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By: Schwertner |
S.B. No. 1076 |
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(In the Senate - Filed February 23, 2017; March 7, 2017, |
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read first time and referred to Committee on Business & Commerce; |
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April 10, 2017, reported adversely, with favorable Committee |
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Substitute by the following vote: Yeas 9, Nays 0; April 10, 2017, |
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sent to printer.) |
| Click here to see the committee vote |
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COMMITTEE SUBSTITUTE FOR S.B. No. 1076 |
By: Schwertner |
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A BILL TO BE ENTITLED
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AN ACT
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relating to amounts charged to an enrollee in a health benefit plan |
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for prescription drugs covered by the plan. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1369.001, Insurance Code, is amended by |
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adding Subdivision (2-a) to read as follows: |
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(2-a) "Enrollee" means an individual who is covered |
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under a health benefit plan, including a covered dependent. |
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SECTION 2. Subchapter A, Chapter 1369, Insurance Code, is |
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amended by adding Section 1369.0041 to read as follows: |
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Sec. 1369.0041. LIMIT ON PAYMENT REQUIRED UNDER PLAN. A |
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health benefit plan issuer that covers prescription drugs may not |
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require an enrollee to make a payment for a prescription drug at the |
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point of sale in an amount greater than the lesser of: |
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(1) the applicable copayment; or |
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(2) the negotiated or allowable claim amount for the |
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prescription drug specified by the agreement between the health |
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benefit plan issuer or its pharmacy benefit manager and the |
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pharmacist or pharmacy providing the prescription drug. |
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SECTION 3. Section 1369.0041, Insurance Code, as added by |
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this Act, applies only to a health benefit plan that is delivered, |
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issued for delivery, or renewed on or after January 1, 2018. A plan |
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delivered, issued for delivery, or renewed before January 1, 2018, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 4. This Act takes effect September 1, 2017. |
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