Texas law on any date › Insurance Code
Insurance Code §1369.555
In force on May 13, 2024 · this text took effect Sep 01, 2021 · same as today's text
PROHIBITION ON CERTAIN REFERRALS AND SOLICITATIONS
(a) A health benefit plan issuer or pharmacy benefit manager may not require a patient to use the issuer's or manager's affiliated provider in order for the patient to receive the maximum benefit for the service under the patient's health benefit plan.
(b) A health benefit plan issuer or pharmacy benefit manager may not offer or implement a health benefit plan that requires or induces a patient to use the issuer's or manager's affiliated provider, including by providing for reduced cost-sharing if the patient uses the affiliated provider.
(c) A health benefit plan issuer or pharmacy benefit manager may not solicit a patient or prescriber to transfer a patient prescription to the issuer's or manager's affiliated provider.
(d) A health benefit plan issuer or pharmacy benefit manager may not require a pharmacy or durable medical equipment provider that is not the issuer's or manager's affiliated provider to transfer a patient's prescription to the issuer's or manager's affiliated provider without the prior written consent of the patient.
History: Added by Acts 2021, 87th Leg., R.S., Ch. 1012 (H.B. 1919 ), Sec. 1, eff. September 1, 2021.
Source: the Legislature's file server, seen Nov 08, 2026.
Every version on file
- Effective Sep 01, 2021 · seen Nov 2026–Nov 2026
Attorney General opinions that cite it
- KP-0480 (May 13, 2024): Whether House Bill 1763 and House Bill 1919, enacted by the 87th Legislature and codified in chapter 1369 of the Insurance Code, are enforceable against a health benefit plan issuer and a pharmacy benefit manager administering the pharmacy benefits of the health benefit plan in certain circumstances
A research copy. The official text is the Legislature's (statutes), the Secretary of State's (Texas Administrative Code) or eCFR's (federal rules). Not legal advice.