Bills supported by all pharmacy groups are beginning to advance in the Senate.  

• SB 493 prohibits “gag clauses” in contracts that prevent pharmacies from telling patients when the cash price for a drug is lower than the price under their insurance plan. SB 493 addresses contractual provisions between some health insurers, pharmacy benefit managers and pharmacies that prohibit pharmacists from freely informing patients if paying out-of-pocket (cash price) for the prescription may be cheaper than the insured’s copay. 

• SB 1122 builds upon the landmark US Supreme Court Rutledge decision and PBM reforms passed in recent years, HB 1919 and HB 1763, by extending the applicability of patient and pharmacy protections already in law to all PBM activity in the state, regardless of the health plan types. It further codifies the February 2025, Texas Attorney General Ken Paxton opinion letter KP-0480, which asserts that Texas has the authority to regulate PBM practices impacting its residents and local pharmacies, even when ERISA-governed plans are involved. 

• SB 1236 amends current law relating to the relationship between pharmacists or pharmacies and health benefit plan issuers or pharmacy benefit managers. SB 1236 would amend Chapter 1369, Insurance Code, to provide reasonable contract protections for pharmacies and pharmacists in their relationships with PBMs. It would also amend existing statutes to clarify language regarding PBM audits and provide transparency in the applicability of Texas laws to contracts and benefit enrollees. This bill was heard in the Senate Health and Human Services Committee on April 1. 

Also in Texas, another priority bill we are trying to advance includes HB 4533 by Rep. Tom Oliverson, MD, (R), legislation that would establish the fee-for-service reimbursement as the rate floor for Medicaid managed care organization claims.  

Also in Texas, all pharmacy groups collaborated on making our united voices heard on our priority legislative issues at the March 26 Pharmacy Day at the Capitol. More than 400 pharmacists, interns and pharmacy students participated in 150 scheduled meetings, urging lawmakers to pass legislation to help save neighborhood pharmacies and the health of their patients. 

Finally in Texas, Gov. Greg Abbott (R) launched a Department of State Health Services (DSHS) online interactive map identifying where Texans can acquire life-saving naloxone (NARCAN) to prevent fentanyl poisonings. This tool is part of the statewide “One Pill Kills” campaign. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The highly contagious measles virus continues to spread in the unvaccinated populations in eleven counties. The Department of State Health Services (DSHS) reported that there are currently 279 confirmed measles cases and two deaths since late January.

Also in Texas, March 14 was the bill filing deadline. In total, 5,646 bills have been filed in the House of Representatives and 3,028 in the Senate.

Also in Texas, HB 4051, legislation allowing test-and-treat for certain minor ailments, was filed by Rep. James Frank (R).

Finally in Texas, HB 4533, critical pharmacy legislation that would require a transparent reimbursement methodology for prescription drugs dispensed in Medicaid and state-funded programs, was introduced by Rep. Tom Oliverson, MD, (R).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Rep. Tom Oliverson (R) filed HB 4533, a Medicaid managed care organization rate floor bill for retail and specialty pharmacies.

Also in Texas, Rep. James Frank (R) filed HB 4051, a test-and-treat bill for flu, strep, COVID and minor, uncomplicated infections. The bill also includes provisions for doctor dispensing.

Also in Texas, last week, the Texas Pharmacy Association and the Texas Pharmacy Business Council testified in support of SB 1122 at the Senate Health and Human Services Committee. This legislation codifies Attorney General Ken Paxton’s February 5, 2025, opinion letter regarding the enforceability of existing laws against health benefit plans and PBMs administering the pharmacy benefits on behalf of an ERISA plan in certain circumstances that do not dictate plan choice or add requirements to a beneficiary’s status. The Texas Association of Business and the National Federation of Independent Business (NFIB) testified in opposition to SB 1122, falsely claiming that it would impose costs to employer-sponsored ERISA health plans of over $5 billion over the next decade. Since Texas is business-friendly, several Senators expressed concerns about rising costs to small businesses. The bill was left pending in the Senate Health and Human Services Committee.

