| 2023 Texas Legislative Wrap-up |
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Hits & Misses: The 88th Legislature’s Impact on Texas Pharmacy
JUMP TO: Session in Brief | Notable Bills Passed Affecting Pharmacy | Pharmacy Losses | Pharmacy Defensive Victories | Other Passed Bills of Interest | 2023 Bill Tracker
The 2023 legislative session was a challenging one for many advocates working in and around the Texas Capitol. Pharmacy was no exception, as priority legislation for TPA ultimately came up short when time expired on the regular session in May. As any veteran of the Legislature will tell you, the legislative process is designed to make it easy to kill bills and difficult to pass them. That certainly proved true this session. A record 8,046 bills were introduced by members of the House and Senate this year. Just 1,170 made it across the finish line to become law—not even 15%. Despite the challenges, there were bright spots to be found this session. All of TPA’s priority bills were heard in committees—getting the chance to make our case, hear our opposition, and see the reaction of legislators. We build upon this for next time. TPA successfully encouraged senior legislators in important positions to file key legislation and identified new champions who will assist pharmacy with important policy debates going forward. Several bills became law that, while not the highest legislative priority for pharmacists, will have a positive impact on our profession and the patients we serve. Pharmacy presented a more unified voice to legislators. TPA and other pharmacy groups successfully collaborated with other stakeholders on numerous issues. Pharmacy helped move legislation for expanded immunization authority further than in any previous session, passing both the House and Senate before the two chambers ultimately failed to reach a final agreement on the bill at the 11th hour. TPA worked with others to defend key victories on PBM issues that passed in 2021, and we laid the foundation for enacting further reforms. There is clear legislative sentiment that pharmacy benefit managers (PBMs) are the “black box” that needs to be opened. TPA is committed to continuing the fight for meaningful legislation that positively impacts the profession and business of pharmacy. Thank you to all the TPA members who engaged in the process, especially those who took time away from work and family to travel to Austin to visit with legislators about issues affecting pharmacy. Additionally, we thank our legislative allies who fought for pharmacy and championed our issues this session.
The Session in Brief
The Legislature was again marked by significant disagreement between the House and Senate on key legislative priorities that have already resulted in now two special sessions being called by Governor Abbott. Tensions between Lt. Governor Dan Patrick and House Speaker Dade Phelan bubbled up early in the regular session and likely peaked at a higher point than any session in recent memory. Lt. Governor Patrick is a well-known statewide official who exerts considerable control over the priorities of the Texas Senate, particularly when it comes to passing legislation important to his conservative base. Speaker Phelan is chosen as the House leader by his peers in the Texas House in both parties, and presides over an institution where rules allow for dissent and procedural defeat for legislation in many instances. The procedural “points of order” called on bills in the Texas House caused delays or defeats on numerous bills that were priorities in both chambers, reaching a point where the Lt. Governor publicly criticized his colleague for allowing such a system to continue to exist. Ultimately, the House and Senate could not reach agreement on how to earmark roughly $15 billion in property tax reductions to be paid for by the budget surplus. When the regular session ended without this key legislation having passed, Gov. Abbott immediately called a special session for the following day. TPA tracked nearly 100 introduced bills throughout the session for their impact on the practice of pharmacy. Some had a very direct impact, such as TPA’s priority legislation on pharmacy benefit manager (PBM) reform and pharmacy practice issues, or legislation regarding physician dispensing. Others affected pharmacy more indirectly or perhaps unintentionally. TPA offered testimony on many of these bills during committee hearings, and worked with legislators and stakeholders on bill language to ensure pharmacy interests were presented and heard throughout the process.
Notable Bills Passed Affecting PharmacyTPA supported and worked on several bills affecting pharmacy that passed this year.
