Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1369.605: NETWORK CONTRACT FEE SCHEDULE.

Where this section sits in the code

INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
CHAPTER 1369. BENEFITS RELATED TO PRESCRIPTION DRUGS AND DEVICES AND RELATED SERVICES
SUBCHAPTER M. CONTRACTS WITH PHARMACISTS AND PHARMACIES

A pharmacy benefit network contract must include a fee schedule. The fee schedule must describe:

(1) specific services or procedures that the pharmacist or pharmacy may deliver and the amount of the corresponding payment;

(2) a methodology for calculating the amount of the payment based on a published fee schedule; or

(3) any other reasonable manner that provides an ascertainable amount for payment for services.

Added by Acts 2021, 87th Leg., R.S., Ch. 142 (H.B. 1763), Sec. 1, eff. September 1, 2021.

Redesignated from Insurance Code, Section 1369.555 by Acts 2023, 88th Leg., R.S., Ch. 768 (H.B. 4595), Sec. 24.001(27), eff. September 1, 2023.

Amended by:

Acts 2025, 89th Leg., R.S., Ch. 183 (S.B. 1236), Sec. 5, eff. September 1, 2025.

Collected 2026-08-27T01:47:21Z. Source file · JSON