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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) A pharmacy benefit manager may not, by contract or otherwise, prohibit or restrict a pharmacist or pharmacy from informing an enrollee of any difference between the enrollee's out-of-pocket cost for a prescription drug under the enrollee's prescription drug benefit and the out-of-pocket cost without submitting a claim under the enrollee's prescription drug benefit.
(b) A provision in a pharmacy benefit manager's pharmacy benefit network contract is void and unenforceable if the provision prohibits or restricts a pharmacist or pharmacy from:
(1) informing an enrollee of any difference between the enrollee's out-of-pocket cost for a prescription drug under the enrollee's prescription drug benefit and the out-of-pocket cost without submitting a claim under the enrollee's prescription drug benefit; or
(2) communicating with plan sponsors or administrators regarding member services with respect to prescription drug benefits, pharmacy services and benefits, network access and adequacy with respect to prescription drug benefits, partnership opportunities, or prescription claim reimbursement.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 4151.155. Certain Disclosures and Communications by Pharmacist or Pharmacy Protected - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-4151-155/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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