Medicaid Prescription Drug FormularyHouse Bill 1283 (Rep. Oliverson/Sen. Hughes)HB 1283 by Rep. Tom Oliverson and Sen. Bryan Hughes maintains state control of the Medicaid prescription drug formulary, ensuring a single Preferred Drug List (PDL) for the entire Medicaid program and standardized prior authorization requirements that must be followed by each managed care organization and PBM providing services to Medicaid beneficiaries. The law providing for state control of the PDL had been set to expire later this year, meaning each Medicaid managed care organization could have established their own unique formulary and prior authorization requirements. Since the carve-in of prescription drugs to Medicaid managed care in 2012, control over the PDL had been given four-year extensions. HB 1283 extends that sunset date for 10 additional years, providing more certainly that the PDL will remain with the state. House Bill 3286 (Rep. Klick/Sen. Hancock)HB 3286 by Rep. Stephanie Klick and Sen. Kelly Hancock enacts changes to the Medicaid Vendor Drug Program formulary and PDL systems based upon stakeholder
feedback that developed during discussion of HB 1283. HB 3286 includes provisions to ensure timely inclusion of new drugs in the Medicaid formulary. The bill allows for Medicaid PBMs to provide exceptions to the PDL in cases where the preferred drug
is contraindicated, would likely cause an adverse reaction, or would likely be ineffective based on known clinical characteristics of the patient and prescription drug regimen. The bill also allows similar exceptions if the patient previously discontinued
taking the preferred drug due to ineffectiveness or adverse events, or if a patient is prescribed a nonpreferred antidepressant or antipsychotic drug and is stable or at risk of complication if the drug is switched. HB 3286 allows exceptions to the
PDL in cases where a drug is in short supply or on backorder, and requires that the PDL include all therapeutic equivalents for a generic drug on the PDL. What does this mean for pharmacists?TPA supports having the state maintain control over the Medicaid PDL, as it ensures uniformity for pharmacists and the Medicaid patients they serve. Passage of HB 1283 means that the system will likely remain in place for another decade. Additionally, the passage of HB 3286 provides for common-sense exceptions to the PDL in cases where the utilization of a nonpreferred drug is clearly in the best interest of the patient. Finally, the bill ensures that the Medicaid PDL will allow for all therapeutically equivalent generic drugs to be included on the PDL as opposed to allowing only a generic drug from a specific manufacturer to be included. Both bills take effect September 1, 2023. Effective Date: September 1, 2023 (both bills).
Coverage of Clinician-Administered Drugs / “White Bagging”House Bill 1647 (Rep. Harris/Sen. Schwertner)
HB 1647 by Rep. Cody Harris and Sen. Charles Schwertner addresses the issue of “white-bagging,” whereby a pharmacy ships a medication to a provider who then administers the medication to a patient. Health plans are increasingly requiring that patients receive certain medications from a PBM-owned specialty pharmacy instead of from a physician practice, on-site infusion pharmacy, or hospital pharmacy. This practice is particularly concerning in the oncology setting, where physicians often modify the dosage of medication when the patient arrives for treatment. TPA worked closely with advocates in support of similar legislation in 2021, and were glad to see the bill passed this session. The bill prohibits a health plan or PBM from requiring clinician-administered drugs be dispensed only by certain pharmacies for patients with chronic, complex, rare, or life-threatening medical conditions for which a delay of care resulting from delivery by another pharmacy would make disease progression or patient harm more probable. What does this mean for pharmacists?The final language in HB 1647 narrows the scope and impact of the new law. While it will not eliminate the practice of white-bagging altogether, it does provide protections in instances where a patient’s physician or health care provider determines that utilizing a PBM-owned specialty pharmacy would result in likely patient harm. This will mostly impact pharmacists dispensing medications used in oncology settings, but there could be other instances where the provisions could protect pharmacists from PBM requirements that a drug only be filled by a mail order pharmacy. Effective Date: September 1, 2023, for health benefits subject to TDI regulation for plans entered into or renewed after January 1, 2024.
