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Texas Insurance Code - INS § 1369.454. Proration of Cost-Sharing Amount Required

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) A health benefit plan that provides benefits for prescription drugs shall prorate any cost-sharing amount charged for a partial supply of a prescription drug if:

(1) the pharmacy or the enrollee's prescribing physician or health care provider notifies the health benefit plan that:

(A) the quantity dispensed is to synchronize the dates that the pharmacy dispenses the enrollee's prescription drugs; and

(B) the synchronization of the dates is in the best interest of the enrollee; and

(2) the enrollee agrees to the synchronization.

(b) The proration described by Subsection (a) must be based on the number of days' supply of the drug actually dispensed.

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Cite this article: FindLaw.com - Texas Insurance Code - INS § 1369.454. Proration of Cost-Sharing Amount Required - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1369-454/

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