Texas 2019 - 86th Regular

Texas House Bill HB1298 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	86R6237 SCL-D
2	2	By: Davis of Harris H.B. No. 1298
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to prescription drug cost increases; imposing a civil
8	8	penalty.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle A, Title 6, Health and Safety Code, is
11	11	amended by adding Chapter 441 to read as follows:
12	12	CHAPTER 441. PRESCRIPTION DRUG COST TRANSPARENCY
13	13	SUBCHAPTER A. GENERAL PROVISIONS
14	14	Sec. 441.0001. DEFINITIONS. In this chapter:
15	15	(1) "Commission" means the Health and Human Services
16	16	Commission.
17	17	(2) "Health benefit plan issuer" means an insurer,
18	18	health maintenance organization, or other entity authorized to
19	19	provide health benefit coverage under the laws of this state.
20	20	(3) "Manufacturer" means a person engaged in the
21	21	business of producing, preparing, propagating, compounding,
22	22	converting, processing, packaging, labeling, or distributing a
23	23	prescription drug. The term does not include a wholesale
24	24	distributor or retailer of prescription drugs or a pharmacist
25	25	licensed under Subtitle J, Title 3, Occupations Code.
26	26	(4) "Prescription drug" has the meaning assigned by
27	27	Section 551.003, Occupations Code.
28	28	Sec. 441.0002. REQUEST FOR INFORMATION. The commission or
29	29	attorney general may request information necessary to carry out the
30	30	purposes of this chapter from another state agency. A state agency
31	31	receiving a request under this section shall provide the requested
32	32	information in a reasonable time.
33	33	SUBCHAPTER B. LISTS OF PRESCRIPTION DRUGS
34	34	Sec. 441.0051. COMMISSION LIST BY WHOLESALE ACQUISITION
35	35	COST. (a) The commission shall annually compile a list of
36	36	prescription drugs by wholesale acquisition cost.
37	37	(b) The list described by Subsection (a) must:
38	38	(1) include 10 prescription drugs:
39	39	(A) on which the commission or another state
40	40	agency spends a significant amount of money under a health benefit
41	41	plan administered by the agency; and
42	42	(B) for which the wholesale acquisition cost has
43	43	increased by at least:
44	44	(i) 50 percent during the previous five
45	45	calendar years; or
46	46	(ii) 15 percent during the previous
47	47	calendar year;
48	48	(2) include at least one generic and one brand name
49	49	drug;
50	50	(3) indicate which drugs on the list are specialty
51	51	drugs;
52	52	(4) include the percentage increase of the wholesale
53	53	acquisition cost for each drug on the list during the previous
54	54	calendar year and during the previous five calendar years;
55	55	(5) rank the drugs on the list from those with the
56	56	largest increase in wholesale acquisition cost to those with the
57	57	smallest increase in wholesale acquisition cost based on the
58	58	previous calendar year;
59	59	(6) state whether each drug on the list was included on
60	60	the list because of the wholesale acquisition cost increase over
61	61	the past five years or during the previous calendar year or both;
62	62	and
63	63	(7) provide the state's total expenditure for each
64	64	drug on the list during the previous calendar year.
65	65	Sec. 441.0052. COMMISSION LIST BY STATE COST. (a) In
66	66	addition to the list described by Section 441.0051, the commission
67	67	shall annually compile a list of prescription drugs by state cost.
68	68	(b) The list described by Subsection (a) must:
69	69	(1) include 10 prescription drugs:
70	70	(A) on which the commission or another state
71	71	agency spends a significant amount of money under a health benefit
72	72	plan administered by the agency; and
73	73	(B) for which the cost to the agency, excluding
74	74	any rebate or other price concession, has increased by at least:
75	75	(i) 50 percent during the previous five
76	76	calendar years; or
77	77	(ii) 15 percent during the previous
78	78	calendar year;
79	79	(2) include at least one generic and one brand name
80	80	drug;
81	81	(3) indicate which drugs on the list are specialty
82	82	drugs;
83	83	(4) rank the drugs on the list from those with the
84	84	largest increase in net cost to those with the smallest increase
85	85	based on the previous calendar year; and
86	86	(5) state whether each drug on the list was included on
87	87	the list because of the cost increase over the past five years or
88	88	during the previous calendar year or both.