Canadian Drug ImportationHouse Bill 25 (Rep. Talarico/Sen. Kolkhorst)HB 25 by Rep. James Talarico directs the Texas Health and Human Services Commission to establish a wholesale drug importation program via contract with prescription drug wholesalers and drug suppliers in Canada. The legislation is intended to allow Texas to establish a program for wholesale drug importation that utilizes the framework set forth by the United States Department of Health and Human Services (HHS) that was established by the Trump Administration and continued under President Biden. Several other states have enacted laws directing state agencies to file an application for approval of a Canadian drug importation program. To date, HHS has yet to approve any such applications, with many applicants unable to find a Canadian drug supplier
or satisfy drug testing and safety requirements. Canadian government officials have also indicated that they would likely oppose any action that could jeopardize its own domestic prescription drug supply; Texas and Florida, just two of the states
to pass such laws, have 12 million more people than the entire nation of Canada. What does this mean for pharmacists?Based on what has happened in other states, we do not expect the program to be implemented in the near term, if ever. TPA will monitor the situation and remain in contact with the Texas officials tasked with implementing such a program to ensure it does not adversely impact pharmacy or the secure supply chain should the prospects for implementation change. Effective Date: September 1, 2023.
PBM Prior Authorization Requirements for Specific ConditionsSeveral bills passed that affect prior authorization or step therapy requirements for drugs prescribed for specified purposes. The bills all apply to commercial health plans subject to oversight by the Texas Department of Insurance. House Bill 755 (Rep. Johnson/Sen. Menéndez)HB 755 by Rep. Julie Johnson and Sen. José Menéndez prohibits a health plan from requiring more than one prior authorization annually for a
prescription drug used to treat an autoimmune disease, hemophilia, or Von Willebrand disease. The bill does not apply to opioids, benozodiazepines, barbiturates, or carisoprodol, nor does it apply to drugs that have a typical treatment of less than
12 months or have a boxed warning assigned by the FDA. House Bill 916 (Rep. Ordaz/Sen. Paxton)HB 916 by Rep. Claudia Ordaz and Sen. Angela Paxton requires a health plan that provides benefits for prescription contraceptives to cover at
least a three-month supply of prescription contraceptives the first time the enrollee obtains the drug, and at least a 12-month supply each subsequent time the patient obtains the drug. House Bill 1337 (Rep. Hull/Sen. Menéndez)HB 1337 by Rep. Lacey Hull and Sen. José Menéndez restricts step therapy or “fail first” requirements for prescription drugs used to treat serious
mental illness. The bill prohibits a health plan or PBM from requiring that an adult patient fail to successfully respond to more than one different drug than the one prescribed prior to obtaining coverage for the prescribed drug. The bill does allow
a health benefit plan to implement a step therapy protocol once during a plan year if a generic or pharmaceutical equivalent drug is added to the plan’s drug formulary. What does this mean for pharmacists?Each of the bills will help patients obtain access to needed prescription drugs by limiting the ability of a health plan or PBM to place barriers such as prior authorization or step therapy requirements. Because pharmacists are often involved in helping patients clear these administrative hurdles, the bills should reduce the need for pharmacist involvement in these specified instances. Effective Date: September 1, 2023, for health plan benefits beginning or renewing on or after January 1, 2024.
Prohibition on Co-Pay Accumulator ProgramsHouse Bill 999 (Rep. Price/Sen. Schwertner)HB 999 by Rep. Four Price and Sen. Charles Schwertner prohibits health plans or PBMs from implementing what have been referred to as “co-pay
accumulators,” whereby the health plan or PBM does not apply any third-party payment or financial assistance programs to a patient’s deductible or other cost-sharing requirements. What does this mean for pharmacists?Many patients can only afford their medications with the use of outside patient assistance programs. In many instances, a patient only learns that payments made by these assistance programs are not counted toward their deductible when standing at the pharmacy counter trying to fill a prescription. Passage of HB 999 should reduce the occurrence of this happening. Effective Date: September 1, 2023, for health benefits subject to TDI regulation for plans entered into or renewed after January 1, 2024.
