Texas 2019 - 86th Regular

Texas House Bill HB3441 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 3441
	1	+	By: Lucio III (Senate Sponsor - Schwertner) H.B. No. 3441
	2	+	(In the Senate - Received from the House April 29, 2019;
	3	+	April 29, 2019, read first time and referred to Committee on
	4	+	Business & Commerce; May 7, 2019, reported favorably by the
	5	+	following vote: Yeas 8, Nays 0; May 7, 2019, sent to printer.)
	6	+	Click here to see the committee vote
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5	11		relating to reimbursement under certain health benefit plans for
6	12		certain services and procedures performed by pharmacists.
7	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	14		SECTION 1. Subchapter C, Chapter 1451, Insurance Code, is
9	15		amended by adding Section 1451.1261 to read as follows:
10	16		Sec. 1451.1261. REIMBURSEMENT FOR CERTAIN SERVICES AND
11	17		PROCEDURES PERFORMED BY PHARMACISTS. (a) Notwithstanding any
12	18		other law, in addition to applying to a policy, agreement, or
13	19		contract described by Section 1451.102, this section applies to any
14	20		other individual or group health benefit plan that provides
15	21		benefits described by Section 1451.102, including:
16	22		(1) a health benefit plan issued by:
17	23		(A) a group hospital service corporation
18	24		operating under Chapter 842;
19	25		(B) a health maintenance organization operating
20	26		under Chapter 843; or
21	27		(C) a multiple employer welfare arrangement that
22	28		holds a certificate of authority under Chapter 846;
23	29		(2) a small employer health benefit plan subject to
24	30		Chapter 1501;
25	31		(3) a standard health benefit plan issued under
26	32		Chapter 1507;
27	33		(4) health benefits provided by or through a church
28	34		benefits board under Subchapter I, Chapter 22, Business
29	35		Organizations Code;
30	36		(5) a regional or local health care program operated
31	37		under Section 75.104, Health and Safety Code; and
32	38		(6) a self-funded health benefit plan sponsored by a
33	39		professional employer organization under Chapter 91, Labor Code.
34	40		(b) This section does not apply to:
35	41		(1) a basic coverage plan under Chapter 1551;
36	42		(2) a basic plan under Chapter 1575;
37	43		(3) a primary care coverage plan under Chapter 1579;
38	44		(4) a plan providing basic coverage under Chapter
39	45		1601;
40	46		(5) the state Medicaid program, including the Medicaid
41	47		managed care program operated under Chapter 533, Government Code;
42	48		or
43	49		(6) the child health plan program under Chapter 62,
44	50		Health and Safety Code.
45	51		(c) Notwithstanding Section 1451.102, this section applies
46	52		to coverage under a group health benefit plan provided to a resident
47	53		of this state regardless of whether the group policy, agreement, or
48	54		contract is delivered, issued for delivery, or renewed in this
49	55		state.
50	56		(d) An insurer or other health benefit plan issuer or a
51	57		third-party administrator or pharmacy benefit manager of a health
52	58		benefit plan may not deny reimbursement to a pharmacist for the
53	59		provision of a service or procedure within the scope of the
54	60		pharmacist's license to practice pharmacy under Subtitle J, Title
55	61		3, Occupations Code, that:
56	62		(1) would be covered by the insurance policy or other
57	63		coverage agreement if the service or procedure were provided by:
58	64		(A) a physician;
59	65		(B) an advanced practice nurse; or
60	66		(C) a physician assistant; and
61	67		(2) is performed by the pharmacist in strict
62	68		compliance with laws and rules related to:
63	69		(A) the provision of the service or procedure;
64	70		and
65	71		(B) the pharmacist's license.
66	72		(e) This section may not be construed to require an insurer
67	73		or other health benefit plan issuer or a third-party administrator
68	74		or pharmacy benefit manager to reimburse a pharmacist or pharmacy
69	75		as an in-network or preferred provider.
70	76		SECTION 2. Section 1451.1261, Insurance Code, as added by
71	77		this Act, applies only to a health benefit plan that is delivered,
72	78		issued for delivery, or renewed on or after January 1, 2020. A plan
73	79		delivered, issued for delivery, or renewed before January 1, 2020,
74	80		is governed by the law as it existed immediately before the
75	81		effective date of this Act, and that law is continued in effect for
76	82		that purpose.
77	83		SECTION 3. This Act takes effect September 1, 2019.
78		-	______________________________ ______________________________
79		-	President of the Senate Speaker of the House
80		-	I certify that H.B. No. 3441 was passed by the House on April
81		-	26, 2019, by the following vote: Yeas 137, Nays 2, 2 present, not
82		-	voting.
83		-	______________________________
84		-	Chief Clerk of the House
85		-	I certify that H.B. No. 3441 was passed by the Senate on May
86		-	15, 2019, by the following vote: Yeas 31, Nays 0.
87		-	______________________________
88		-	Secretary of the Senate
89		-	APPROVED: _____________________
90		-	Date
91		-	_____________________
92		-	Governor
	84	+	* * * * *