Relating to the practices and operation of pharmacy benefit managers; providing administrative penalties. The bill would amend the Insurance Code relating to the practices and operation of pharmacy benefit managers; providing administrative penalties.

The bill would the Texas Department of Insurance (TDI) to establish a complaint resolution program relating to the reimbursement practices of pharmacy benefit managers. Pharmacists or pharmacies may file complaints against pharmacy benefit managers that violate the provisions of the bill. Pharmacists or pharmacies may request mandatory mediation with pharmacy benefit managers to settle a claim. The Commissioner of Insurance is required to impose an administrative penalty if a pharmacy benefit manager acted in bad faith mediation. The bill applies only to a contract between a pharmacy benefit manager and a pharmacist or pharmacy entered into or renewed on or after January 1, 2020. The bill would take effect on September 1, 2019.