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Bill

HB 2978

Relating to the minimum reimbursement amount for prescription drugs and devices to health benefit plan network pharmacists and pharmacies.

89th Legislature (2025) Introduced by Cody Harris and 1 co-sponsor

Texas bill requiring health insurers to establish minimum reimbursement rates for network pharmacies and pharmacists to improve medication access and pharmacy viability.

Referred to Insurance
#health--children'sinsurance(i0388) #insurance #commissionerof(v0396) #insurance--health&accident(i0422) #medicaid(s4885) #medicine&prescriptiondrugs(s7338) #pharmacies&pharmacists(s1192) #pharmacybenefitmanagers(s0648)
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Bill Summary · HB 2978

Legislative bill overview

HB 2978 establishes minimum reimbursement requirements for prescription drugs and devices paid by health benefit plans to network pharmacists and pharmacies in Texas. The bill aims to set baseline compensation standards for pharmacy services within insurance networks, addressing concerns about inadequate reimbursement rates.

Why is this important

Pharmacy reimbursement rates directly affect medication access and the viability of independent and smaller pharmacies. Inadequate reimbursement can lead to pharmacy closures in underserved areas, reduced service availability, and potential staffing cuts that impact patient care quality. This issue affects millions of Texans with health insurance coverage.

Potential points of contention

  • Insurance industry costs: Health insurers will likely argue that minimum reimbursement mandates increase premium costs for consumers and reduce plan options
  • Scope and specificity: The bill's actual reimbursement formula, whether it's cost-plus-percentage or another model, will determine its practical impact and feasibility
  • Network participation: Unclear whether requirements apply uniformly or if insurers can use reduced networks as a workaround, affecting pharmacy choice and patient access

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

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