{"data":{"id":"us-tx/tex.-insurance-code-1369.603","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1369.603","heading":"REDUCTION OF CERTAIN CLAIM PAYMENT AMOUNTS PROHIBITED.","body":"(a) A health benefit plan issuer or pharmacy benefit manager may not directly or indirectly reduce the amount of a claim payment to a pharmacist or pharmacy after adjudication of the claim through the use of an aggregated effective rate, quality assurance program, other direct or indirect remuneration fee, or otherwise, except in accordance with an audit performed under Subchapter F.\n(b) Nothing in this section prohibits a health benefit plan issuer or pharmacy benefit manager from increasing a claim payment amount after adjudication of the claim.\nAdded by Acts 2021, 87th Leg., R.S., Ch. 142 (H.B. 1763), Sec. 1, eff. September 1, 2021.\nRedesignated from Insurance Code, Section 1369.553 by Acts 2023, 88th Leg., R.S., Ch. 768 (H.B. 4595), Sec. 24.001(27), eff. September 1, 2023.","path":["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"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.603","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"9959d7690e1446e1870ed374135875ca96dbaab6003aca60bf769df01d2efbaf","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1369.6027","next":"us-tx/tex.-insurance-code-1369.604"},"notice":"GroundRules: Original legal text. Not legal advice."}