Testimony Opposing HB 1283: PDL Outside of Managed care
The Texas Association of Health Plans opposes HB 1283 because it prioritizes drug rebates for the state over patient care for Texans. HB 1283 repeals the planned implementation of management of the state’s preferred drug list (PDL) by Medicaid managed care organizations (MCOs), effectively allowing HHSC to permanently control the state’s drug formulary.
Texas has delayed the adoption of the state’s drug formulary by health plans for 10 years, prioritizing rebates over improved patient care and taxpayer savings. Under the state’s management of the drug formulary, the PDL frequently changes based on the amount the state can receive in rebates on a drug, known as “rebate chasing.” It also means the state’s preferred list of drugs looks very different from what patients, pharmacists, and doctors are used to prescribing.
This unusual formulary design creates an administrative burden for physicians, pharmacists, and health plans. Physicians often prescribe generics, but if that doesn’t align with the PDL, the doctor will have to request prior authorization or change the prescription. Pharmacists can’t switch to alternative drugs for their Medicaid clients.
Read the full letter.