89	89	Sec. 441.0053. MAJOR HEALTH BENEFIT PLAN ISSUER LIST;
90	90	REPORT. (a) This section applies only to a health benefit plan
91	91	issuer that is authorized to write a health benefit plan in this
92	92	state and that provides health benefit plan coverage for at least
93	93	5,000 enrollees.
94	94	(b) A health benefit plan issuer shall annually compile a
95	95	list of prescription drugs by cost.
96	96	(c) The list described by Subsection (b) must:
97	97	(1) include 10 prescription drugs:
98	98	(A) on which the health benefit plan issuer
99	99	spends a significant amount of money; and
100	100	(B) for which the cost to the issuer's health
101	101	benefit plans, excluding any rebate or other price concession, has
102	102	increased by at least:
103	103	(i) 50 percent during the previous five
104	104	calendar years; or
105	105	(ii) 15 percent during the previous
106	106	calendar year;
107	107	(2) include at least one generic and one brand name
108	108	drug;
109	109	(3) indicate which drugs on the list are specialty
110	110	drugs;
111	111	(4) rank the drugs on the list from those with the
112	112	largest increase in net cost to those with the smallest increase
113	113	based on the previous calendar year; and
114	114	(5) state whether each drug on the list was included on
115	115	the list because of the cost increase over the past five years or
116	116	during the previous calendar year or both.
117	117	(d) A health benefit plan issuer shall provide to the
118	118	attorney general an annual written report on the list described by
119	119	Subsection (b) that states:
120	120	(1) the percentage by which the net cost to the
121	121	issuer's health benefit plans has increased during the previous
122	122	calendar year and during the previous five calendar years for each
123	123	prescription drug on the list; and
124	124	(2) the issuer's total expenditure, excluding any
125	125	rebate or other price concession, for each drug on the list during
126	126	the previous calendar year.
127	127	(e) Except as provided by Section 441.0054(b), information
128	128	provided to the attorney general under Subsection (d) is
129	129	confidential and excepted from disclosure under Chapter 552,
130	130	Government Code.
131	131	(f) The commissioner of insurance, in consultation with the
132	132	executive commissioner, may adopt rules necessary to implement this
133	133	section, including rules:
134	134	(1) designating which prescription drugs are
135	135	considered to be specialty drugs for purposes of this chapter; and
136	136	(2) governing the manner in which a health benefit
137	137	plan issuer identifies a drug as a specialty drug for purposes of
138	138	this chapter.
139	139	Sec. 441.0054. REPORT TO ATTORNEY GENERAL. (a) Not later
140	140	than June 1 of each year, the commission and each health benefit
141	141	plan issuer to which Section 441.0053 applies shall provide each
142	142	list required under this subchapter to the attorney general.
143	143	(b) The attorney general and commission shall post the lists
144	144	described by Subsection (a) on the attorney general's and
145	145	commission's Internet websites.
146	146	SUBCHAPTER C. PRICE JUSTIFICATION
147	147	Sec. 441.0101. ATTORNEY GENERAL LIST. (a) Using the lists
148	148	provided under Section 441.0054 and except as provided by
149	149	Subsection (b), the attorney general shall compile an aggregate
150	150	list of 15 prescription drugs for which the greatest amount of money
151	151	was spent across all payers during the previous calendar year.
152	152	(b) If fewer than 15 prescription drugs appear on more than
153	153	one payer's list, the attorney general shall rank the remaining
154	154	drugs based on the amount of money spent by any one payer during the
155	155	previous calendar year, in descending order, and may select as many
156	156	of the drugs based on that ranking as necessary to reach a total of
157	157	15 drugs required under Subsection (a).
