By: Schwertner, Flores, Hughes S.B. No. 1122
(In the Senate - Filed February 6, 2025; February 24, 2025,
read first time and referred to Committee on Health & Human
Services; March 31, 2025, reported favorably by the following
vote: Yeas 6, Nays 2, one present not voting; March 31, 2025, sent
to printer.)
A BILL TO BE ENTITLED
AN ACT
relating to applicability of certain prescription drug insurance
laws to health benefit plans and pharmacy benefit managers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter L, Chapter 1369, Insurance Code, is
amended by adding Section 1369.5515 to read as follows:
Sec. 1369.5515. APPLICABILITY OF SUBCHAPTER. (a) Except
as provided by this subsection, a pharmacy benefit manager must
comply with the provisions of this subchapter with respect to each
health benefit plan administered by the pharmacy benefit manager,
regardless of whether a provision of this subchapter is
specifically made applicable to the plan. A pharmacy benefit
manager is not required to comply with a provision of this
subchapter with respect to a plan expressly excluded by this
subchapter from the applicability of the provision.
(b) This subchapter applies to a health benefit plan
provided to a resident of this state, regardless of whether the
plan, policy, agreement, or contract is delivered, issued for
delivery, or renewed within or outside this state and to the
pharmacy benefit manager for that plan.
SECTION 2. Section 1369.602, Insurance Code, is amended by
adding Subsections (d) and (e) to read as follows:
(d) Except as provided by this subsection, a pharmacy
benefit manager must comply with the provisions of this subchapter
with respect to each health benefit plan administered by the
pharmacy benefit manager, regardless of whether a provision of this
subchapter is specifically made applicable to the plan. A pharmacy
benefit manager is not required to comply with a provision of this
subchapter with respect to a plan expressly excluded by this
subchapter from the applicability of the provision.
(e) This subchapter applies to a health benefit plan
provided to a resident of this state, regardless of whether the
plan, policy, agreement, or contract is delivered, issued for
delivery, or renewed within or outside this state and to the
pharmacy benefit manager for that plan.
SECTION 3. As soon as practicable after the effective date
of this Act, the commissioner of insurance shall repeal all rules
that are inconsistent with the changes in law made by this Act.
SECTION 4. The changes in law made by this Act apply only to
a health benefit plan that is delivered, issued for delivery, or
renewed on or after January 1, 2026. A health benefit plan
delivered, issued for delivery, or renewed before January 1, 2026,
is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 5. This Act takes effect September 1, 2025.
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