89th Legislature

SB 1236

Principle Criteria
Free Enterprise
Property Rights
Personal Responsibility
Limited Government
Individual Liberty
Digest
SB 1236 strengthens transparency and fairness in contracts between pharmacies and health benefit plan issuers or pharmacy benefit managers. It requires that health benefit plans include a unique identifier on enrollee ID cards to ensure compliance with state regulations. The bill limits the ability of health benefit plan issuers or pharmacy benefit managers to deny or adjust payments to pharmacies after claims have been adjudicated unless fraud, duplicate payments, or substantive dispensing errors are involved. It mandates that pharmacy network contracts be available online and prohibits requiring pharmacists to join multiple networks as a condition of participation.
Author
Bryan Hughes
Co-Author
Cesar Blanco
Kevin Sparks
Sponsor
Cole Hefner
Jared Patterson