By: Shelton, et al. (Senate Sponsor - Davis) H.B. No. 1138
(In the Senate - Received from the House May 6, 2009;
May 7, 2009, read first time and referred to Committee on State
Affairs; May 20, 2009, reported favorably, as amended, by the
following vote: Yeas 7, Nays 0; May 20, 2009, sent to printer.)
COMMITTEE AMENDMENT NO. 1 By: Duncan
Amend H.B. 1138 (house engrossed version) between SECTION 2
and SECTION 3 of the bill (page 2, between lines 34 and 35), by
inserting the following new SECTION 3, and renumbering the
following SECTIONS accordingly:
SECTION 3. Section 1369.154, Insurance code, is amended to
read as follows:
Sec. 1369.154. RULES. (a) The commissioner shall adopt
rules as necessary to implement this subchapter.
(b) Rules adopted by the commissioner must be consistent
with national standards established by the Workgroup for Electronic
Data Interchange or by other similar organizations recognized by
the commissioner.
A BILL TO BE ENTITLED
AN ACT
relating to information required on pharmacy benefit cards.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1369.151, Insurance Code, is amended to
read as follows:
Sec. 1369.151. APPLICABILITY OF SUBCHAPTER. (a) This
subchapter applies only to a health benefit plan that provides
benefits for medical or surgical expenses incurred as a result of a
health condition, accident, or sickness, including an individual,
group, blanket, or franchise insurance policy or insurance
agreement, a group hospital service contract, or an individual or
group evidence of coverage or similar coverage document that is
offered by:
(1) an insurance company;
(2) a group hospital service corporation operating
under Chapter 842;
(3) a fraternal benefit society operating under
Chapter 885;
(4) a stipulated premium company operating under
Chapter 884;
(5) a reciprocal exchange operating under Chapter 942;
(6) a health maintenance organization operating under
Chapter 843;
(7) a multiple employer welfare arrangement that holds
a certificate of authority under Chapter 846; or
(8) an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
(b) Notwithstanding any other law, this subchapter applies
to coverage under:
(1) the basic coverage plan under Chapter 1551;
(2) the basic plan under Chapter 1575;
(3) the primary care coverage plan under Chapter 1579;
(4) the basic coverage plan under Chapter 1601;
(5) the child health plan program under Chapter 62,
Health and Safety Code; and
(6) the medical assistance program under Chapter 32,
Human Resources Code.
SECTION 2. Section 1369.153, Insurance Code, is amended to
read as follows:
Sec. 1369.153. INFORMATION REQUIRED ON IDENTIFICATION
CARD. (a) An issuer of a health benefit plan that provides
pharmacy benefits to enrollees shall include on the front of the
identification card of each enrollee:
(1) the name [or logo] of the entity administering the
pharmacy benefits if the entity is different from the health
benefit plan issuer;
(2) the group number applicable to the enrollee;
(3) the identification number of the enrollee, which
may not be the enrollee's social security number;
(4) the bank identification number necessary for
electronic billing;
(5) [(3)] the effective date of the coverage evidenced
by the card; and
(6) [(4) a telephone number for contacting an
appropriate person to obtain information relating to the pharmacy
benefits provided under the plan; and
[(5)] copayment information for generic and
brand-name prescription drugs.
(b) In addition to the information required under
Subsection (a), the issuer of a health benefit plan shall include on
the identification card of each enrollee:
(1) the logo of the entity administering the pharmacy
benefits if the entity is different from the health benefit plan
issuer; and
(2) a telephone number for contacting an appropriate
person to obtain information relating to the pharmacy benefits
provided under the plan.
(c) In addition to complying with Subsections (a) and (b),
an issuer of a health benefit plan may provide the information
required under Subsections (a) and (b) in electronically readable
form on the back of the identification card.
(d) This section does not require a health benefit plan
issuer that administers its own pharmacy benefits to issue an
identification card separate from any identification card issued to
an enrollee to evidence coverage under the plan if the
identification card issued to evidence coverage contains the
information required by Subsections [Subsection] (a) and (b).
SECTION 3. This Act applies only to an insurance policy or
contract or evidence of coverage that is delivered, issued for
delivery, or renewed on or after January 1, 2010. An insurance
policy or contract or evidence of coverage delivered, issued for
delivery, or renewed before January 1, 2010, is governed by the law
as it existed immediately before the effective date of this Act, and
that law is continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2009.
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