During the most recent legislative session, the state of Texas took steps towards regulating PBMs. The Texas Legislature passed House Bill 3218, creating registration requirements for PBMs contracting with HMOs, and Senate Bill 680, requiring clinical and medical criteria of prior authorization for prescriptions.
Audra L. Conwell, Executive Director of the Alliance of Independent Pharmacists of Texas and NASPA Associate Member, wrote that these “[s]tatutory changes give regulators clearer authority, supervision and direction over the business of insurance that includes the administration of pharmacy benefits. These laws assist consumers, providers and payers in the state with growing prescription drug costs.”
Conwell also pointed out the importance of several “pro-patient” bills currently pending at the federal level in Congress, including the “Improving Transparency and Accuracy in Medicare Part D Drug Spending Act” and the “Prescription Drug Price Transparency Act.”