Tex. Insurance Code § 1301.104
DEADLINE FOR ACTION ON PHARMACY CLAIMS; PAYMENT
Texas · Texas Insurance Code · Status: effective
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- Citation
- Tex. Insurance Code § 1301.104, DEADLINE FOR ACTION ON PHARMACY CLAIMS; PAYMENT, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/681808
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Full text
(a) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is electronically submitted shall pay the total amount of the claim through electronic funds transfer not later than the 18th day after the date on which the claim was affirmatively adjudicated.
(b) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is not electronically submitted shall pay the total amount of the claim not later than the 21st day after the date on which the claim was affirmatively adjudicated.