Sec. 1369.252. EXCEPTIONS TO APPLICABILITY OF SUBCHAPTER. This subchapter does not apply to an issuer or provider of health benefits under or a pharmacy benefit manager administering pharmacy benefits under:
(1) the state Medicaid program;
(2) the federal Medicare program;
(3) the state child health plan or health benefits plan for children under Chapter 62 or 63, Health and Safety Code;
(4) the TRICARE military health system;
(5) a workers' compensation insurance policy or other form of providing medical benefits under Title 5, Labor Code; or
(6) a self-funded health benefit plan as defined by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).
Added by Acts 2013, 83rd Leg., R.S., Ch. 915 (H.B. 1358), Sec. 1, eff. September 1, 2013.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages
Chapter 1369 - Benefits Related to Prescription Drugs and Devices and Related Services
Subchapter F. Audits of Pharmacists and Pharmacies
Section 1369.252. Exceptions to Applicability of Subchapter
Section 1369.253. Conflict With Other Laws
Section 1369.254. Audit of Pharmacist or Pharmacy; Notice; General Provisions
Section 1369.255. Completion of Audit
Section 1369.256. Audit Requiring Professional Judgment
Section 1369.257. Access to Pharmacy Area
Section 1369.258. Validation Using Certain Records Authorized
Section 1369.2581. Audit Discrepancies; Wholesale Invoices
Section 1369.259. Calculation of Recoupment; Use of Extrapolation Prohibited
Section 1369.260. Clerical or Recordkeeping Error; Fraud Allegation
Section 1369.261. Access to Previous Audit Reports; Uniform Audit Standards
Section 1369.262. Compensation of Auditor
Section 1369.263. Conclusion of Audit; Summary; Preliminary Audit Report
Section 1369.264. Final Audit Report
Section 1369.265. Certain Audits Exempt From Deadlines
Section 1369.266. Recoupment and Interest Charged After Audit
Section 1369.267. Waiver Prohibited
Section 1369.268. Remedies Not Exclusive