H.B. No. 3441
 
 
 
 
AN ACT
  relating to reimbursement under certain health benefit plans for
  certain services and procedures performed by pharmacists.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter C, Chapter 1451, Insurance Code, is
  amended by adding Section 1451.1261 to read as follows:
         Sec. 1451.1261.  REIMBURSEMENT FOR CERTAIN SERVICES AND
  PROCEDURES PERFORMED BY PHARMACISTS. (a)  Notwithstanding any
  other law, in addition to applying to a policy, agreement, or
  contract described by Section 1451.102, this section applies to any
  other individual or group health benefit plan that provides
  benefits described by Section 1451.102, including:
               (1)  a health benefit plan issued by:
                     (A)  a group hospital service corporation
  operating under Chapter 842;
                     (B)  a health maintenance organization operating
  under Chapter 843; or
                     (C)  a multiple employer welfare arrangement that
  holds a certificate of authority under Chapter 846;
               (2)  a small employer health benefit plan subject to
  Chapter 1501;
               (3)  a standard health benefit plan issued under
  Chapter 1507;
               (4)  health benefits provided by or through a church
  benefits board under Subchapter I, Chapter 22, Business
  Organizations Code;
               (5)  a regional or local health care program operated
  under Section 75.104, Health and Safety Code; and
               (6)  a self-funded health benefit plan sponsored by a
  professional employer organization under Chapter 91, Labor Code.
         (b)  This section does not apply to:
               (1)  a basic coverage plan under Chapter 1551;
               (2)  a basic plan under Chapter 1575;
               (3)  a primary care coverage plan under Chapter 1579;
               (4)  a plan providing basic coverage under Chapter
  1601;
               (5)  the state Medicaid program, including the Medicaid
  managed care program operated under Chapter 533, Government Code;
  or
               (6)  the child health plan program under Chapter 62,
  Health and Safety Code.
         (c)  Notwithstanding Section 1451.102, this section applies
  to coverage under a group health benefit plan provided to a resident
  of this state regardless of whether the group policy, agreement, or
  contract is delivered, issued for delivery, or renewed in this
  state.
         (d)  An insurer or other health benefit plan issuer or a
  third-party administrator or pharmacy benefit manager of a health
  benefit plan may not deny reimbursement to a pharmacist for the
  provision of a service or procedure within the scope of the
  pharmacist's license to practice pharmacy under Subtitle J, Title
  3, Occupations Code, that:
               (1)  would be covered by the insurance policy or other
  coverage agreement if the service or procedure were provided by:
                     (A)  a physician;
                     (B)  an advanced practice nurse; or
                     (C)  a physician assistant; and 
               (2)  is performed by the pharmacist in strict
  compliance with laws and rules related to:
                     (A)  the provision of the service or procedure;
  and
                     (B)  the pharmacist's license.
         (e)  This section may not be construed to require an insurer
  or other health benefit plan issuer or a third-party administrator
  or pharmacy benefit manager to reimburse a pharmacist or pharmacy
  as an in-network or preferred provider.
         SECTION 2.  Section 1451.1261, Insurance Code, as added by
  this Act, applies only to a health benefit plan that is delivered,
  issued for delivery, or renewed on or after January 1, 2020. A plan
  delivered, issued for delivery, or renewed before January 1, 2020,
  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 3.  This Act takes effect September 1, 2019.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 3441 was passed by the House on April
  26, 2019, by the following vote:  Yeas 137, Nays 2, 2 present, not
  voting.
 
  ______________________________
  Chief Clerk of the House   
 
 
         I certify that H.B. No. 3441 was passed by the Senate on May
  15, 2019, by the following vote:  Yeas 31, Nays 0.
 
  ______________________________
  Secretary of the Senate    
  APPROVED:  _____________________
                     Date          
   
            _____________________
                   Governor