Sec. 1369.355. UPDATES. (a) A health benefit plan issuer or pharmacy benefit manager shall establish a process that will in a timely manner eliminate drugs from maximum allowable cost lists or modify maximum allowable cost prices to remain consistent with changes in pricing data used in formulating maximum allowable cost prices and product availability.
(b) A health benefit plan issuer or pharmacy benefit manager shall review and update maximum allowable cost price information for each drug at least once every seven days to reflect any modification of maximum allowable cost pricing.
Added by Acts 2015, 84th Leg., R.S., Ch. 596 (S.B. 332), Sec. 1, eff. January 1, 2016.
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 H. Maximum Allowable Cost
Section 1369.352. Certain Benefits Excluded
Section 1369.353. Criteria for Drugs on Maximum Allowable Cost Lists
Section 1369.354. Formulation of Maximum Allowable Costs; Disclosures
Section 1369.356. Access to Maximum Allowable Cost Lists
Section 1369.357. Appeal From Maximum Allowable Cost Price Determination
Section 1369.358. Confidentiality of Maximum Allowable Cost List
Section 1369.359. Waiver Prohibited