reglab/housing_qa huggingface dataset:
TX Health & Safety Code § 65.053 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter B. Establishment and Administration of Prescription Drug Savings Program|Section 65.053. Pharmacy Benefit Manager Contract, Monitoring, and Reporting Requirements

Sec. 65.053.  PHARMACY BENEFIT MANAGER CONTRACT, MONITORING, AND REPORTING REQUIREMENTS.  (a)  The commission shall contract with a pharmacy benefit manager to provide discounted prescription drugs to enrollees under the program.(b)  The commission shall monitor through reporting or other methods the contracted pharmacy benefit manager to ensure performance under the contract and quality delivery of services.(c)  The contracted pharmacy benefit manager shall report to the commission on the commission's request information related to the program, including information on rebate amounts, prescription drug rates contracted with pharmacies, administrative costs, and out-of-pocket costs paid by enrollees at the point of sale of the prescription drugs.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.054 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter B. Establishment and Administration of Prescription Drug Savings Program|Section 65.054. Contract Functions

Sec. 65.054.  CONTRACT FUNCTIONS.  (a)  The commission may contract with a third-party administrator or other entity to perform any or all program functions for the commission under this chapter.(b)  A third-party administrator or other entity may perform tasks under a contract entered into under Subsection (a) that would otherwise be performed by the commission.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.055 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter B. Establishment and Administration of Prescription Drug Savings Program|Section 65.055. Community Outreach Campaign

Sec. 65.055.  COMMUNITY OUTREACH CAMPAIGN.  The commission shall conduct or contract to conduct a community outreach and education campaign in the form and manner determined by the commission to provide information on the program's availability to eligible individuals.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.101 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter C. Trust Fund; Program Suspension|Section 65.101. Establishment of Fund

Sec. 65.101.  ESTABLISHMENT OF FUND. (a)  A trust fund is established outside the state treasury for the purposes of this chapter.(b)  The fund consists of:(1)  gifts, grants, and donations received by this state for the purposes of the fund;(2)  legislative appropriations of money for the purposes of this chapter;(3)  federal money available to this state that by law may be used for the purposes of this chapter; and(4)  interest, dividends, and other income of the fund.(c)  The commission shall administer the fund as trustee for the benefit of the program established by this chapter.(d)  Money in the fund may be used only to administer the program and provide program services.(e)  The commission shall ensure money spent from the fund to assist enrollees in purchasing prescription drugs is cost neutral after collecting the prescription drug rebates under the program.(f)  The commission may solicit and accept gifts, grants, and donations for the fund.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.102 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter C. Trust Fund; Program Suspension|Section 65.102. Sufficient Funding Required

Sec. 65.102.  SUFFICIENT FUNDING REQUIRED.  Notwithstanding any other provision of this chapter, the commission is not required to implement the program unless money is provided and by law made available for deposit to the credit of the fund.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.103 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter C. Trust Fund; Program Suspension|Section 65.103. Suspension of Program

Sec. 65.103.  SUSPENSION OF PROGRAM.  On the fourth anniversary of the date the program is established, the commission shall suspend the program and seek legislative approval to continue the program unless the ongoing costs of administering the program are fully funded through enrollee cost sharing.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.151 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter D. Program Eligibility and Enrollee Requirements|Section 65.151. Eligibility Criteria

Sec. 65.151.  ELIGIBILITY CRITERIA.  (a)  Except as provided by Subsection (b), an individual is eligible for benefits under the program if the individual is:(1)  a resident of this state;(2)  a citizen or lawful permanent resident of the United States; and(3)  uninsured, as determined by the commission.(b)  If the commission determines necessary, the commission may consider an applicant's financial vulnerability as an additional factor for determining program eligibility.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.152 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter D. Program Eligibility and Enrollee Requirements|Section 65.152. Cost Sharing

Sec. 65.152.  COST SHARING.  (a)  To the extent necessary, the commission shall require enrollees to share the cost of the program, including requiring enrollees to pay a copayment at the point of sale of a prescription drug.(b)  The commission must:(1)  allow an enrollee to pay all or part of the enrollee's share from any source the enrollee selects; and(2)  accept another assistance program if that assistance program wholly or partly covers the enrollee share of the prescription drug cost.(c)  The commission shall require an enrollee to pay a copayment to compensate the pharmacy, pharmacy benefit manager, and commission for the costs of administering the program in accordance with Subsection (d) and under the methodology determined by the commission.(d)  Enrollees shall pay the costs of ongoing administration of the program through an additional charge at the point of sale of an eligible prescription drug only if the total number of enrollees in the program allows for the additional charge to be an amount not to exceed the lesser of:(1)  an amount similar to the amount charged for a prescription drug in other state pharmaceutical assistance programs administered by the commission; or(2)  10 percent of the total amount charged at the point of sale for the prescription drug.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.201 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter E. Operation of Program|Section 65.201. Program Benefits

