Texas § 1369.402 CERTAIN FEES PROHIBITED.

Texas Statutes

§ 1369.402 — CERTAIN FEES PROHIBITED.

Texas § 1369.402

Code INInsurance Code

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Bluebook

Tex. Insurance Code Code Ann. § 1369.402 (2026).

Text

Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit plan issuer or a pharmacy benefit manager may not directly or indirectly charge or hold a pharmacist or pharmacy responsible for a fee for any step of or component or mechanism related to the claim adjudication process, including:

(1)the adjudication of a pharmacy benefit claim;

(2)the processing or transmission of a pharmacy benefit claim;

(3)the development or management of a claim processing or adjudication network; or

(4)participation in a claim processing or adjudication network. SUBCHAPTER J. COVERAGE RELATED TO PRESCRIPTION DRUG SYNCHRONIZATION

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Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit plan issuer or a pharmacy benefit manager may not directly or indirectly charge or hold a pharmacist or pharmacy responsible for a fee for any step of or component or mechanism related to the claim adjudication process, including:
(1) the adjudication of a pharmacy benefit claim;
(2) the processing or transmission of a pharmacy benefit claim;
(3) the development or management of a claim processing or adjudication network; or
(4) participation in a claim processing or adjudication network.
SUBCHAPTER J. COVERAGE RELATED TO PRESCRIPTION DRUG SYNCHRONIZATION