Tex. Ins. Code § 1369.6023 · Subchapter M. CONTRACTS WITH PHARMACISTS AND PHARMACIES
PHARMACY BENEFIT NETWORK CONTRACT: OTHER MODIFICATIONS AND ADDENDUMS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A health benefit plan issuer or pharmacy benefit manager must, not later than the 90th day before the date a proposed modification or addendum to a pharmacy benefit network contract, other than an adverse material change as defined by Section 1369.6022, is to take effect:
(1) post the proposed modification or addendum to the online portal described by Section 1369.6021; and
(2) provide to the pharmacist or pharmacy notice of the proposed modification or addendum by e-mail, including:
(A) a link to the online portal;
(B) the National Council for Prescription Drug Programs number or other identifier approved by the commissioner for the pharmacist or pharmacy to which the proposed modification or addendum applies; and
(C) a description of the proposed modification or addendum in a manner that allows the pharmacist or pharmacy to compare the proposed modification or addendum to the current contract.
(b) If a pharmacist or pharmacy does not respond before the 31st day after the date the pharmacist or pharmacy receives notice of a proposed modification or addendum under Subsection (a), the health benefit plan issuer or pharmacy benefit manager may consider the proposed modification or addendum approved by the pharmacist or pharmacy and the modification or addendum takes effect on the date described by Subsection (a).
(c) A pharmacy benefit network contract may not incorporate by reference a document not included in a contract or contract attachment, including a provider manual described by Section 1369.6025. All financial terms, including reimbursement rates and methodology, must be set forth in the contract.
(d) This section does not apply to:
(1) a pharmacy benefit network contract:
(A) with an unspecified and indefinite duration;
(B) with no stated or automatic renewal period or event; and
(C) that may only be terminated by notice from one party to the other; or
(2) a proposed modification or addendum to a pharmacy benefit network contract that is required by state or federal law or rule.
Notes and commentary — not statutory text
History
Added by Acts 2025, 89th Leg., R.S., Ch. 183 (S.B. 1236), Sec. 4, eff. September 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm
- Text hash
- sha256 0dec9b773c1404c7f7e23924def463dfdd45a3f9d12ce1efc022cd9e9de64b1c
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Insurance Code
- Tex. Ins. Code § 1369.6021ONLINE ACCESS TO PHARMACY BENEFIT NETWORK CONTRACT.Printed as Section 1369.6021
- Tex. Ins. Code § 1369.6022PHARMACY BENEFIT NETWORK CONTRACT: ADVERSE MATERIAL CHANGES.Printed as Section 1369.6022
- Tex. Ins. Code § 1369.6025PROVIDER MANUAL DISCLOSURE.Printed as Section 1369.6025
Cited by 1 provision
Provisions in this library whose text cites Tex. Ins. Code § 1369.6023. Each shows the citation as that text prints it.
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.