The bill, S.B. No. 1122, amends the Insurance Code to clarify the applicability of certain prescription drug insurance laws to health benefit plans and pharmacy benefit managers. It introduces a new section, 1369.5515, which mandates that pharmacy benefit managers must comply with the provisions of the subchapter for each health benefit plan they administer, regardless of whether specific provisions are applicable to the plan. However, they are exempt from compliance if a plan is expressly excluded from the subchapter. Additionally, the bill states that the subchapter applies to health benefit plans provided to Texas residents, irrespective of where the plan is delivered or renewed.

Furthermore, the bill adds subsections (d) and (e) to Section 1369.602, reiterating the compliance requirements for pharmacy benefit managers and the applicability of the subchapter to health benefit plans for Texas residents. The bill also stipulates that the changes will only apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, while plans prior to this date will continue to be governed by existing law. The effective date of the bill is set for September 1, 2025.

Statutes affected:
Introduced: Insurance Code 1369.602 (Insurance Code 1369)