SB2857 - Relating to a prescription drug purchasing pool for certain health benefit plan issuers and employers.

      By: Blanco, et al. S.B. No. 2857     (Talarico)           A BILL TO BE ENTITLED   AN ACT   relating to a prescription drug purchasing pool for certain health   benefit plan issuers and employers.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subtitle A, Title 6, Health and Safety Code, is   amended by adding Chapter 446 to read as follows:   CHAPTER 446. PRESCRIPTION DRUG PURCHASING POOL           Sec. 446.001.  DEFINITIONS. In this chapter:                 (1)     "Commission"   means the Health and Human Services   Commission.                 (2)     "Health benefit plan issuer" means an insurer,   health maintenance organization, or other entity authorized to   provide health benefits coverage under the laws of this state.                 (3)     "Participant" means a health benefit plan issuer,   qualified public employer, or qualified private employer enrolled   in the prescription drug purchasing pool.                 (4)     "Qualified private employer" means a self-insured   private employer conducting business in this state.                 (5)  "Qualified public employer" means:                       (A)     a political subdivision of this state,   including a county, municipality, or public school district;                       (B)     a university system or an institution of   higher education, as those terms are defined by Section 61.003,   Education Code; or                       (C)  a quasi-public agency.           Sec.   446.002.     PRESCRIPTION DRUG PURCHASING POOL. (a) The   commission shall establish a prescription drug purchasing pool   through which a participating health benefit plan issuer, qualified   public employer, or qualified private employer may purchase   prescription drugs for their employees, employees' dependents, and   retirees from vendors at a discounted rate or under terms the   commission negotiates.           (b)     The prescription drug purchasing pool does not   constitute a risk pool, and each health benefit plan issuer,   qualified public employer, and qualified private employer   participating in the pool is responsible for paying the cost of a   claim or prescription drug in accordance with any applicable health   benefit coverage agreement with their employees, employees'   dependents, and retirees.           Sec.   446.003.     ADMINISTRATION OF PRESCRIPTION DRUG   PURCHASING POOL. The executive commissioner by rule shall   establish procedures for administering the prescription drug   purchasing pool, including procedures establishing:                 (1)     the eligibility criteria for a health benefit plan   issuer, qualified public employer, or qualified private employer to   participate in the pool;                 (2)     the manner by which a health benefit plan issuer,   qualified public employer, or qualified private employer may enroll   in the pool;                 (3)     the duration of eligibility for a health benefit   plan issuer, qualified public employer, or qualified private   employer to participate in the pool;                 (4)     the method by which a participant contributes   money to the pool; and                 (5)     the method for disenrolling a participant from the   pool or terminating a participant's eligibility to participate in   the pool.           Sec.   446.004.     OPTIONAL STOP LOSS COVERAGE. The commission   shall provide a participant the option to purchase stop loss   coverage from an insurer at a rate the commission negotiates.           Sec.   446.005.     MULTIPLE EMPLOYER PRESCRIPTION DRUG   PURCHASING AGREEMENTS. (a) Two or more participants may jointly   purchase through the prescription drug purchasing pool   prescription drugs for their employees, employees' dependents, and   retirees.           (b)     An arrangement to jointly purchase prescription drugs   under this section does not constitute a multiple employer welfare   arrangement, as defined by Section 846.001, Insurance Code.           Sec.   446.006.     RULES. The executive commissioner shall   adopt rules as necessary to implement this chapter.          SECTION 2.  As soon as practicable after the effective date   of this Act, the Health and Human Services Commission shall   establish the prescription drug purchasing pool as required by   Chapter 446, Health and Safety Code, as added by this Act.          SECTION 3.  The Health and Human Services Commission is   required to implement a provision of this Act only if the   legislature appropriates money specifically for that purpose.  If   the legislature does not appropriate money specifically for that   purpose, the commission may, but is not required to, implement a   provision of this Act using other money available for that purpose.          SECTION 4.  This Act takes effect September 1, 2025.