Certain Fees Prohibited

Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit plan issuer or a pharmacy benefit manager may not directly or indirectly charge or hold a pharmacist or pharmacy responsible for a fee for any step of or component or mechanism related to the claim adjudication process, including: (1) the adjudication of a pharmacy benefit claim; (2) the processing or transmission of a pharmacy benefit claim; (3) the development or management of a claim processing or adjudication network; or (4) participation in a claim processing or adjudication network. Added by Acts 2015, 84th Leg., R.S., Ch. 10 (S.B. 94), Sec. 1, eff. September 1, 2015. SUBCHAPTER J. COVERAGE RELATED TO PRESCRIPTION DRUG SYNCHRONIZATION