Texas § 1560.004 PRESCRIPTION DRUG REIMBURSEMENT RATES.

Texas Statutes

§ 1560.004 — PRESCRIPTION DRUG REIMBURSEMENT RATES.

Texas § 1560.004

Code INInsurance Code

This text of Texas § 1560.004 (PRESCRIPTION DRUG REIMBURSEMENT RATES.) 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. § 1560.004 (2026).

Text

Sec. 1560.004. PRESCRIPTION DRUG REIMBURSEMENT RATES.

(a)An issuer of a health benefit plan that provides pharmacy benefits to enrollees shall reimburse pharmacies participating in the health plan using prescription drug reimbursement rates, for both brand name and generic prescription drugs, that are based on a current and nationally recognized benchmark index that includes average wholesale price and maximum allowable cost.

(b)Regardless of whether a pharmacy is a mail order pharmacy or a community retail pharmacy, an issuer of a health benefit plan shall use the same benchmark index, including the same average wholesale price, maximum allowable cost, and national prescription drug codes, to reimburse all pharmacies participating in the health benefit plan.

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Sec. 1560.004. PRESCRIPTION DRUG REIMBURSEMENT RATES. (a) An issuer of a health benefit plan that provides pharmacy benefits to enrollees shall reimburse pharmacies participating in the health plan using prescription drug reimbursement rates, for both brand name and generic prescription drugs, that are based on a current and nationally recognized benchmark index that includes average wholesale price and maximum allowable cost.
(b) Regardless of whether a pharmacy is a mail order pharmacy or a community retail pharmacy, an issuer of a health benefit plan shall use the same benchmark index, including the same average wholesale price, maximum allowable cost, and national prescription drug codes, to reimburse all pharmacies participating in the health benefit plan.

Legislative History

Added by Acts 2009, 81st Leg., R.S., Ch. 1207 (S.B. 704 ), Sec. 5, eff. September 1, 2009.

Nearby Sections

4

§ 1560.001

DEFINITIONS.

§ 1560.002

APPLICABILITY OF CHAPTER.

§ 1560.003

MULTIPLE-MONTH SUPPLY OF PRESCRIPTION DRUG.

§ 1560.004

PRESCRIPTION DRUG REIMBURSEMENT RATES.

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Texas § 1560.004, Counsel Stack Legal Research, https://law.counselstack.com/statute/tx/IN/1560.004.