{"data":{"id":"us-tx/tex.-insurance-code-1560.004","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1560.004","heading":"PRESCRIPTION DRUG REIMBURSEMENT RATES.","body":"(a) An issuer of a health benefit plan that provides pharmacy benefits to enrollees shall reimburse pharmacies participating in the health plan using prescription drug reimbursement rates, for both brand name and generic prescription drugs, that are based on a current and nationally recognized benchmark index that includes average wholesale price and maximum allowable cost.\n(b) Regardless of whether a pharmacy is a mail order pharmacy or a community retail pharmacy, an issuer of a health benefit plan shall use the same benchmark index, including the same average wholesale price, maximum allowable cost, and national prescription drug codes, to reimburse all pharmacies participating in the health benefit plan.\nAdded by Acts 2009, 81st Leg., R.S., Ch. 1207 (S.B. 704), Sec. 5, eff. September 1, 2009.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL EMPLOYEES","CHAPTER 1560. DELIVERY OF PRESCRIPTION DRUGS BY MAIL"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1560.htm#1560.004","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"8f771bdba30a2f16513230149e28c9a34144e291078882c9211d96b13d96591e","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1560.003","next":"us-tx/tex.-insurance-code-1575.001"},"notice":"GroundRules: Original legal text. Not legal advice."}