H.B. No. 4402
AN ACT
relating to a study regarding insurance coverage of prescription
drugs provided under a health benefit plan.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 1369, Insurance Code, is
amended by adding Section 1369.0551 to read as follows:
Sec. 1369.0551. STUDY. (a) The department shall conduct a
study to evaluate the ways in which pharmacy benefit managers use
prescription drug information to manage therapeutic drug
interchange programs and other drug substitution recommendations
made by pharmacy benefit managers or other similar entities. The
study must include information regarding pharmacy benefit
managers:
(1) intervening in the delivery or transmission of a
prescription from a prescribing health care practitioner to a
pharmacist for purposes of influencing the prescribing health care
practitioner's choice of therapy;
(2) recommending that a prescribing health care
practitioner change from the originally prescribed medication to
another medication, including generic substitutions and
therapeutic interchanges;
(3) changing a drug or device prescribed by a health
care practitioner without the consent of the prescribing health
care practitioner;
(4) changing a patient cost-sharing obligation for the
cost of a prescription drug or device, including placing a drug or
device on a higher formulary tier than the initial contracted
benefit level; and
(5) removing a drug or device from a group health
benefit plan formulary without providing proper enrollee notice.
(b) Not later than August 1, 2010, the department shall
submit to the governor, the lieutenant governor, the speaker of the
house of representatives, and the appropriate standing committees
of the legislature a report regarding the results of the study
required by Subsection (a), together with any recommendations for
legislation.
(c) This section expires September 1, 2010.
SECTION 2. This Act takes effect September 1, 2009.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 4402 was passed by the House on May 5,
2009, by the following vote: Yeas 139, Nays 5, 1 present, not
voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 4402 was passed by the Senate on May
26, 2009, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor