Texas
Enacted & Passed
| TOPIC | SUMMARY | PRACTICAL NOTE | LINK TO EXISTING/PROPOSED LAW | MORE INFORMATION |
|---|---|---|---|---|
| Any Willing Provider |
A health insurance policy or managed care plan may not deny a pharmacy or pharmacist… | While this law provides strong ‘Any Willing Provider Law’ … | Tex. Ins. Code Ann. § 21.52B | |
| DIR Fees | A contract between a health insurer and PBM is prohibited from requiring a payment for… | While this law does not apply directly to DIR fees,… | V.T.C.A., Insurance Code § 1369.0041 | |
| Fair Pharmacy Audit | The state’s fair audit law includes requirements such as: the audit period covered… | This state has a fairly basic fair audit law… | Fla. Stat. Ann. § 465.1885 | |
| Maximum Allowable Cost | There is no appeal process but the PBM must update the maximum allowable… | This law is very meek in substance … | F.S.A. § 627.64741 | |
| PBM Licensure | Starting January 1, 2019, PBMs must register with the Office of Insurance… | While this law requires registration of PBMs … | F.S.A. 624.490 | |
| Prompt Pay | Upon receipt of clean claim the carrier must: (1) pay the total amount of the… | While PBMs are not specifically… | Title 28 Part 1 Ch. 21 Subchapter T Rules 28 TAC §21.2807 | |
| USP 797 | Policies established by the pharmacy should consider provisions of USP 797… | Citations
Texas Sterile Compounding Regulations ADOPTED BY REFERENCE ONLY? No |
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| USP 800 | While USP 800 is not incorporated, current requirements can be found at TSBP Rules, §291.133… | Citations Sterile Compounding Regulations ADOPTED BY REFERENCE ONLY? No |
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| White Bagging | A health benefit plan issuer may not, for a patient with a cancer or cancer-related… | This is a very strong bill aimed at prohibiting mandatory white… | HB 1586 |
