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