Tex. Gov't Code Section 549.0106
Program Benefits Instead of Supplemental Rebates; Monetary Contribution or Donation


(a)

For purposes of this section, a program benefit may mean a disease management program authorized under this title, a drug product donation program, a drug utilization control program, prescriber and beneficiary counseling and education, a fraud or abuse initiative, and another service or administrative investment with guaranteed savings to a program a health and human services agency operates.

(b)

The commission may enter into a written agreement with a manufacturer to accept a program benefit instead of a supplemental rebate only if:

(1)

the program benefit yields savings that are at least equal to the amount the manufacturer would have provided under a state supplemental rebate agreement during the current biennium as determined by the written agreement;

(2)

the manufacturer:

(A)

posts a performance bond guaranteeing savings to this state; and

(B)

agrees that if the savings are not achieved in accordance with the written agreement, the manufacturer will forfeit the bond to this state, less any savings that were achieved; and

(3)

the program benefit is in addition to other program benefits the manufacturer currently offers to recipients of Medicaid or related programs.

(c)

For purposes of this subchapter, the commission may consider a monetary contribution or donation to the arrangements described in Subsection (b) for the purpose of offsetting expenditures to other state health care programs, but that funding may not be used to offset expenditures for covered outpatient drugs as defined by 42 U.S.C. Section 1396r-8(k)(2) under the vendor drug program. An arrangement under this subsection may not yield less than the amount this state would have benefited under a supplemental rebate. The commission may consider an arrangement under this subchapter as satisfying the requirements of Section 549.0204 (Limitation on Drugs Included on Preferred Drug Lists; Exceptions)(a).
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Source: Section 549.0106 — Program Benefits Instead of Supplemental Rebates; Monetary Contribution or Donation, https://statutes.­capitol.­texas.­gov/Docs/GV/htm/GV.­549.­htm#549.­0106 (accessed May 18, 2024).

549.0001
Bulk Purchasing with Another State of Prescription Drugs and Other Medications
549.0002
Value-based Arrangement in Medicaid Vendor Drug Program
549.0003
Period of Validity of Prescriptions Under Medicaid
549.0004
Certain Medications for Sex Offenders Prohibited
549.0005
Prior Approval of and Pharmacy Provider Access to Certain Communications with Certain Recipients and Enrollees
549.0051
Periodic Review of Vendor Drug Program Purchases
549.0052
Medicaid Prescription Drug Use and Expenditure Patterns
549.0101
Definitions
549.0102
Requirement to Negotiate for Supplemental Rebates for Certain Programs
549.0103
Voluntary Negotiation for Manufacturer and Labeler Supplemental Rebates
549.0104
Considerations in Supplemental Rebate Negotiations
549.0105
Required Disclosures in Negotiations for Supplemental Rebates
549.0106
Program Benefits Instead of Supplemental Rebates
549.0107
Limitations on Agreement to Accept Program Benefits Instead of Supplemental Rebates
549.0108
Treatment of Program Benefits for Certain Purposes
549.0151
Certain Prescription Drug Information Confidential
549.0152
General Prescription Drug Information Not Confidential
549.0153
Existence or Nonexistence of Supplemental Rebate Agreement Not Confidential
549.0201
Definition
549.0202
Preferred Drug Lists Required for Medicaid Vendor Drug and Child Health Plan Programs
549.0203
Preferred Drug Lists Authorized for Certain Programs
549.0204
Limitation on Drugs Included on Preferred Drug Lists
549.0205
Considerations for Including Drug on Preferred Drug Lists
549.0206
Submission of Evidence to Support Including Drug on Preferred Drug Lists
549.0207
Publication of Information Relating to and Distribution of Preferred Drug Lists
549.0251
Drugs Subject to Prior Authorization Requirements
549.0252
Prior Authorization and Certain Protocol Requirements Prohibited for Certain Antiretroviral Drugs
549.0253
Prior Authorization Prohibited for Certain Nonpreferred Antipsychotic Drugs
549.0254
Administration of Prior Authorization Requirements
549.0255
Prerequisite to Implementing Prior Authorization Requirement for Certain Drugs
549.0256
Notice of Prior Authorization Requirement Implementation and Procedures
549.0257
Prior Authorization Procedures
549.0258
Prior Authorization Automation and Point-of-sale Requirements
549.0259
Applicability of Prior Authorization Requirements to Prior Prescriptions
549.0260
Appeal of Prior Authorization Denial Under Medicaid Vendor Drug Program
549.0301
Definition
549.0302
Board Composition
549.0303
Conflicts of Interest
549.0304
Board Member Terms
549.0305
Presiding Officer
549.0306
Inapplicability of Other Law to Board
549.0307
Administrative Support for Board
549.0308
Rules for Board Operation
549.0309
General Powers and Duties of Board
549.0310
Board Meetings
549.0311
Board Summary of Certain Information Required
549.0312
Public Disclosure of Certain Board Recommendations Required
549.0351
Definitions
549.0352
Drug Use Reviews
549.0353
Annual Report
549.0401
Definition
549.0402
Provision of Program Information by Pharmaceutical Company
549.0403
Public Access to Program Information
549.0451
Development and Implementation of State Prescription Drug Program
549.0452
Program Eligibility
549.0453
Rules
549.0454
Generic Equivalent Authorized
549.0455
Program Funding and Funding Priorities

Accessed:
May 18, 2024

§ 549.0106’s source at texas​.gov