Texas Pharmaceutical InitiativeHouse Bill 4990 (Rep. Bonnen/Sen. Kolkhorst)HB 4990 by Rep. Greg Bonnen and Sen. Lois Kolkhorst establishes the Texas Pharmaceutical Initiative, which aims to provide cost-effective access to
prescription drugs and other medical supplies to individuals receiving health benefits paid for by the state through higher education institutions, the Employee Retirement System of Texas, Teacher Retirement System, correctional institutions, and
individuals served by the Health and Human Services system such as Medicaid. In its original filed form, the bill directed the Texas Pharmaceutical Initiative to establish a statewide PBM to serve Texas government employees and retirees, and included
provisions allowing for the creation of a generic drug manufacturing facility, mail order and specialty pharmacies, and a distribution network with a central service center for the distribution of drugs and supplies. HB 4990 as enacted into law instead
establishes a board of directors and advisory council, and requires the Initiative to submit a business plan to the Legislature by October 1, 2024, to document the process and resources required to establish a statewide PBM, distribution network,
and pharmaceutical preparation or manufacturing. What does this mean for pharmacists?TPA testified as neutral on the original version of the bill. While we supported the intent of the bill as we believed uprooting the current PBM vendors with a transparent PBM could provide substantial benefits, we had concerns about the lack of detail and clarity regarding other aspects of the original legislation. Most importantly, we wanted to ensure that community pharmacies could continue to serve patients who are covered under state-sponsored health plans. We believe that by first requiring the Texas Pharmaceutical Initiative to submit a detailed business plan with significant details regarding cost and potential savings, the Initiative has a greater chance of achieving success while taking stakeholder feedback and expertise into account. The legislation should not impact pharmacists in the short term, but we expect legislation on this topic to appear again in 2025. Effective Date: June 13, 2023.
Prescription Drug DonationHouse Bills 4166, 4331, and 4332 (Rep. Klick/Sen. Sparks)HB 4166, HB 4331, and HB 4332 by Rep. Stephanie Klick amend Texas’ existing laws relating to prescription drug donation. The bills provide that drug manufacturers and health care facilities, including pharmacies, may donate prescription drugs under
the program. The bills authorize the donation of prescription drugs in unopened bottles or containers, in addition to unit-dose packing as currently allowed. Finally, the new legislation sets forth requirements for labeling and record-keeping related
to donated prescription drugs, and directs the Texas State Board of Pharmacy to adopt rules necessary to implement the laws. What does this mean for pharmacists? According to the online database maintained by the Department of State Health Services, only seven pharmacies in Texas are enrolled as participating providers in the Texas Prescription Drug Donation Program. The new legislation expands the types of prescription
drugs that may be donated under the program, and ensures that the Texas State Board of Pharmacy will play a key role in making sure that participating pharmacies comply with Board guidelines and rules. Effective Date: September 1, 2023 (all three bills).
Safe Disposal of Prescription DrugsSenate Bill 2173 (Sen. Alvarado/Rep. Dean)SB 2173 by Sen. Carol Alvarado and Rep. Jay Dean directs the Texas State Board of Pharmacy to develop and implement a prescription drug safe disposal
pilot program to increase the number of locations where unused, unwanted, or expired prescription drugs are collected from the public for safe disposal. The board shall designate each pharmacy participating in the pilot program as a Texas premier
pharmacy provider committed to safe prescription drug disposal and shall pay certain costs associated with the program. What does this mean for pharmacists?A pharmacy may apply to the board to participate in the pilot program if it is registered as an authorized drug collection site with the DEA and meets other eligibility requirements. Effective Date: September 1, 2023.
