Texas House Bill HB2618

Texas 2015 - 84th Regular

Caption

Relating to the regulation of third-party administrators, including pharmacy benefit managers; expanding the requirement of a certificate of authority to engage in an occupation; adding provisions subject to a criminal penalty.

Impact

The changes proposed in HB 2618 have the potential to significantly reshape the regulatory landscape for pharmacy benefit managers in Texas. By mandating transparency in claims data handling and providing conditions under which pharmacies can be included in networks, the bill seeks to enhance consumer protection and ensure equitable treatment for local pharmacies. This moves towards a regulatory framework that prioritizes the needs of consumers and local businesses while potentially curbing practices that could harm access to necessary medications.

Summary

House Bill 2618 addresses the regulation of third-party administrators, with a particular focus on pharmacy benefit managers (PBMs). The bill mandates that these administrators obtain a certificate of authority to operate within the state, thus expanding regulatory oversight. The intention behind this legislation is to create more accountability in how PBMs manage prescription drug benefits and interact with various stakeholders, including insurers, pharmacies, and beneficiaries. Specifically, it aims to ensure that retail pharmacies are not unfairly excluded from participating in benefit networks, promoting greater accessibility for consumers seeking medications.

Contention

While supporters argue that HB 2618 will lead to better regulation of pharmacy benefit managers and greater access to medications for patients, opponents may raise concerns regarding the increased regulation on PBMs. Critics could argue that such measures might lead to unintended consequences, such as higher overall administrative costs for managing pharmacy benefits, which could, in turn, impact insurance premiums. Additionally, the bill's implications for existing contracts and relationships between PBMs and pharmacies could raise questions among stakeholders about compliance and adaptability to the new legal landscape.