| 1 | 1 | | 85R26238 BEE-F |
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| 2 | 2 | | By: Bonnen of Galveston, Sheffield, H.B. No. 2360 |
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| 3 | 3 | | Anderson of Dallas, Oliverson |
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| 4 | 4 | | Substitute the following for H.B. No. 2360: |
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| 5 | 5 | | By: Phillips C.S.H.B. No. 2360 |
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| 6 | 6 | | |
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| 7 | 7 | | |
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| 8 | 8 | | A BILL TO BE ENTITLED |
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| 9 | 9 | | AN ACT |
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| 10 | 10 | | relating to amounts charged to an enrollee in a health benefit plan |
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| 11 | 11 | | for prescription drugs covered by the plan. |
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| 12 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 13 | 13 | | SECTION 1. Section 1369.001, Insurance Code, is amended by |
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| 14 | 14 | | adding Subdivision (2-a) to read as follows: |
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| 15 | 15 | | (2-a) "Enrollee" means an individual who is covered |
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| 16 | 16 | | under a health benefit plan, including a covered dependent. |
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| 17 | 17 | | SECTION 2. Subchapter A, Chapter 1369, Insurance Code, is |
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| 18 | 18 | | amended by adding Section 1369.0041 to read as follows: |
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| 19 | 19 | | Sec. 1369.0041. LIMIT ON PAYMENT REQUIRED UNDER PLAN. A |
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| 20 | 20 | | health benefit plan issuer that covers prescription drugs may not |
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| 21 | 21 | | require an enrollee to make a payment for a prescription drug at the |
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| 22 | 22 | | point of sale in an amount greater than the lesser of: |
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| 23 | 23 | | (1) the applicable copayment; |
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| 24 | 24 | | (2) the allowable claim amount for the prescription |
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| 25 | 25 | | drug; or |
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| 26 | 26 | | (3) the amount an individual would pay for the drug if |
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| 27 | 27 | | the individual purchased the drug without using a health benefit |
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| 28 | 28 | | plan or any other source of drug benefits or discounts. |
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| 29 | 29 | | SECTION 3. Section 1369.0041, Insurance Code, as added by |
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| 30 | 30 | | this Act, applies only to a health benefit plan that is delivered, |
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| 31 | 31 | | issued for delivery, or renewed on or after January 1, 2018. A plan |
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| 32 | 32 | | delivered, issued for delivery, or renewed before January 1, 2018, |
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| 33 | 33 | | is governed by the law as it existed immediately before the |
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| 34 | 34 | | effective date of this Act, and that law is continued in effect for |
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| 35 | 35 | | that purpose. |
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| 36 | 36 | | SECTION 4. This Act takes effect September 1, 2017. |
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