2024–25 State BudgetHouse Bill 1 (Rep. Bonnen/Sen. Huffman)HB 1 is a $321.3 billion, two-year spending plan that takes advantage of a historic cash windfall to invest unprecedented amounts of money into tax
cuts, mental health, state parks, colleges and universities, the state’s energy grid, broadband and water infrastructure. It seeks to spend $144.1 billion in general revenue, including an agreement to spend $12.3 billion in new money for property
tax cuts. Some of those funds are tied to bills still in flux in the Legislature or are dependent on voters to pass in a constitutional election later this year. What does this mean for pharmacists?Funding was approved from the General Revenue (GR) Fund for both NarxCare and statewide integration of the Prescription Monitoring Program when the new state budget starts in September. This means that pharmacies that are currently paying for integration and NarxCare will no longer have to fund it themselves. Also, since this is a GR-funded item, it does not require a TSBP dues increase to cover it. Effective Date: September 1, 2023.
Pharmacy LossesTPA is grateful that all of our priority bills received committee hearings this session, allowing us to testify in support of legislation that we believe would greatly benefit pharmacists and their patients. However, we are extremely disappointed that most of them were not voted out of committee and thus failed to pass the Legislature.
Expanded Immunization Authority for Pharmacists—TPA PRIORITYHouse Bill 1105 (Rep. Price) / Senate Bill 749 (Sen. Flores)HB 1105 by Rep. Four Price and SB 749 by Sen. Pete Flores would have allowed pharmacists to order and administer CDC-recommended vaccines to children 3 years and older, and to delegate vaccine administration to a certified pharmacy technician, thus making permanent in Texas the federal Public Readiness and Emergency Preparedness (PREP) Act authority. TPA and other pharmacy advocates worked to make this authority permanent by modifying state law that only allows pharmacists to administer flu vaccines to children 7 years and older and other vaccines to children 14 years and older. Similar legislation passed the House last session, but a change in committee membership and much more strident opposition from the medical community and anti-vaccine activists meant that passage out of the House this session was no certainty. Pharmacy advocates and local constituent pharmacists worked extremely hard to get HB 1105, championed by Rep. Price, reported favorably from the House Public Health Committee. Allies of anti-vaccine activists then attempted to offer amendments to severely weaken the bill on the House floor, which were defeated, after which the bill passed the full House by a margin of 111–32. The bill then headed to the Texas Senate, where similar legislation never received a hearing in 2021. Again, pharmacy advocates and TPA members worked diligently to persuade the Senate Health and Human Services Committee to hear the bill, and after considerable back and forth, it was scheduled to be heard during the final committee hearing of the session. Chairwoman Lois Kolkhorst designated herself as the Senate sponsor of HBl 1105 and added new language to the bill that included language from her own Senate Bill 1024, which had passed the Senate but had not received a committee hearing in the House. The new language added to HB 1105 dealt with COVID-19 vaccination mandates. After the new language was added, Chair Kolkhorst passed HB 1105 out of committee and it was voted out of the Senate on a mostly party-line vote 22–9. TPA was clear to all that it did not intend to take a position for or against the new language that was added to the bill. We supported passage of the bill in whatever form the Legislature chose, so long as pharmacy's expanded immunization authority was
included. Ultimately, Rep. Price, the House author of the bill, requested the appointment of a conference committee to resolve differences in the bill between the two chambers, which was not agreed to by the Senate, leaving the bill to die in the
final days of the session.
“Test and Treat” Authorization for Pharmacists—TPA PRIORITYHouse Bill 2079 (Rep. Jetton)HB 2079 by Rep. Jacey Jetton, as well as similar bills by Rep. Donna Howard and Sen. Charles Perry, would have allowed pharmacists to furnish medications
following a positive CLIA-waived test for COVID-19, influenza, or strep throat. Pharmacists in Texas are already permitted to perform CLIA-waived tests for these conditions, but they cannot furnish treatment if the result is positive. TPA testified
that this creates an unnecessary delay in treatment and care for the patient, who must visit a physician to get a prescription. HB 2079 received a hearing in the House Public Health Committee but was not brought up for a subsequent vote, largely due
to opposition from physician groups.
