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Governor Signs Bill Allowing Payment for Services

Friday, May 31, 2019   (0 Comments)
Posted by: Brian Sparks
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Payment for Services

 

Late Friday, May 31, 2019, Texas Governor Greg Abbott signed House Bill 3441 by State Rep. Eddie Lucio III and Sen. Charles Schwertner, marking a significant win for pharmacy.

The legislation amends the Insurance Code for commercial health plans in Texas. It prohibits a health benefit plan issuer or pharmacy benefit manager of a health benefit plan from denying reimbursement to a pharmacist for the provision of a service or procedure within the scope of the pharmacist’s license that would be covered by the insurance policy or other coverage agreement if the service or procedure were provided by a physician, an advanced practice nurse, or a physician assistant.

What does this mean for pharmacists?

Pharmacists may now be part of provider networks and be reimbursed for pharmacist-provided services that are within the pharmacist’s scope of practice. Types of services that may be covered include: medication management; administering CLIA-waived tests like those for flu, cholesterol, and blood glucose testing; chronic disease management, like diabetes self-management; and other patient education programs.

Effective Date: For health benefit plans issued or renewed on or after January 1, 2020

 

TPA's online legislative wrapup offers a full list of which bills passed, which bills failed, and which bills TPA helped to defeat. It also provides effective dates and a detailed explanation of what the legislation means for pharmacy.


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