Texas 2019 - 86th Regular

Texas House Bill HB1455 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 1455
	1	+	By: Hunter, et al. H.B. No. 1455
	2	+	(Senate Sponsor - Buckingham, Schwertner)
	3	+	(In the Senate - Received from the House April 25, 2019;
	4	+	April 29, 2019, read first time and referred to Committee on
	5	+	Business & Commerce; May 15, 2019, reported favorably by the
	6	+	following vote: Yeas 7, Nays 0; May 15, 2019, sent to printer.)
	7	+	Click here to see the committee vote
2	8
3	9
	10	+	A BILL TO BE ENTITLED
4	11		AN ACT
5	12		relating to the audit of wholesale invoices during certain audits
6	13		of pharmacists and pharmacies.
7	14		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	15		SECTION 1. Subchapter F, Chapter 1369, Insurance Code, is
9	16		amended by adding Section 1369.2581 to read as follows:
10	17		Sec. 1369.2581. AUDIT DISCREPANCIES; WHOLESALE INVOICES.
11	18		(a) A health benefit plan issuer or pharmacy benefit manager that
12	19		audits wholesale invoices during an audit of a pharmacist or
13	20		pharmacy may not audit the pharmacy claims of another health
14	21		benefit plan or pharmacy benefit manager.
15	22		(b) A health benefit plan issuer or pharmacy benefit manager
16	23		shall reverse a finding of a discrepancy if:
17	24		(1) the National Drug Code for the dispensed drug is in
18	25		a quantity that is a subunit or multiple of the drug purchased by
19	26		the pharmacist or pharmacy as supported by a wholesale invoice;
20	27		(2) the pharmacist or pharmacy dispensed the correct
21	28		quantity of the drug according to the prescription; and
22	29		(3) the drug dispensed by the pharmacist or pharmacy
23	30		shares all but the last two digits of the National Drug Code of the
24	31		drug reflected on the supplier invoice.
25	32		(c) A health benefit plan issuer or pharmacy benefit manager
26	33		must accept as evidence to support the validity of a pharmacy claim
27	34		related to a dispensed drug:
28	35		(1) subject to validation, including validation by
29	36		pharmacy purchase order and payment of a supplier invoice, copies
30	37		of supplier invoices in the pharmacist's or pharmacy's possession,
31	38		including:
32	39		(A) supplier invoices issued before the date the
33	40		drug was dispensed and not earlier than 60 days before the first day
34	41		of the audit period; and
35	42		(B) invoices and any supporting documents from
36	43		any supplier authorized by federal or state law to transfer
37	44		ownership of the drug acquired by the pharmacist or pharmacy; and
38	45		(2) reports required by any state board or agency.
39	46		(d) A health benefit plan issuer or pharmacy benefit manager
40	47		must provide, not later than the fifth business day after the date
41	48		of a request by the pharmacist or pharmacy, any supporting
42	49		documents the pharmacist's or pharmacy's suppliers provided to the
43	50		health benefit plan issuer or pharmacy benefit manager.
44	51		SECTION 2. The changes in law made by this Act apply only to
45	52		an audit conducted under a contract between a pharmacist or
46	53		pharmacy and a health benefit plan issuer or pharmacy benefit
47	54		manager entered into, amended, or renewed on or after the effective
48	55		date of this Act.
49	56		SECTION 3. This Act takes effect September 1, 2019.
50		-	______________________________ ______________________________
51		-	President of the Senate Speaker of the House
52		-	I certify that H.B. No. 1455 was passed by the House on April
53		-	24, 2019, by the following vote: Yeas 147, Nays 0, 1 present, not
54		-	voting.
55		-	______________________________
56		-	Chief Clerk of the House
57		-	I certify that H.B. No. 1455 was passed by the Senate on May
58		-	19, 2019, by the following vote: Yeas 31, Nays 0.
59		-	______________________________
60		-	Secretary of the Senate
61		-	APPROVED: _____________________
62		-	Date
63		-	_____________________
64		-	Governor
	57	+	* * * * *