| 1 | 1 | | H.B. No. 4402 |
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| 2 | 2 | | |
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| 3 | 3 | | |
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| 4 | 4 | | AN ACT |
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| 5 | 5 | | relating to a study regarding insurance coverage of prescription |
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| 6 | 6 | | drugs provided under a health benefit plan. |
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| 7 | 7 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 8 | 8 | | SECTION 1. Subchapter B, Chapter 1369, Insurance Code, is |
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| 9 | 9 | | amended by adding Section 1369.0551 to read as follows: |
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| 10 | 10 | | Sec. 1369.0551. STUDY. (a) The department shall conduct a |
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| 11 | 11 | | study to evaluate the ways in which pharmacy benefit managers use |
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| 12 | 12 | | prescription drug information to manage therapeutic drug |
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| 13 | 13 | | interchange programs and other drug substitution recommendations |
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| 14 | 14 | | made by pharmacy benefit managers or other similar entities. The |
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| 15 | 15 | | study must include information regarding pharmacy benefit |
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| 16 | 16 | | managers: |
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| 17 | 17 | | (1) intervening in the delivery or transmission of a |
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| 18 | 18 | | prescription from a prescribing health care practitioner to a |
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| 19 | 19 | | pharmacist for purposes of influencing the prescribing health care |
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| 20 | 20 | | practitioner's choice of therapy; |
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| 21 | 21 | | (2) recommending that a prescribing health care |
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| 22 | 22 | | practitioner change from the originally prescribed medication to |
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| 23 | 23 | | another medication, including generic substitutions and |
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| 24 | 24 | | therapeutic interchanges; |
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| 25 | 25 | | (3) changing a drug or device prescribed by a health |
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| 26 | 26 | | care practitioner without the consent of the prescribing health |
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| 27 | 27 | | care practitioner; |
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| 28 | 28 | | (4) changing a patient cost-sharing obligation for the |
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| 29 | 29 | | cost of a prescription drug or device, including placing a drug or |
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| 30 | 30 | | device on a higher formulary tier than the initial contracted |
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| 31 | 31 | | benefit level; and |
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| 32 | 32 | | (5) removing a drug or device from a group health |
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| 33 | 33 | | benefit plan formulary without providing proper enrollee notice. |
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| 34 | 34 | | (b) Not later than August 1, 2010, the department shall |
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| 35 | 35 | | submit to the governor, the lieutenant governor, the speaker of the |
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| 36 | 36 | | house of representatives, and the appropriate standing committees |
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| 37 | 37 | | of the legislature a report regarding the results of the study |
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| 38 | 38 | | required by Subsection (a), together with any recommendations for |
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| 39 | 39 | | legislation. |
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| 40 | 40 | | (c) This section expires September 1, 2010. |
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| 41 | 41 | | SECTION 2. This Act takes effect September 1, 2009. |
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| 42 | 42 | | ______________________________ ______________________________ |
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| 43 | 43 | | President of the Senate Speaker of the House |
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| 44 | 44 | | I certify that H.B. No. 4402 was passed by the House on May 5, |
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| 45 | 45 | | 2009, by the following vote: Yeas 139, Nays 5, 1 present, not |
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| 46 | 46 | | voting. |
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| 47 | 47 | | ______________________________ |
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| 48 | 48 | | Chief Clerk of the House |
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| 49 | 49 | | I certify that H.B. No. 4402 was passed by the Senate on May |
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| 50 | 50 | | 26, 2009, by the following vote: Yeas 31, Nays 0. |
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| 51 | 51 | | ______________________________ |
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| 52 | 52 | | Secretary of the Senate |
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| 53 | 53 | | APPROVED: _____________________ |
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| 54 | 54 | | Date |
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| 55 | 55 | | _____________________ |
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| 56 | 56 | | Governor |
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