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89(R) HB 1464 - House Committee Report version - Bill Text
89R24512 MPF-D
By: Talarico
H.B. No. 1464
Substitute the following for H.B. No. 1464:
By: Dean
C.S.H.B. No. 1464
A BILL TO BE ENTITLED
AN ACT
relating to a prescription drug purchasing pool for certain health
benefit plan issuers and employers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle A, Title 6, Health and Safety Code, is
amended by adding Chapter 446 to read as follows:
CHAPTER 446. PRESCRIPTION DRUG PURCHASING POOL
Sec. 446.001. DEFINITIONS. In this chapter:
(1)
"Commission"
means the Health and Human Services
Commission.
(2)
"Health benefit plan issuer" means an insurer,
health maintenance organization, or other entity authorized to
provide health benefits coverage under the laws of this state.
(3)
"Participant" means a health benefit plan issuer,
qualified public employer, or qualified private employer enrolled
in the prescription drug purchasing pool.
(4)
"Qualified private employer" means a self-insured
private employer conducting business in this state.
(5) "Qualified public employer" means:
(A)
a political subdivision of this state,
including a county, municipality, or public school district;
(B)
a university system or an institution of
higher education, as those terms are defined by Section 61.003,
Education Code; or
(C) a quasi-public agency.
Sec.
446.002.
PRESCRIPTION DRUG PURCHASING POOL. (a) The
commission shall establish a prescription drug purchasing pool
through which a participating health benefit plan issuer, qualified
public employer, or qualified private employer may purchase
prescription drugs for their employees, employees' dependents, and
retirees from vendors at a discounted rate or under terms the
commission negotiates.
(b)
The prescription drug purchasing pool does not
constitute a risk pool, and each health benefit plan issuer,
qualified public employer, and qualified private employer
participating in the pool is responsible for paying the cost of a
claim or prescription drug in accordance with any applicable health
benefit coverage agreement with their employees, employees'
dependents, and retirees.
Sec.
446.003.
ADMINISTRATION OF PRESCRIPTION DRUG
PURCHASING POOL. The executive commissioner by rule shall
establish procedures for administering the prescription drug
purchasing pool, including procedures establishing:
(1)
the eligibility criteria for a health benefit plan
issuer, qualified public employer, or qualified private employer to
participate in the pool;
(2)
the manner by which a health benefit plan issuer,
qualified public employer, or qualified private employer may enroll
in the pool;
(3)
the duration of eligibility for a health benefit
plan issuer, qualified public employer, or qualified private
employer to participate in the pool;
(4)
the method by which a participant contributes
money to the pool; and
(5)
the method for disenrolling a participant from the
pool or terminating a participant's eligibility to participate in
the pool.
Sec.
446.004.
OPTIONAL STOP LOSS COVERAGE. The commission
shall provide a participant the option to purchase stop loss
coverage from an insurer at a rate the commission negotiates.
Sec.
446.005.
MULTIPLE EMPLOYER PRESCRIPTION DRUG
PURCHASING AGREEMENTS. (a) Two or more participants may jointly
purchase through the prescription drug purchasing pool
prescription drugs for their employees, employees' dependents, and
retirees.
(b)
An arrangement to jointly purchase prescription drugs
under this section does not constitute a multiple employer welfare
arrangement, as defined by Section 846.001, Insurance Code.
Sec.
446.006.
RULES. The executive commissioner shall
adopt rules as necessary to implement this chapter.
SECTION 2. As soon as practicable after the effective date
of this Act, the Health and Human Services Commission shall
establish the prescription drug purchasing pool as required by
Chapter 446, Health and Safety Code, as added by this Act.
SECTION 3. This Act takes effect September 1, 2025.