Relating to certain contracts between pharmacy benefit managers and the Employees Retirement System of Texas, the Teacher Retirement System of Texas, The Texas A&M University System, or The University of Texas System.
Impact
The enactment of HB4596 is expected to enhance regulatory oversight over PBMs. It outlines requirements such as the necessity for these managers to disclose reasons behind therapeutic interchanges of drugs, as well as all financial dealings related to drug formulary changes. This is anticipated to improve the quality of information available to the retirement systems regarding prescription drug management, potentially leading to better cost management and patient outcomes.
Summary
House Bill 4596 concerns contracts between pharmacy benefit managers (PBMs) and various Texas state retirement systems, including the Employees Retirement System, the Teacher Retirement System, and the Texas A&M and University of Texas Systems. The bill amends sections of the Insurance Code to regulate the terms and conditions under which these contracts can be awarded. Key provisions mandate that in awarding PBM contracts, the boards are not required to select the lowest bid, but must select contracts that meet specified criteria focused on accountability and transparency in PBM operations.
Contention
Notable points of contention surrounding the bill may involve concerns from PBMs regarding the adjustment of their operational processes to meet the added regulatory requirements. Critics may argue that increased transparency could lead to administrative burdens, while supporters assert that these measures are essential for safeguarding financial resources within state retirement systems and ensuring beneficiaries receive effective medication management. The balance between establishing robust oversight and maintaining operational flexibility for PBMs is likely to be a central theme in discussions regarding this bill.
Identical
Relating to certain contracts between pharmacy benefit managers and the Employees Retirement System of Texas, the Teacher Retirement System of Texas, The Texas A&M University System, or The University of Texas System.
Relating to certain contracts between pharmacy benefit managers and the Employees Retirement System of Texas, the Teacher Retirement System of Texas, The Texas A&M University System, or The University of Texas System.
Insurance: other; an enrollee's defined cost sharing for prescription drugs; provide for. Amends secs. 5, 7 & 9 of 2022 PA 11 (MCL 550.815 et seq.) & adds sec. 10.