Texas § 1369.454 PRORATION OF COST-SHARING AMOUNT REQUIRED.

Texas Statutes

§ 1369.454 — PRORATION OF COST-SHARING AMOUNT REQUIRED.

Texas § 1369.454

Code INInsurance Code

This text of Texas § 1369.454 (PRORATION OF COST-SHARING AMOUNT REQUIRED.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Insurance Code Code Ann. § 1369.454 (2026).

Text

Sec. 1369.454. PRORATION OF COST-SHARING AMOUNT REQUIRED.

(a)A health benefit plan that provides benefits for prescription drugs shall prorate any cost-sharing amount charged for a partial supply of a prescription drug if:

(1)the pharmacy or the enrollee's prescribing physician or health care provider notifies the health benefit plan that:

(A)the quantity dispensed is to synchronize the dates that the pharmacy dispenses the enrollee's prescription drugs; and

(B)the synchronization of the dates is in the best interest of the enrollee; and

(2)the enrollee agrees to the synchronization.

(b)The proration described by Subsection (a) must be based on the number of days' supply of the drug actually dispensed.

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Sec. 1369.454. PRORATION OF COST-SHARING AMOUNT REQUIRED. (a) A health benefit plan that provides benefits for prescription drugs shall prorate any cost-sharing amount charged for a partial supply of a prescription drug if:
(1) the pharmacy or the enrollee's prescribing physician or health care provider notifies the health benefit plan that:
(A) the quantity dispensed is to synchronize the dates that the pharmacy dispenses the enrollee's prescription drugs; and
(B) the synchronization of the dates is in the best interest of the enrollee; and
(2) the enrollee agrees to the synchronization.
(b) The proration described by Subsection (a) must be based on the number of days' supply of the drug actually dispensed.