158	158	(c) The attorney general shall provide written notice to
159	159	each manufacturer of a prescription drug on the list described by
160	160	Subsection (a) of the drug's placement on the list and the
161	161	manufacturer's duties under this subchapter.
162	162	Sec. 441.0102. PRICE JUSTIFICATION REQUIRED. (a) On
163	163	receipt of the notice described by Section 441.0101(c), a
164	164	manufacturer shall provide to the attorney general in the form and
165	165	manner prescribed by the attorney general a written report on the
166	166	prescription drug described by the notice.
167	167	(b) The report described by Subsection (a) must include:
168	168	(1) a justification for the increase in the net cost of
169	169	the prescription drug for the commission, a health benefit plan
170	170	issuer, or both; and
171	171	(2) all relevant information and supporting
172	172	documentation necessary to support the justification described by
173	173	Subdivision (1), including:
174	174	(A) each factor that specifically caused the net
175	175	cost increase;
176	176	(B) the percentage of the total cost increase
177	177	attributable to each factor; and
178	178	(C) an explanation of the role of each factor in
179	179	contributing to the cost increase.
180	180	(c) A manufacturer shall provide the report described by
181	181	Subsection (a) in the form and manner prescribed by the attorney
182	182	general to the attorney general.
183	183	(d) A manufacturer shall provide additional information
184	184	concerning a listed prescription drug or a cost increase to the
185	185	attorney general on request by the attorney general.
186	186	(e) A manufacturer may request a portion of the information
187	187	provided to be excepted from publication and held as confidential
188	188	in accordance with Section 552.110, Government Code, or other
189	189	applicable law, and shall provide an explanation for each request
190	190	to the attorney general. If the attorney general finds that the
191	191	request is justified, the information shall:
192	192	(1) be redacted from the report provided under this
193	193	section;
194	194	(2) be confidential; and
195	195	(3) be excepted from disclosure under Chapter 552,
196	196	Government Code.
197	197	(f) The attorney general may adopt rules necessary to
198	198	implement this section.
199	199	Sec. 441.0103. ATTORNEY GENERAL REPORT TO LEGISLATURE. (a)
200	200	Not later than December 1 of each year, the attorney general shall
201	201	provide a written report to the legislature on the manufacturer
202	202	reports described by Section 441.0102 received by the attorney
203	203	general during the previous calendar year.
204	204	(b) The attorney general and commission shall post the
205	205	report described by Subsection (a) and each copy of a
206	206	manufacturer's report provided under Section 441.0102, redacted as
207	207	necessary, on the attorney general's and commission's Internet
208	208	websites. The attorney general and commission may inform the
209	209	public of the availability of the reports posted under this
210	210	subsection.
211	211	Sec. 441.0104. CONSTRUCTION OF SUBCHAPTER. This subchapter
212	212	may not be construed to restrict the legal ability of a manufacturer
213	213	to increase prescription drug prices in accordance with federal
214	214	law.
215	215	Sec. 441.0105. ENFORCEMENT. A manufacturer that violates
216	216	Section 441.0102 or a rule adopted under this chapter is liable to
217	217	the state for a civil penalty of not more than $10,000 for each
218	218	violation. Each failure to provide information to the attorney
219	219	general is a separate violation. The attorney general may bring
220	220	suit to provide for injunctive relief or to recover a civil penalty,
221	221	or both. The attorney general may recover court costs and
222	222	reasonable attorney's fees.
223	223	SECTION 2. As soon as practicable after the effective date
224	224	of this Act, the executive commissioner of the Health and Human
225	225	Services Commission shall identify, provide to the attorney
226	226	general, and post on the commission's Internet website the list of
227	227	prescription drugs and manufacturers required by Sections 441.0051
228	228	and 441.0052, Health and Safety Code, as added by this Act.
229	229	SECTION 3. Notwithstanding Section 441.0103, Health and
230	230	Safety Code, as added by this Act, the attorney general is not
231	231	required to submit the initial report required by that section
232	232	before December 1, 2020.
233	233	SECTION 4. This Act takes effect September 1, 2019.