Expansion of PBM Reform to All Commercial Plans—TPA PRIORITYHouse Bill 2021 (Rep. Oliverson) / Senate Bill 1137 (Sen. Schwertner)In light of the 2020 U.S. Supreme Court ruling in Rutledge v. PCMA regarding state authority to regulate commercial PBM activity regardless of plan type, TPA spearheaded legislation that would have applied the PBM reforms enacted in 2021 to all
commercial PBM activity in Texas. HB 2021 by Rep. Tom Oliverson and SB 1137 by Sen. Charles Schwertner would have done just that, and we are grateful to both legislators for introducing each bill. Both bills received a hearing in committee, but neither was brought up for a vote. Unfortunately, misinformation by the PBMs persuaded business groups to actively testify and work against the legislation under the belief that passage would result in higher prescription drug costs for large employers. The PBMs themselves smartly did not testify during either committee hearing, leaving it to business organizations to be the face of the opposition. The simple fact is that the only language in the PBM reforms enacted last session that affected how much
a PBM must reimburse a pharmacy is a provision that prohibits PBMs from paying their own affiliated pharmacies more than they pay competitors. Other political issues unrelated to the policy of the bill further impacted the bill’s prospects, but we
believe there is still solid support for addressing PBM reforms, and we plan to continue pursuing this issue next session.
Medicaid Prescription Drug Payment Reform—TPA PRIORITYHouse Bill 1293 (Rep. Rose)TPA also led efforts for passage of HB 1293 by Rep. Toni Rose, legislation that would have required Medicaid managed care organizations and their
PBMs to reimburse pharmacies based on the same methodology used in the Medicaid fee-for-service program. The bill would have required Medicaid PBMs to use the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee as the
benchmark for reimbursements. The bill was largely identical to legislation that passed the House overwhelmingly in 2019. Unfortunately, a number of factors worked against the bill this session, including much stronger opposition from the Medicaid
managed care plans and a higher fiscal note that we believe was due to an incorrect analysis. The bill was well received in a late hearing by the House Human Services Committee, which indicated it intends to review the issue during the interim for
possible consideration next session.
Medicaid Usual & Customary DeterminationHouse Bill 3214 (Rep. Howard) / Senate Bill 1619 (Sen. Perry)HB 3214 by Rep. Donna Howard and SB 1619 by Sen. Charles Perry would have clarified that the state Medicaid program shall exclude from its usual and customary (U&C) price calculation any prices used under a third party prescription drug discount card program. In 2020, HHSC announced
that it intended to include third-party discount card programs in its usual and customary calculations, something that it had not previously done. Because pharmacies regularly have no ability to opt-out of discount card programs, we do not believe
it is appropriate to consider these discount prices as part of the calculation. Senate Bill 1619 was heard in committee, but unfortunately was never brought up for a vote.
Texas State Board of Pharmacy Cleanup BillHouse Bill 2088 (Rep. Bucy)HB 2088 by Rep. John Bucy was a “cleanup bill” that would have amended legislation passed in 2021 that granted pharmacists the authority to dispense
an emergency 30-day supply of insulin and insulin-related products. Since prepackaged pens cannot be broken up into smaller doses and the law requires that it cannot exceed a 30-day supply, this puts the pharmacy at risk of not being reimbursed by
the patient’s insurance provider. The bill would have allowed a pharmacist to dispense the smallest prepackaged insulin dose, so long as it is at least a 30-day supply, even if it provides a few extra days due to the packaging. The House passed the
bill, but it never received a committee hearing in the Senate.
Pharmacy Defensive VictoriesTPA closely monitored proposed legislation that would have a negative impact on pharmacists or pharmacies and their patients. Pharmacist members testified in opposition to these bills to educate legislators and successfully defeated a number of provisions
that could have hurt the profession.
