Legislative Initiatives 

The Alliance has three legislative priorities for 2019 Texas Legislative Session, which begins January 8, 2019.

PBM Reform
The Alliance, along with our advocacy have developed legislation that would provide reasonable protections for pharmacies and patients who receive prescription drug benefits through a commercial health plan subject to Texas Department of Insurance regulation.

Further details are available through our Member’s Only portal.

85th Session Budget Rider 23
Value-Based Payment for Quality Improvement for Patient OutcomesThe Alliance is working with Health and Human Services Vendor Drug and Managed Care Organizations to develop payment for pharmacy services and medication therapy management. 

85th Session Budget Rider 60 (Previously Rider 219)
HHSC shall study potential cost savings in the administration of prescription drug benefits. In studying potential cost savings, the Health and Human Services Commission may consider savings achieved from, but not limited to: a single statewide claims processor model to deliver prescription drug benefits in Medicaid, CHIP, Women’s Health, Children with Special Health Care Needs Services, and Kidney Health Care programs, reduction of the Affordable Care Act Health Insurance Provider Fees, guaranteed risk margins, and administrative services fees from decreasing capitation related to pharmacy benefits; and transitioning to a prescription pricing methodology based on national Average Drug Acquisition Cost with a professional dispensing fee commensurate with the most recent study commissioned by the Health and Human Services Commission.

Further details are available through our Member’s Only portal.