Any Willing Provider Law – TEXAS

TEXAS SUMMARY OF EXISTING LAW

A health insurance policy or managed care plan may not deny a pharmacy or pharmacist the right to participate as a contract provider under the plan if the pharmacy/pharmacist agrees to provide pharmaceutical services that meet all terms and requirements, including professional conditions, that apply to pharmacies/pharmacists participating under the plan.

As to Medicaid, (d) Except as provided in subsection (e) of this section, a health care MCO must enter into a network provider agreement with any pharmacy provider that meets the health care MCO’s credentialing requirements, and agrees to the health care MCO’s financial terms and other reasonable administrative and professional terms.

Link to Existing Law: Tex. Ins. Code Ann. § 21.52B

PRACTICAL NOTE FOR EXSISTING LAW

While this law provides strong ‘Any Willing Provider Law’ requirements, its benefits to physician dispensers may be limited, since it refers to ‘pharmacies’ and ‘pharmacists.’