Sec. 1369.554. REIMBURSEMENT OF AFFILIATED AND NONAFFILIATED PHARMACISTS AND PHARMACIES. (a) In this section:
(1) "Affiliated pharmacist or pharmacy" means a pharmacist or pharmacy that directly, or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a pharmacy benefit manager.
(2) "Nonaffiliated pharmacist or pharmacy" means a pharmacist or pharmacy that does not directly, or indirectly through one or more intermediaries, control and is not controlled by or under common control with a pharmacy benefit manager.
(b) A pharmacy benefit manager may not pay an affiliated pharmacist or pharmacy a reimbursement amount that is more than the amount the pharmacy benefit manager pays a nonaffiliated pharmacist or pharmacy for the same pharmacist service.
Added by Acts 2021, 87th Leg., R.S., Ch. 142 (H.B. 1763), 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. Contracts With Pharmacists and Pharmacies
Section 1369.552. Applicability of Subchapter
Section 1369.553. Reduction of Certain Claim Payment Amounts Prohibited
Section 1369.554. Reimbursement of Affiliated and Nonaffiliated Pharmacists and Pharmacies
Section 1369.555. Network Contract Fee Schedule
Section 1369.556. Disclosure of Pharmacy Services Administrative Organization Contract
Section 1369.557. Delivery of Drugs
Section 1369.558. Professional Standards and Scope of Practice Requirements