Sec. 1369.503. HEALTH BENEFIT PLAN ISSUER INFORMATION. (a) Not later than March 1 of each year, each health benefit plan issuer shall submit to the commissioner a report that states for the immediately preceding calendar year:
(1) the names of the 25 most frequently prescribed prescription drugs across all plans;
(2) the percent increase in annual net spending for prescription drugs across all plans;
(3) the percent increase in premiums that were attributable to prescription drugs across all plans;
(4) the percentage of specialty drugs with utilization management requirements across all plans; and
(5) the premium reductions that were attributable to specialty drug utilization management.
(b) A report submitted by a health benefit plan issuer may not disclose the identity of a specific health benefit plan or the price charged for a specific prescription drug or class of prescription drugs.
(c) Not later than June 1 of each year, the commissioner shall publish the aggregated data from all reports for that year required by this section in an appropriate location on the department's Internet website. The combined aggregated data from the reports must be published in a manner that does not disclose or tend to disclose proprietary or confidential information of any health benefit plan issuer.
Added by Acts 2019, 86th Leg., R.S., Ch. 1291 (H.B. 2536), Sec. 2, eff. September 1, 2019.
Amended by:
Acts 2021, 87th Leg., R.S., Ch. 50 (H.B. 1033), Sec. 7, eff. September 1, 2021.
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 K. Prescription Drug Cost Transparency
Section 1369.502. Pharmacy Benefit Manager Information
Section 1369.503. Health Benefit Plan Issuer Information