whether such provisions are specifically applicable to those plans. The legislation aims to create a more consistent regulatory framework for managing health benefit plans concerning prescription drug coverage.

Contention

Discussions surrounding HB5102 may reveal points of contention regarding the regulatory responsibilities placed on pharmacy benefit managers. Some stakeholders may argue that increasing regulation could impose additional burdens on these managers, potentially influencing the cost and availability of prescription drugs. Advocates of the bill may counter that stronger regulatory oversight is essential for safeguarding patient access to medications and ensuring that insurance practices are transparent and fair.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 1369. Benefits Related To Prescription Drugs And Devices And Related Services
  • Section: New Section
  • Section: 602