| 6 | 4 | | AN ACT |
|---|
| 7 | 5 | | relating to certain fees charged for the adjudication of pharmacy |
|---|
| 8 | 6 | | benefit claims. |
|---|
| 9 | 7 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 10 | 8 | | SECTION 1. Chapter 1369, Insurance Code, is amended by |
|---|
| 11 | 9 | | adding Subchapter I to read as follows: |
|---|
| 12 | 10 | | SUBCHAPTER I. PHARMACY BENEFIT CLAIM ADJUDICATION |
|---|
| 13 | 11 | | Sec. 1369.401. DEFINITION. In this subchapter, "pharmacy |
|---|
| 14 | 12 | | benefit manager" has the meaning assigned by Section 4151.151. |
|---|
| 15 | 13 | | Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit |
|---|
| 16 | 14 | | plan issuer or a pharmacy benefit manager may not directly or |
|---|
| 17 | 15 | | indirectly charge or hold a pharmacist or pharmacy responsible for |
|---|
| 18 | 16 | | a fee for any step of or component or mechanism related to the claim |
|---|
| 19 | 17 | | adjudication process, including: |
|---|
| 20 | 18 | | (1) the adjudication of a pharmacy benefit claim; |
|---|
| 21 | 19 | | (2) the processing or transmission of a pharmacy |
|---|
| 22 | 20 | | benefit claim; |
|---|
| 23 | 21 | | (3) the development or management of a claim |
|---|
| 24 | 22 | | processing or adjudication network; or |
|---|
| 25 | 23 | | (4) participation in a claim processing or |
|---|
| 26 | 24 | | adjudication network. |
|---|
| 27 | 25 | | SECTION 2. The change in law made by this Act does not |
|---|
| 28 | 26 | | affect the terms of a contract, if any, entered into or renewed |
|---|
| 29 | 27 | | before the effective date of this Act until a renewal of the |
|---|
| 30 | 28 | | contract that occurs on or after the effective date of this Act. |
|---|
| 31 | 29 | | SECTION 3. This Act takes effect September 1, 2015. |
|---|
| 30 | + | ______________________________ ______________________________ |
|---|
| 31 | + | President of the Senate Speaker of the House |
|---|
| 32 | + | I hereby certify that S.B. No. 94 passed the Senate on |
|---|
| 33 | + | April 9, 2015, by the following vote: Yeas 29, Nays 2. |
|---|
| 34 | + | ______________________________ |
|---|
| 35 | + | Secretary of the Senate |
|---|
| 36 | + | I hereby certify that S.B. No. 94 passed the House on |
|---|
| 37 | + | May 1, 2015, by the following vote: Yeas 136, Nays 0, two present |
|---|
| 38 | + | not voting. |
|---|
| 39 | + | ______________________________ |
|---|
| 40 | + | Chief Clerk of the House |
|---|
| 41 | + | Approved: |
|---|
| 42 | + | ______________________________ |
|---|
| 43 | + | Date |
|---|
| 44 | + | ______________________________ |
|---|
| 45 | + | Governor |
|---|