PBMs Must “Spill The Beans” Under Texas Statute

Now as a matter of public record you can find out more about your PBM’s revenue streams earned from pharmaceutical drug manufacturers under a Texas statute and TDI amendment to the Texas Insurance Code.

HB2536 effective 9/01/2019 effects Pharmacy Benefit Managers licensed as TPAs and amends Chapter 1369 of the Texas Insurance Code requiring pharmacy benefit managers to report to TDI the aggregated rebates, fees, price protection payments, and any other payments collected from pharmaceutical drug manufacturers that were passed to health benefit plan issuers, enrollees at the point of sale, or retained as revenue by the pharmacy benefit manager.

The first report was due on February 1, 2020 with data covering the preceding calendar year. See Commissioner’s Bulletin B-0013-19