Sec. 1369.554. PROHIBITION ON CERTAIN COMMUNICATIONS. (a) A health benefit plan issuer or pharmacy benefit manager may not steer or direct a patient to use the issuer's or manager's affiliated provider through any oral or written communication, including:
(1) online messaging regarding the provider; or
(2) patient- or prospective patient-specific advertising, marketing, or promotion of the provider.
(b) This section does not prohibit a health benefit plan issuer or pharmacy benefit manager from including the issuer's or manager's affiliated provider in a patient or prospective patient communication, if the communication:
(1) is regarding information about the cost or service provided by pharmacies or durable medical equipment providers in the network of a health benefit plan in which the patient or prospective patient is enrolled; and
(2) includes accurate comparable information regarding pharmacies or durable medical equipment providers in the network that are not the issuer's or manager's affiliated providers.
Added by Acts 2021, 87th Leg., R.S., Ch. 1012 (H.B. 1919), Sec. 1, 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 L. Affiliated Providers
Section 1369.552. Exceptions to Applicability of Subchapter
Section 1369.553. Transfer or Acceptance of Certain Records Prohibited
Section 1369.554. Prohibition on Certain Communications
Section 1369.555. Prohibition on Certain Referrals and Solicitations