(a) A pharmacy benefit manager may not retaliate against a pharmacist or pharmacy based on the pharmacist’s or pharmacy’s exercise of any right or remedy under this chapter. Retaliation prohibited by this section includes:
(1) terminating or refusing to renew a contract with the pharmacist or pharmacy;
(2) subjecting the pharmacist or pharmacy to increased audits; or
(3) failing to promptly pay the pharmacist or pharmacy any money owed by the pharmacy benefit manager to the pharmacist or pharmacy.
(b) For purposes of this section, a pharmacy benefit manager is not considered to have retaliated against a pharmacist or pharmacy if the pharmacy benefit manager:
(1) takes an action in response to a credible allegation of fraud against the pharmacist or pharmacy; and
(2) provides reasonable notice to the pharmacist or pharmacy of the allegation of fraud and the basis of the allegation before taking the action.

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Terms Used In Texas Insurance Code 1369.609

  • Allegation: something that someone says happened.
  • Contract: A legal written agreement that becomes binding when signed.
  • Fraud: Intentional deception resulting in injury to another.