Texas 2023 - 88th Regular

Texas House Bill HB3026 Compare Versions

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1	1	By: Oliverson, Morales of Maverick H.B. No. 3026
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the administration of a prescription drug manufacturer
7	7	or third-party prescription assistance program.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 65.002(b), Health and Safety Code, is
10	10	amended to read as follows:
11	11	(b) The purpose of this chapter is to authorize the
12	12	commission to establish a program to provide uninsured individuals
13	13	access to prescription drug benefits using money from the fund to
14	14	pay an amount equal to the value of a prescription drug rebate at
15	15	the point of sale and returning that rebate amount to the fund to
16	16	ensure the amounts credited to the fund equal the amounts paid from
17	17	the fund.
18	18	SECTION 2. Section 65.051(a), Health and Safety Code, is
19	19	amended to read as follows:
20	20	(a) The commission may [shall] develop and design a
21	21	prescription drug savings program that partners with a pharmacy
22	22	benefit manager to offer prescription drugs at a discounted rate to
23	23	uninsured individuals.
24	24	SECTION 3. Section 65.204, Health and Safety Code, is
25	25	amended to read as follows:
26	26	Sec. 65.204. ANNUAL PROGRAM REPORTS. Not later than
27	27	December 1 of each year following the first year in which the
28	28	program is established, the commission shall provide a written
29	29	report to the governor, lieutenant governor, speaker of the house
30	30	of representatives, and standing committees of the legislature with
31	31	primary jurisdiction over the program. The report must include:
32	32	(1) a line-item list of all program administrative
33	33	costs incurred by the commission;
34	34	(2) the amount of the pharmacy benefit manager and
35	35	third-party administrator fees;
36	36	(3) the aggregate amounts of rebates anticipated and
37	37	received for the program; and
38	38	(4) other program expenditures as the commission
39	39	determines appropriate.
40	40	SECTION 4. Subtitle C, Title 2, Health and Safety Code, is
41	41	amended by adding Chapter 66 to read as follows:
42	42	CHAPTER 66. PRESCRIPTION DRUG ASSISTANCE PROGRAM
43	43	SUBCHAPTER A. GENERAL PROVISIONS
44	44	Sec. 66.001. DEFINITIONS. In this chapter:
45	45	(1) "Prescription drug" has the meaning assigned by
46	46	Section 551.003, Occupations Code.
47	47	(2) "Program" means the prescription drug assistance
48	48	program established under this chapter.
49	49	Sec. 66.002. CONSTRUCTION OF CHAPTER; PURPOSE. (a) This
50	50	chapter does not establish an entitlement to assistance in
51	51	obtaining benefits for certain individuals.
52	52	(b) The purpose of this chapter is to authorize the
53	53	commission to establish a program to provide certain individuals
54	54	access to prescription drug benefits using a prescription drug
55	55	manufacturer or third-party prescription assistance programs.
56	56	(c) This chapter does not expand the Medicaid program.
57	57	Sec. 66.003. RULES. The executive commissioner may adopt
58	58	the rules necessary to implement this chapter.
59	59	SUBCHAPTER B. ESTABLISHMENT AND ADMINISTRATION OF PRESCRIPTION
60	60	DRUG ASSISTANCE PROGRAM
61	61	Sec. 66.051. ESTABLISHMENT OF PROGRAM. (a) The commission
62	62	shall develop and design a prescription drug assistance program to
63	63	increase access to prescription drugs for certain individuals
64	64	through a prescription drug manufacturer or other third-party
65	65	patient assistance program.
66	66	(b) In developing and implementing the program, the
67	67	commission may not exclude from the program benefits prescription
68	68	drugs used for the elective termination of a pregnancy if the drug
69	69	is prescribed:
70	70	(1) for a purpose other than the elective termination
71	71	of a pregnancy; or
72	72	(2) to terminate a pregnancy in accordance with an
73	73	exception under Section 170A.002.
74	74	(c) The commission shall ensure the program is designed to
75	75	provide the greatest value to program enrollees by considering:
76	76	(1) the adequacy of prescription drugs available
77	77	through the program;
78	78	(2) the net costs of the drugs to enrollees;
79	79	(3) the cost to this state; and
80	80	(4) other important factors as determined by the
81	81	commission.
82	82	Sec. 66.052. GENERAL POWERS AND DUTIES OF COMMISSION. (a)
83	83	The commission shall oversee the implementation of the program and
84	84	develop procedures for accepting applications for program
85	85	enrollment.
86	86	(b) The commission shall list in a central location on the
87	87	commission's Internet website information that directs a patient to
88	88	the appropriate assistance available under the program.
