{"data":{"id":"us-tx/tex.-insurance-code-1301.104","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1301.104","heading":"DEADLINE FOR ACTION ON PHARMACY CLAIMS; PAYMENT.","body":"(a) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is electronically submitted shall pay the total amount of the claim through electronic funds transfer not later than the 18th day after the date on which the claim was affirmatively adjudicated.\n(b) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is not electronically submitted shall pay the total amount of the claim not later than the 21st day after the date on which the claim was affirmatively adjudicated.\nAdded by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.\nAmended by:\nActs 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.\nActs 2011, 82nd Leg., R.S., Ch. 798 (H.B. 2292), Sec. 9, eff. September 1, 2011.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE D. PROVIDER PLANS","CHAPTER 1301. PREFERRED PROVIDER BENEFIT PLANS","SUBCHAPTER C. PROMPT PAYMENT OF CLAIMS"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm#1301.104","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"6b82a8f70eae39721820b6ad41507fd55f324ed1daf3b4d64f834f27e57c8016","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1301.103","next":"us-tx/tex.-insurance-code-1301.105"},"notice":"GroundRules: Original legal text. Not legal advice."}