Sec. 1369.559. RETALIATION PROHIBITED. (a) A pharmacy benefit manager may not retaliate against a pharmacist or pharmacy based on the pharmacist's or pharmacy's exercise of any right or remedy under this chapter. Retaliation prohibited by this section includes:
(1) terminating or refusing to renew a contract with the pharmacist or pharmacy;
(2) subjecting the pharmacist or pharmacy to increased audits; or
(3) failing to promptly pay the pharmacist or pharmacy any money owed by the pharmacy benefit manager to the pharmacist or pharmacy.
(b) For purposes of this section, a pharmacy benefit manager is not considered to have retaliated against a pharmacist or pharmacy if the pharmacy benefit manager:
(1) takes an action in response to a credible allegation of fraud against the pharmacist or pharmacy; and
(2) provides reasonable notice to the pharmacist or pharmacy of the allegation of fraud and the basis of the allegation before taking the action.
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