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No significant fiscal implication to the State is anticipated.
Also, based on information provided by TDI, this analysis assumes implementation of the bill would result in an increase in filings, which could result in a one-time revenue gain of $39,600 in FY 2016 to be deposited to the credit of General Revenue-Dedicated Texas Department of Insurance Fund 36 (Fund 36). Since Fund 36 is a self-leveling account, this analysis also assumes that any additional revenue resulting from the implementation of the bill would accumulate in account fund balances and TDI would adjust the assessment of the maintenance tax or other fees accordingly in the following year.
The bill takes effect September 1, 2015 but applies only to a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2016.
No fiscal implication to units of local government is anticipated.
The bill would add a subchapter to Chapter 1369 of the Insurance Code to require a health benefit plan to establish a process through which a health benefit plan, the covered person, the prescribing physician or health care provider, and a pharmacist, may jointly approve a medication synchronization plan to treat a covered person’s chronic illness. The subchapter would apply to certain health benefit plans including, but not limited to: group health coverage made available by a school district; a small employer health benefit plan; and a consumer choice of benefits plan.
The bill sets forth provisions to require a health benefit plan to provide coverage for a medication dispensed in accordance with the dates established in the medication synchronization plan and to establish a process that would allow a pharmacist or pharmacy to override the health benefit plan's denial of coverage for a medication to treat a person's chronic illness.
While we support the concept of medication synchronization plans, we oppose all new mandates on health insurance carriers.
Our issues with HB 3025 are that it would require a health benefit plan to provide coverage for a medication dispensed in accordance with the dates established in the medication synchronization plan and would allow a pharmacist or pharmacy to override a health benefit plan's denial of coverage for a medication to treat a person's chronic illness.
This legislation represents yet another example of the government interfering with private businesses. The high cost of health care and health insurance is partly the result of government interference in the form of mandates. Every time the government tinkers with the system to take choices away from providers and patients, costs tend to rise.
Creating new state mandates on private enterprise abridges our limited government and free market principles. Therefore, we oppose HB 3025.
It is worth noting that Texas has one of the highest number of insurance mandates in the U.S.