Bill > HB970

This bill introduces new regulations for prescription drug pricing in Texas, specifically targeting pharmacy benefit managers (PBMs) to ensure that drug price reductions negotiated with manufacturers are fully passed on to patients at the point of sale. The bill defines a manufacturer as an entity involved in producing, packaging, or labeling prescription drugs, and applies to a wide range of health benefit plans, including those offered by insurance companies, health maintenance organizations, and various government-related health programs. The legislation requires PBMs to ensure that any price reductions obtained from manufacturers (through discounts or rebates) are completely reflected in the price of prescription drugs when dispensed to patients. Patients can be charged a fixed copayment or coinsurance calculated based on the reduced net price. For non-compliance, PBMs face significant penalties, including a civil penalty of three times the amount of the unReflected price reduction plus $5,000 per violation. The attorney general is empowered to bring legal actions to enforce these provisions, with such actions potentially filed in Travis County or the county where the violation occurred. The bill will take effect on September 1, 2025, and will apply to health benefit plans delivered or renewed on or after January 1, 2026. Notably, the bill does not apply to certain healthcare programs like Medicaid, TRICARE, or workers' compensation insurance.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB970