Texas PBM Steerage Bill Becomes Law

AUSTIN, Texas, June 19, 2021 /PRNewswire-PRWeb/ -- In a significant victory for Texas pharmacists and their patients, Texas has enacted House Bill 1919, important legislation that protects community pharmacies and ensures patient choice by prohibiting pharmacy benefit managers (PBMs) from steering patients to pharmacies they own. The law will be effective September 1, 2021.

The Texas Pharmacy Association (TPA) identified PBM reform as a top priority for the 87th Legislative Session and worked closely with legislators to enact meaningful legislation. The three largest PBMs—which act as the middlemen between insurance companies, pharmacies and patients—control upwards of 80% of all prescription drug reimbursement in this country. While having a virtual monopoly on the payer side, they also own their own pharmacies that compete with local community pharmacies not affiliated with a PBM. Because PBMs are largely unregulated, they have been allowed to implement anti-competitive practices steering patients to their own pharmacies, which benefits their bottom line, limits patient choice, and harms small businesses.

"This legislation provides reasonable safeguards to ensure patients' best interests are protected, and that decisions based on profits do not overrule the choices of patients and their healthcare providers," said TPA President Michelle Beall, Pharm.D.

TPA is grateful to Texas legislators for recognizing that PBM practices shortchange pharmacists and create barriers, limiting access for patients to receive needed medications from their local pharmacy. PBM practices are rife with self-dealing and threaten community pharmacies' continued viability.

"What started in the 1980s as a mechanism to keep rising drug prices in check has turned into anti-free market steering practices that remove the patient from the decision-making process," said Representative Cody Harris, who authored the legislation. "House Bill 1919 brings competition to the marketplace and transparency to the consumer. With patient choice restored, this bill allows patients to once again choose their preferred pharmacy without being punished."

House Bill 1919 prohibits PBMs from steering patients to their affiliated pharmacies through online or patient-specific messaging. Additionally, it prohibits PBMs from requiring or inducing patients with reduced cost-sharing to use their affiliated pharmacy, prohibits PBMs from using patient-specific prescription information for commercial purposes, and requires patient consent to transfer a prescription.

This the second piece of PBM reform legislation enacted in Texas this year. In May, Governor Abbott signed into law House Bill 1763, which improves patient access to needed prescription drugs while ensuring pharmacies are protected from PBM overreach.

"We thank Governor Abbott for once again standing with Texas patients and acknowledging the need to reform this system," said TPA Chief Executive Officer Debbie Garza, R.Ph. "Community pharmacies have been under attack due to predatory business practices at the hands of PBMs. This legislation represents a significant step toward leveling the playing field for pharmacists across the state."

Media Contact

Debbie Garza, R.Ph., Texas Pharmacy Association, +1 512-615-9140, [email protected]

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SOURCE Texas Pharmacy Association