Physician DispensingSeveral bills were filed that would have allowed physician dispensing in Texas. TPA has a long-standing position of opposing any expansion of physician dispensing. While we appreciate that the lead author of one bill was willing to make changes to ensure
physicians would be required to follow the same rules and regulations that a pharmacy must adhere to, we continued to oppose physician dispensing efforts this session. While House Bill 1240 did make it out of committee in conjunction with the pharmacy immunization bill, the physician dispensing proposal was not scheduled for debate on the House floor.
PBM Reform ExemptionsSeveral bills were introduced that would have allowed insurers to sell health coverage products that are exempt from many state laws intended to provide consumer protections. One of these bills, House Bill 1001, would have allowed “Consumer Choice Plans” to be exempted from a number of provisions in the Insurance Code, including the PBM reform provisions passed in 2021. TPA worked in collaboration with other pharmacy advocates
to ensure none of these bills moved out of committee.
Telepharmacy ExpansionTPA testified in opposition to House Bill 594, legislation that would have greatly expanded where a telepharmacy can be located. The legislation would
have also repealed a prohibition on the dispensing of controlled substances at telepharmacy locations and no longer required pharmacist visits to the remote dispensing site. Understanding that there is considerable legislative support for telemedicine,
TPA worked to ensure legislators understood that the name “telepharmacy” is a misnomer, as it refers to a physical remote dispensing location that is not required to have a pharmacist present to dispense prescription drugs. The bill received a hearing
but did not come up for a subsequent vote.
COVID-19 Legislation Impacting PharmacyTwo Senate bills were heard that would have negatively impacted pharmacy in their original form. Senate Bill 301 dealt with the use of ivermectin
or hydroxychloroquine to treat COVID-19. The bill originally included language that would have prohibited a pharmacist from counseling a patient regarding the efficacy or safety of either medication unless specifically requested. TPA testified against
the bill and cited concerns with this language. The provisions regarding pharmacist counseling was then removed from the bill, which passed the Senate but did not receive a hearing in the House. Senate Bill 426 was an attempt to clarify that physicians could continue to prescribe medication for off-label use to treat COVID-19. The original
draft included a reference to physicians prescribing and dispensing medications, to which TPA offered testimony pointing out that the language could have been interpreted as allowing physicians to dispense COVID-19 prescriptions. The bill’s author
indicated that this reference was an inadvertent drafting error, and the dispensing reference was deleted from the bill. SB 426 also passed the Senate but did not receive a hearing in the House.
Other Passed Bills of InterestThe following bills passed this session that may be of interest to pharmacists and pharmacy owners.
Opioid AntagonistsSenate Bill 629 (Sen. Menéndez/Rep. Talarico)SB 629 by Sen. José Menéndez and Rep. James Talarico requires each school district to adopt and implement a policy regarding the maintenance and administration of opioid antagonists on each school campus serving grades 6 through 12. Districts are required to train school personnel on the use of Narcan and make reports within 10 days of the administration of an opioid antagonist. Effective Date: June 18, 2023. Senate Bill 998 (Sen. West/Rep. Geren)SB 998 by Sen. Royce West and Rep. Charlie Geren requires the Texas Alcoholic Beverage Commission (TABC) to develop a training program on the signs of opioid-related overdose and on the administration of an opioid antagonist. Effective Date: September 1, 2023. Senate Bill 867 (Sen. West/Rep. Rose)SB 867 by Sen. Royce West and Rep. Toni Rose adds institutions of higher education to the list of entities eligible to receive opioid antagonists through an existing program administered by the Texas Health and Human Services Commission (HHSC). Effective Date: June 17, 2023.
Criminal Penalties for FentanylHouse Bill 6 (Rep. Goldman/Sen. Huffman)HB 6 by Rep. Craig Goldman and Sen. Joan Huffman increases criminal penalties for the production and distribution of illicit fentanyl, and requires that the medical certification of a death certificate include the term “fentanyl toxicity” or “fentanyl poisoning” if toxicology examinations determine that to be the cause of a person’s death. Effective Date: September 1, 2023.
