| 1 | 1 | | 89R1175 SCL-F |
|---|
| 2 | 2 | | By: Bonnen H.B. No. 5102 |
|---|
| 3 | 3 | | |
|---|
| 4 | 4 | | |
|---|
| 5 | 5 | | |
|---|
| 6 | 6 | | |
|---|
| 7 | 7 | | A BILL TO BE ENTITLED |
|---|
| 8 | 8 | | AN ACT |
|---|
| 9 | 9 | | relating to applicability of certain prescription drug insurance |
|---|
| 10 | 10 | | laws to health benefit plans and pharmacy benefit managers. |
|---|
| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 12 | 12 | | SECTION 1. Subchapter L, Chapter 1369, Insurance Code, is |
|---|
| 13 | 13 | | amended by adding Section 1369.5515 to read as follows: |
|---|
| 14 | 14 | | Sec. 1369.5515. APPLICABILITY OF SUBCHAPTER. (a) Except |
|---|
| 15 | 15 | | as provided by this subsection, a pharmacy benefit manager must |
|---|
| 16 | 16 | | comply with the provisions of this subchapter with respect to each |
|---|
| 17 | 17 | | health benefit plan administered by the pharmacy benefit manager, |
|---|
| 18 | 18 | | regardless of whether a provision of this subchapter is |
|---|
| 19 | 19 | | specifically made applicable to the plan. A pharmacy benefit |
|---|
| 20 | 20 | | manager is not required to comply with a provision of this |
|---|
| 21 | 21 | | subchapter with respect to a plan expressly excluded by this |
|---|
| 22 | 22 | | subchapter from the applicability of the provision. |
|---|
| 23 | 23 | | (b) This subchapter applies to a health benefit plan |
|---|
| 24 | 24 | | provided to a resident of this state, regardless of whether the |
|---|
| 25 | 25 | | plan, policy, agreement, or contract is delivered, issued for |
|---|
| 26 | 26 | | delivery, or renewed within or outside this state and to the |
|---|
| 27 | 27 | | pharmacy benefit manager for that plan. |
|---|
| 28 | 28 | | SECTION 2. Section 1369.602, Insurance Code, is amended by |
|---|
| 29 | 29 | | adding Subsections (d) and (e) to read as follows: |
|---|
| 30 | 30 | | (d) Except as provided by this subsection, a pharmacy |
|---|
| 31 | 31 | | benefit manager must comply with the provisions of this subchapter |
|---|
| 32 | 32 | | with respect to each health benefit plan administered by the |
|---|
| 33 | 33 | | pharmacy benefit manager, regardless of whether a provision of this |
|---|
| 34 | 34 | | subchapter is specifically made applicable to the plan. A pharmacy |
|---|
| 35 | 35 | | benefit manager is not required to comply with a provision of this |
|---|
| 36 | 36 | | subchapter with respect to a plan expressly excluded by this |
|---|
| 37 | 37 | | subchapter from the applicability of the provision. |
|---|
| 38 | 38 | | (e) This subchapter applies to a health benefit plan |
|---|
| 39 | 39 | | provided to a resident of this state, regardless of whether the |
|---|
| 40 | 40 | | plan, policy, agreement, or contract is delivered, issued for |
|---|
| 41 | 41 | | delivery, or renewed within or outside this state and to the |
|---|
| 42 | 42 | | pharmacy benefit manager for that plan. |
|---|
| 43 | 43 | | SECTION 3. As soon as practicable after the effective date |
|---|
| 44 | 44 | | of this Act, the commissioner of insurance shall repeal all rules |
|---|
| 45 | 45 | | that are inconsistent with the changes in law made by this Act. |
|---|
| 46 | 46 | | SECTION 4. The changes in law made by this Act apply only to |
|---|
| 47 | 47 | | a health benefit plan that is delivered, issued for delivery, or |
|---|
| 48 | 48 | | renewed on or after January 1, 2026. A health benefit plan |
|---|
| 49 | 49 | | delivered, issued for delivery, or renewed before January 1, 2026, |
|---|
| 50 | 50 | | is governed by the law as it existed immediately before the |
|---|
| 51 | 51 | | effective date of this Act, and that law is continued in effect for |
|---|
| 52 | 52 | | that purpose. |
|---|
| 53 | 53 | | SECTION 5. This Act takes effect September 1, 2025. |
|---|