Finally in Texas, Gov. Greg Abbott (R) notified state agencies to transition remote workers back to the office to ensure the efficient use of taxpayer dollars and that state agencies remain engaged and effective in serving the public.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Department of State Health Services (DSHS) briefed health partners on the measles outbreak throughout Texas. DSHS is posting updates on Tuesdays and Fridays when there are new cases to report. 

Also in Texas, the Health and Human Services Commission (HHSC) issued an updated Pharmacy Provider Procedure Manual.  

Also in Texas, Gov. Greg Abbott (R) appointed Heisha Freeman as a public member to the Board of Pharmacy, replacing Garrett Marquis who resigned. Freeman’s term will expire on August 31, 2029.  

Finally in Texas, March 14 marks the 60th day of the 89th Regular Legislature Session, and the deadline for House and Senate members to file a bill.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

NACDS issued a press release acknowledging the favorable opinion (KP-0408) released by Texas Attorney General Ken Paxton (R) on February 5, 2024. This opinion addresses the enforceability of two laws passed in 2021 against health benefit insurers and PBMs. Paxton’s opinion clarifies how HB 1763 and HB 1919 regulate certain contracts between ERISA issuers, their PBMs, and pharmacies. It also addresses steering practices concerning affiliated pharmacies, clarifying that ERISA does not preempt HB 1763 and HB 1919, as these laws do not dictate plan choices or add requirements to a beneficiary’s status. At the request of pharmacy groups, State Senator Charles Schwertner (R), a physician and pharmacist who chairs the Senate Business and Commerce Committee, sent a letter to the Attorney General requesting this opinion.

Also in Texas, Speaker Dustin Burrows (R) finally posted the new chairs and the House Committee membership lists on February 13, 2025.

Also in Texas, Sen. Bryan Hughes, and Rep. Cody Harris (R), two champions of PBM reforms, filed identical bills, SB 1354 and HB 2978 will establish a rate floor for the commercial market.

Also in Texas, Sen. Bryan Hughes also filed SB 1236, PBM reform legislation that addresses clawbacks, establishes audit guardrails, and would prohibit a health plan or PBM from denying or reducing a claim payment to a pharmacy or pharmacist after adjudication under certain circumstances. The bill also protects patient choice to pharmacies by ensuring that pharmacies have a voice in their network and contract discussions.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Gov. Greg Abbott (R) delivered his state-of-the-state address online on February 2.  

Also in Texas, the Board of Pharmacy approved proposed rules removing the ratio of pharmacists to pharmacy technicians in a central fill facility.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The House of Representatives, under the new leadership of Speaker Dustin Burrows (R), established new rules stating that House committees’ chairmanships will be held by the majority party – Republicans, and the vice chairs will be held by the minority party – Democrats.

Also in Texas, the agenda for the February 4, 2025, Board of Pharmacy meeting is now available. For those note able to attend, the meeting will be Live Streamed.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Several bills of interest to pharmacies have been filed. 

• SB 254 by Sen. Pete Flores (R) allows pharmacists to order and administer immunizations and vaccinations to patients ages three years and older, and to those younger than three years of age, if referred by a physician. It also gives pharmacist’s authority to delegate vaccine administration to a certified pharmacy technician.  

• SB 398 by Sen. Kevin Sparks (R) allows a pharmacy technician of a pharmacist’s authority to administer an immunization or vaccine under the supervision of a pharmacist. 

• SB 623 by Sen. Charles Schwertner (R) gives the pharmacists the right to determine if a vaccine, including a COVID vaccine, should be administered to a patient. 

Also in Texas, the Health and Human Services Commission’s (HHSC) Medicaid Vendor Drug Program (VDP) met with pharmacy stakeholders on January 22. The agenda included updates on the timeline on implementing legislation passed in 2023, and the progress on several pending projects, including adult vaccinations and adding non-drug like Continuous Glucose Monitors (CGM) to the Medicaid formulary. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Board of Pharmacy posted the rules adopted at the November 5 quarterly board meeting.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.