A pharmacy benefit network contract must specify or reference a separate fee schedule. Unless otherwise available in the contract, the fee schedule must be provided electronically in an easily accessible and complete spreadsheet format and, on request, in writing to each contracted pharmacist and pharmacy. 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. Tex. Ins. Code § 1369.605
Amended by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 768,Sec. 24.001, eff. 9/1/2023.Added by Acts 2021, Texas Acts of the 87th Leg. - Regular Session, ch. 142,Sec. 1, eff. 9/1/2021.