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Bill

SB 1122

Relating to applicability of certain prescription drug insurance laws to health benefit plans and pharmacy benefit managers.

89th Legislature (2025) Introduced by Bryan Hughes and 1 co-sponsor

Texas bill expands insurance regulations to pharmacy benefit managers and health plans to increase oversight of prescription drug pricing and coverage practices.

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#insurance #commissionerof(v0396) #insurance--health&accident(i0422) #medicine&prescriptiondrugs(s7338) #pharmacybenefitmanagers(s0648)
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Bill Summary · SB 1122

Legislative bill overview

SB 1122 expands the applicability of Texas prescription drug insurance regulations to health benefit plans and pharmacy benefit managers (PBMs) that were previously exempt or less regulated. The bill brings additional oversight and requirements to these entities regarding how they handle prescription drug coverage and pricing practices.

Why is this important

PBMs serve as intermediaries between insurers, pharmacies, and patients, controlling drug formularies and pricing structures. This bill affects how millions of Texans access and pay for prescription medications by subjecting PBMs to stricter state insurance regulations, potentially impacting drug costs, pharmacy reimbursement rates, and insurance premiums.

Potential points of contention

  • Cost implications: PBMs and insurers may argue compliance increases administrative costs, potentially raising premiums for consumers
  • Federal preemption questions: Some regulations on health plans are federally controlled (ERISA); state-level requirements could create conflicts or legal challenges
  • Pharmacy access: Changes to PBM operations could affect which pharmacies participate in networks and how independent pharmacies are reimbursed

Compiled from official sources — confirm details with the bill’s official record.

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