Texas HB2978 sets minimum reimbursement rules for pharmacists and pharmacies under health benefit plans.

Texas HB2978 amends the Insurance Code to establish minimum reimbursement rules for pharmacists and pharmacies under health benefit plans. It mandates that pharmacy benefit managers cannot reimburse pharmacists or pharmacies less than the actual cost of prescription drugs or devices. The bill outlines procedures for appealing reimbursements and requires pharmacy benefit managers to provide certain information if they prevail in an appeal. It also specifies that certain health benefit plans, like Medicaid and TRICARE, are exempt from these rules.

Texas HB2978 sets minimum reimbursement rules for pharmacists and pharmacies under health benefit plans.

Texas HB2978 amends the Insurance Code to establish minimum reimbursement rules for pharmacists and pharmacies under health benefit plans. It mandates that pharmacy benefit managers cannot reimburse pharmacists or pharmacies less than the actual cost of prescription drugs or devices. The bill outlines procedures for appealing reimbursements and requires pharmacy benefit managers to provide certain information if they prevail in an appeal. It also specifies that certain health benefit plans, like Medicaid and TRICARE, are exempt from these rules.