| Old | New | Differences | |
|---|---|---|---|
| 1 | - | ||
| 1 | + | 89R3906 MPF-D | |
| 2 | 2 | By: Talarico H.B. No. 1464 | |
| 3 | - | Substitute the following for H.B. No. 1464: | |
| 4 | - | By: Dean C.S.H.B. No. 1464 | |
| 5 | 3 | ||
| 6 | 4 | ||
| 7 | 5 | ||
| 8 | 6 | ||
| 9 | 7 | A BILL TO BE ENTITLED | |
| 10 | 8 | AN ACT | |
| 11 | 9 | relating to a prescription drug purchasing pool for certain health | |
| 12 | 10 | benefit plan issuers and employers. | |
| 13 | 11 | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | |
| 14 | 12 | SECTION 1. Subtitle A, Title 6, Health and Safety Code, is | |
| 15 | 13 | amended by adding Chapter 446 to read as follows: | |
| 16 | 14 | CHAPTER 446. PRESCRIPTION DRUG PURCHASING POOL | |
| 17 | 15 | Sec. 446.001. DEFINITIONS. In this chapter: | |
| 18 | - | (1) "Commission" means the Health and Human Services | |
| 19 | - | Commission. | |
| 20 | - | (2) "Health benefit plan issuer" means an insurer, | |
| 16 | + | (1) "Health benefit plan issuer" means an insurer, | |
| 21 | 17 | health maintenance organization, or other entity authorized to | |
| 22 | 18 | provide health benefits coverage under the laws of this state. | |
| 23 | - | ( | |
| 19 | + | (2) "Participant" means a health benefit plan issuer, | |
| 24 | 20 | qualified public employer, or qualified private employer enrolled | |
| 25 | 21 | in the prescription drug purchasing pool. | |
| 26 | - | ( | |
| 22 | + | (3) "Qualified private employer" means a self-insured | |
| 27 | 23 | private employer conducting business in this state. | |
| 28 | - | ( | |
| 24 | + | (4) "Qualified public employer" means: | |
| 29 | 25 | (A) a political subdivision of this state, | |
| 30 | 26 | including a county, municipality, or public school district; | |
| 31 | 27 | (B) a university system or an institution of | |
| 32 | 28 | higher education, as those terms are defined by Section 61.003, | |
| 33 | 29 | Education Code; or | |
| 34 | 30 | (C) a quasi-public agency. | |
| 35 | 31 | Sec. 446.002. PRESCRIPTION DRUG PURCHASING POOL. (a) The | |
| 36 | - | | |
| 32 | + | comptroller shall establish a prescription drug purchasing pool | |
| 37 | 33 | through which a participating health benefit plan issuer, qualified | |
| 38 | 34 | public employer, or qualified private employer may purchase | |
| 39 | 35 | prescription drugs for their employees, employees' dependents, and | |
| 40 | 36 | retirees from vendors at a discounted rate or under terms the | |
| 41 | - | | |
| 37 | + | comptroller negotiates. | |
| 42 | 38 | (b) The prescription drug purchasing pool does not | |
| 43 | 39 | constitute a risk pool, and each health benefit plan issuer, | |
| 44 | 40 | qualified public employer, and qualified private employer | |
| 45 | 41 | participating in the pool is responsible for paying the cost of a | |
| 46 | 42 | claim or prescription drug in accordance with any applicable health | |
| 47 | 43 | benefit coverage agreement with their employees, employees' | |
| 48 | 44 | dependents, and retirees. | |
| 49 | 45 | Sec. 446.003. ADMINISTRATION OF PRESCRIPTION DRUG | |
| 50 | - | PURCHASING POOL. The | |
| 51 | - | ||
| 52 | - | ||
| 46 | + | PURCHASING POOL. The comptroller by rule shall establish | |
| 47 | + | procedures for administering the prescription drug purchasing | |
| 48 | + | pool, including procedures establishing: | |
| 53 | 49 | (1) the eligibility criteria for a health benefit plan | |
| 54 | 50 | issuer, qualified public employer, or qualified private employer to | |
| 55 | 51 | participate in the pool; | |
| 56 | 52 | (2) the manner by which a health benefit plan issuer, | |
| 57 | 53 | qualified public employer, or qualified private employer may enroll | |
| 58 | 54 | in the pool; | |
| 59 | 55 | (3) the duration of eligibility for a health benefit | |
| 60 | 56 | plan issuer, qualified public employer, or qualified private | |
| 61 | 57 | employer to participate in the pool; | |
| 62 | 58 | (4) the method by which a participant contributes | |
| 63 | 59 | money to the pool; and | |
| 64 | 60 | (5) the method for disenrolling a participant from the | |
| 65 | 61 | pool or terminating a participant's eligibility to participate in | |
| 66 | 62 | the pool. | |
| 67 | - | Sec. 446.004. OPTIONAL STOP LOSS COVERAGE. The | |
| 63 | + | Sec. 446.004. OPTIONAL STOP LOSS COVERAGE. The comptroller | |
| 68 | 64 | shall provide a participant the option to purchase stop loss | |
| 69 | - | coverage from an insurer at a rate the | |
| 65 | + | coverage from an insurer at a rate the comptroller negotiates. | |
| 70 | 66 | Sec. 446.005. MULTIPLE EMPLOYER PRESCRIPTION DRUG | |
| 71 | 67 | PURCHASING AGREEMENTS. (a) Two or more participants may jointly | |
| 72 | 68 | purchase through the prescription drug purchasing pool | |
| 73 | 69 | prescription drugs for their employees, employees' dependents, and | |
| 74 | 70 | retirees. | |
| 75 | 71 | (b) An arrangement to jointly purchase prescription drugs | |
| 76 | 72 | under this section does not constitute a multiple employer welfare | |
| 77 | 73 | arrangement, as defined by Section 846.001, Insurance Code. | |
| 78 | - | Sec. 446.006. RULES. The | |
| 79 | - | ||
| 74 | + | Sec. 446.006. RULES. The comptroller shall adopt rules as | |
| 75 | + | necessary to implement this chapter. | |
| 80 | 76 | SECTION 2. As soon as practicable after the effective date | |
| 81 | - | of this Act, the | |
| 82 | - | ||
| 83 | - | ||
| 77 | + | of this Act, the comptroller of public accounts shall establish the | |
| 78 | + | prescription drug purchasing pool as required by Chapter 446, | |
| 79 | + | Health and Safety Code, as added by this Act. | |
| 84 | 80 | SECTION 3. This Act takes effect September 1, 2025. |