89	89	(c) To the extent feasible, the commission shall integrate a
90	90	prescription drug manufacturer or third-party patient assistance
91	91	program into the prescription drug assistance program. A
92	92	prescription drug manufacturer or other third party may decline to
93	93	link the prescription drug manufacturer's or third party's patient
94	94	assistance program to the prescription drug assistance program.
95	95	Sec. 66.053. CONTRACT AND GRANT AUTHORITY. (a) The
96	96	commission may contract with a third-party administrator or other
97	97	entity to perform any or all of the commission's program duties
98	98	under this chapter.
99	99	(b) A third-party administrator or other entity under a
100	100	contract entered into under Subsection (a) may perform the actions
101	101	the commission would otherwise perform to implement the program.
102	102	(c) The commission may award grants to or enter into other
103	103	arrangements with a governmental entity or nonprofit organization
104	104	to implement this chapter.
105	105	Sec. 66.054. COMMUNITY OUTREACH AND EDUCATION CAMPAIGN. The
106	106	commission shall conduct a community outreach and education
107	107	campaign to provide information on the program's availability to
108	108	eligible individuals.
109	109	SUBCHAPTER C. FUNDING; PROGRAM SUSPENSION
110	110	Sec. 66.101. FUNDING. (a) The commission may accept and
111	111	use money to implement this chapter, including:
112	112	(1) gifts, grants, and donations;
113	113	(2) legislative appropriations; and
114	114	(3) federal money available under law.
115	115	(b) Money accepted under Subsection (a) may be used only to
116	116	administer the prescription drug assistance program and provide
117	117	program services.
118	118	Sec. 66.102. SUFFICIENT FUNDING REQUIRED. Notwithstanding
119	119	any other provision of this chapter, the commission is not required
120	120	to implement the program unless appropriated money is made
121	121	available for the program.
122	122	SUBCHAPTER D. PROGRAM ELIGIBILITY AND ENROLLEE REQUIREMENTS
123	123	Sec. 66.151. ELIGIBILITY CRITERIA. (a) Except as provided
124	124	by Subsection (b), an individual is eligible for benefits under the
125	125	program if the individual meets eligibility criteria as determined
126	126	by a prescription drug manufacturer or other third party's
127	127	prescription assistance program.
128	128	(b) The commission may identify additional factors the
129	129	program must consider for program eligibility.
130	130	SUBCHAPTER E. OPERATION OF PROGRAM
131	131	Sec. 66.201. PROGRAM BENEFITS. The commission must approve
132	132	program benefits offered under this chapter. The commission shall
133	133	ensure the benefits comply with all applicable federal and state
134	134	laws and rules.
135	135	Sec. 66.202. REPORT. (a) A third-party administrator or
136	136	other entity the commission contracts with under Section 66.053
137	137	shall report to the commission in the form and manner prescribed by
138	138	the commission on the benefits and services provided under the
139	139	program.
140	140	(b) The commission shall establish a procedure to monitor
141	141	the provision of benefits and services under this chapter.
142	142	Sec. 66.203. ANNUAL PROGRAM REPORT. Not later than
143	143	December 1 of each year, the commission shall provide a written
144	144	report to the governor, lieutenant governor, speaker of the house
145	145	of representatives, and standing committees of the legislature with
146	146	primary jurisdiction over the program. The report must include:
147	147	(1) a line-item list of all program administrative
148	148	costs incurred by the commission, including costs incurred by a
149	149	third-party administrator or other entity;
150	150	(2) the aggregate amount of prescription drug cost
151	151	savings accrued under the program; and
152	152	(3) other program expenditures as the commission
153	153	determines appropriate.
154	154	SECTION 5. Section 65.102, Health and Safety Code, is
155	155	repealed.
156	156	SECTION 6. The Health and Human Services Commission is
157	157	required to implement a provision of this Act only if the
158	158	legislature appropriates money specifically for that purpose. If
159	159	the legislature does not appropriate money specifically for that
160	160	purpose, the Health and Human Services Commission may, but is not
161	161	required to, implement a provision of this Act using other
162	162	appropriations available for that purpose.
163	163	SECTION 7. As soon as practicable after the effective date
164	164	of this Act, the executive commissioner of the Health and Human
165	165	Services Commission and any other state agency designated by the
166	166	executive commissioner shall adopt rules necessary to implement
167	167	Chapter 65, Health and Safety Code, as amended by this Act, and
168	168	Chapter 66, Health and Safety Code, as added by this Act.
169	169	SECTION 8. This Act takes effect September 1, 2023.