Texas pharmacists now providers in private health plans

In Texas, pharmacists can now be included in provider networks for all commercial health plans and be reimbursed for services they provide that are within their scope of practice.

On May 29, Texas Governor Greg Abbott signed HB 1757 into law, which amends Texas’ insurance code for commercial health plans and will allow a beneficiary of a commercial health plan to select a pharmacist to provide services in the health insurance policy.  

According to a statement from the Texas Pharmacy Association, by being listed as a practitioner, “an insurer may not discriminate against pharmacists for payment or reimbursement for services performed in the scope of the pharmacist’s license if the same service or procedures are provided and covered by another listed health care practitioner.”

The law will affect health benefit plans in Texas issued or renewed on or after January 1, 2020.

Washington state and Tennessee have similar laws, passed in 2015 and 2017, respectively. Like the new law in Texas, laws in Washington and Tennessee ensure that pharmacists are paid for the services they provide when they are part of provider networks in private health insurance plans.