The Legislature adjourned its biennial session on June 2. 

Also in Texas, Gov. Greg Abbott (R) signed into law SB 1236, by Sen. Bryan Hughes (R) and Rep. Cody Harris (R), PBM reform legislation that provides fair and transparent contract protections for pharmacies, requires that a group number identifying the plan be on the enrollee's identification card, enhances audit protections and ensures compliance with existing laws. It will take effect on September 1, 2025. 

Also in Texas, despite our efforts to successfully negotiate a compromise bill with the Texas Medical Association (TMA) and the Texas Pediatric Society and overcome the toxic anti-vaxxer environment and the Lt. Governor's prohibition on referring House bills that had more Democrat votes than Republicans, it was the strong opposition by grocers and the food industry opposing SB 25, Sen. Lois Kolkhorst's priority bill that killed HB 3540, legislation that would have allowed pharmacists to order and administer immunizations, and technicians to vaccinate. 

Also in Texas, HB 3441, legislation amending current law relating to the liability of vaccine manufacturers that advertise a harmful vaccine, was sent to Gov. Greg Abbott (R). 

Finally in Texas, Gov. Greg Abbott (R) has until June 2 to sign or veto any bills sent to him. If he does not sign or veto a bill within this period, it will automatically become law. 

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

SB 1236, PBM reform legislation that provides fair and transparent contract protections for pharmacies, requires that a group number identifying the plan be on the enrollee's identification card, audit protections and ensures compliance with existing laws, passed unanimously approved by both houses and sent to Gov. Greg Abbott (R) to sign into law. 

Also in Texas, the House passed HB 3540 (SB 254), a bill that authorizes pharmacists to order and administer all childhood vaccines to individuals five years of age and older (three years of age and older for flu & COVID) and allows pharmacists to delegate vaccine administration to a certified technician. The bill is supported by the Texas Medical Association, the Texas Pediatric Society and all pharmacy groups. It was referred to the Senate Health and Human Services Committee awaiting a hearing. 

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

Several bills of interest to pharmacy are advancing in the final three weeks of the biennial session:  

• SB 1236 (HB 3317), PBM reform legislation that provides contract protections for pharmacies. The bill provides fairness and transparency, requires that a group number identifying the plan be on the enrollee's identification card, provides audit protections and ensures compliance with existing laws. The bill passed both houses and is on its way to Gov. Greg Abbott (R).

• HB 3540 (SB 254) permanently authorizes pharmacists to order and administer all childhood vaccines to individuals five years of age and older (three years of age and older for flu & COVID) and allows pharmacists to delegate vaccine administration to a certified technician. Physicians, pediatricians and pharmacies reached a compromise. The bill is supported by the Texas Medical Association, the Texas Pediatric Society and all pharmacy groups. The bill is on the House calendar this week. More than a dozen pharmacists from Albertsons, Brookshire Brothers, Kroger and Walgreens spent all-day Tuesday advocating for the immunizations bill and distributing the joint HB 3540 one-pager on the agreed-to bill. The chain pharmacists helped field questions and count votes. 

• HB 1027, legislation aimed at increasing access to pharmacies in underserved areas, would remove the current mileage restrictions on telepharmacies and also repeals provisions that prohibit a telepharmacy system located at a remote dispensing site from dispensing a Schedule II controlled substance. The bill passed the House and was referred to be considered next by the Senate Health and Human Services Committee.  

Also in Texas, Albertsons pharmacist Rob Gagliardi, who also serves as the Bedford Mayor Pro Tem, connected with his friend Rep. Tony Tinderholt (R), the influential Floor Leader for the House Republican Caucus. 

Also in Texas, the Health and Human Services Commission (HHSC) is interested in quality improvement and value-based payment initiatives for Medicaid and other publicly funded health services. HHSC is seeking a pharmacist to serve on the Value-Based Payment and Quality Improvement Advisory Committee. The Texas Health and Human Services Commission executive commissioner will appoint members to the committee to serve a term expiring December 31, 2028. Applications are due by 11:59 pm, May 23. More information is available on the website. 

Finally in Texas, the Board of Pharmacy (TSBP) approved rules exempting central fill pharmacies from the 6:1 pharmacy technician-to-pharmacist ratio at the May 6 board meeting. The rules take effect immediately after publication in the Texas Register. 

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

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.