Governor Signs Bill Allowing 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.