Prohibitions on Gender Transitioning Care for MinorsSenate Bill 14 (Sen. Campbell/Rep. Oliverson)SB 14 by Sen. Donna Campbell and Rep. Tom Oliverson prohibits the provision of treatment, including prescribing or dispensing prescription drugs, for the purpose of transitioning a child’s biological sex as determined by sex organs, chromosomes, and endogenous profile of the child. The bill includes exceptions for certain genetic disorders related to chromosomes or in cases of continuing care that was begun prior to June 1, 2023. Effective Date: September 1, 2023.
Immunization DiscriminationHouse Bill 44 (Rep. Swanson/Sen. Middleton)HB 44 by Rep. Valoree Swanson and Sen. Mayes Middleton prevents a Medicaid provider from refusing to provide care to a Medicaid or CHIP recipient based solely on the recipient’s refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease. The bill provides exceptions for policies adopted by providers that allow exemptions for reasons of conscious or contraindicated medical conditions, and does not apply to providers who specialize in oncology or organ transplant services. Effective Date: September 1, 2023.
Medicaid Coverage Expansion for WomenHouse Bill 12 (Rep. Rose/Sen. Kolkhorst)HB 12 by Rep. Toni Rose and Sen. Lois Kolkhorst extends Medicaid coverage for eligible women for up to one year after childbirth and for 6 months after a miscarriage. Texas currently offers two months of postpartum coverage. Effective Date: September 1, 2023, pending federal approval.
COVID-19 Government Response AuthoritySenate Bill 29 (Sen. Birdwell/Rep. Lozano)SB 29 by Sen. Brian Birdwell and Rep. J.M. Lozano prohibits governmental entities from implementing mask mandates or requiring individuals to receive a vaccination against COVID-19. The bill also prevents governmental entities from requiring that schools or businesses close to prevent the spread of COVID-19. Effective Date: September 1, 2023.
Sales Tax ExemptionsSenate Bill 379 (Sen. Huffman/Rep. Howard)SB 379 by Sen. Joan Huffman and Rep. Donna Howard exempts sales tax on menstrual products, as well as diapers for adults and children, baby wipes, breast milk pumping products, baby bottles and maternity clothes, as well as wound care dressing. Effective Date: September 1, 2023.
Broadband AccessHouse Bill 9/House Joint Resolution 125 (Rep. Ashby/Sen. Huffman)HB 9 and HJR 125 by Rep. Trent Ashby and Sen. Joan Huffman establishes the Texas Broadband Infrastructure Fund to pay for various broadband and communication projects. The legislation calls for a one-time transfer of $1.08 billion to the Fund for eligible projects. Effective Date: January 1, 2024, contingent on the passage of a constitutional ballot by voters in November 2023.
Retail Theft Task ForceHouse Bill 1826 (Rep. Turner/Sen. Whitmire)HB 1826 by Rep. Chris Turner Sen. John Whitmire establishes the Organized Retail Theft Task Force with designated representatives from brick-and-mortar and online retailers, law enforcement, and others to make recommendations to the governor and Legislature on ways to increase transparency, improve security, enhance consumer protections, and prevent organized retail theft. Effective Date: September 1, 2023.
2023 Bill TrackerTrack the progress of pharmacy priority bills from the 88th Texas Legislature (2023) with TPA's Bill Tracker.
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PharmPAC is the political action committee of the Texas Pharmacy Association, 3200 Steck Ave. #370, Austin, TX 78757. Call (512) 836-8350 for information. According to Texas Government Code 305.027, this material may be considered “legislative advertising.” Authorization for its publication is made by Debbie Garza, Chief Executive Officer, Texas Pharmacy Association. |
The 88th Legislature can probably be remembered as the “post-COVID” session, as the Capitol fully reopened to the public for the first time since
the pandemic began. Additionally, the state dealt with a $33 billion budget surplus, by far the largest in the state’s history, in part because of a booming and inflation-fed economy combined with large influxes of federal dollars that in some cases
supplanted the need for state revenue for budget items like Medicaid.