Sec. 65.201.  PROGRAM BENEFITS.  The commission must approve program benefits offered under this chapter.  The commission shall ensure the benefits comply with all applicable federal and state laws, rules, and regulations.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.202 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter E. Operation of Program|Section 65.202. Reporting

Sec. 65.202.  REPORTING.  (a)  A third-party administrator, pharmacy benefit manager, or any other entity the commission contracts with under Section 65.054 shall report to the commission in the form and manner prescribed by the commission on the benefits and services provided under the program.(b)  The commission shall establish a procedure to monitor the provision of benefits and services under this chapter.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.203 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter E. Operation of Program|Section 65.203. Fraud Prevention

Sec. 65.203.  FRAUD PREVENTION.  The executive commissioner by rule shall develop and implement fraud prevention and detection for pharmacy benefit managers, contracted third parties, and other entities involved in the program.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.204 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter E. Operation of Program|Section 65.204. Annual Program Reports

Sec. 65.204.  ANNUAL PROGRAM REPORTS.  Not later than December 1 of each year, the commission shall provide a written report to the governor, lieutenant governor, speaker of the house of representatives, and standing committees of the legislature with primary jurisdiction over the program. The report must include:(1)  a line-item list of all program administrative costs incurred by the commission;(2)  the amount of the pharmacy benefit manager and third-party administrator fees;(3)  the aggregate amounts of rebates anticipated and received for the program; and(4)  other program expenditures as the commission determines appropriate.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 75.001 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter A. General Provisions|Section 75.001. Purpose

Sec. 75.001.  PURPOSE.  The purpose of this chapter is to:(1)  improve the health of employees of small employers and their families by improving the employees' access to health care and by reducing the number of those employees who are uninsured;(2)  reduce the likelihood that those employees and their families will require services from state-funded entitlement programs such as Medicaid;(3)  contribute to economic development by helping small businesses remain competitive with a healthy workforce and health care benefits that will attract employees; and(4)  encourage innovative solutions for providing and funding health care services and benefits.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.002 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter A. General Provisions|Section 75.002. Definitions

Sec. 75.002.  DEFINITIONS.  In this chapter:(1)  "Employee" means an individual employed by an employer.  The term includes a partner of a partnership and the proprietor of a sole proprietorship.(2)  "Governing body" means:(A)  the commissioners courts of the counties participating in a regional health care program;(B)  the commissioners court of a county participating in a local health care program; or(C)  the governing body of the joint council, nonprofit entity exempt from federal taxation, or other entity that operates a regional or local health care program.(3)  "Local health care program" means a local health care program operating in one county and established for the benefit of the employees of small employers under Subchapter B.(4)  "Regional health care program" means a regional health care program operating in two or more counties and established for the benefit of the employees of small employers under Subchapter B.(5)  "Small employer" means a person who employed an average of at least two employees but not more than 50 employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.051 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter B. Regional or Local Health Care Program|Section 75.051. Establishment of Program; Multicounty Cooperation

Sec. 75.051.  ESTABLISHMENT OF PROGRAM; MULTICOUNTY COOPERATION.  (a)  The commissioners court of a county may, by order, establish or participate in a local health care program under this subchapter.(b)  The commissioners courts of two or more counties may, by joint order, establish or participate in a regional health care program under this subchapter.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.052 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter B. Regional or Local Health Care Program|Section 75.052. Governance of Program

Sec. 75.052.  GOVERNANCE OF PROGRAM.  (a)  A regional health care program may be operated subject to the direct governance of the commissioners courts of the participating counties.  A local health care program may be operated subject to the direct governance of the commissioners court of the participating county.  A regional or local health care program may be operated by a joint council, tax-exempt nonprofit entity, or other entity that:(1)  operates the program under a contract with the commissioners court or courts, as applicable; or(2)  is an entity in which the county or counties participate or that is established or designated by the commissioners court or courts, as applicable, to operate the program.(b)  In selecting an entity described by Subsection (a)(1) or (2) to operate a regional or local health care program, the commissioners court or courts, as applicable, shall require, to the extent possible, that the entity be authorized under federal law to accept donations on a basis that is tax-deductible or otherwise tax-advantaged for the contributor.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.053 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter B. Regional or Local Health Care Program|Section 75.053. Operation of Program

Sec. 75.053.  OPERATION OF PROGRAM.  A regional or local health care program provides health care services or benefits to the employees of participating small employers who are located within the boundaries of the participating county or counties, as applicable.  A program may also provide services or benefits to the dependents of those employees.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.054 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter B. Regional or Local Health Care Program|Section 75.054. Participation by Small Employers; Share of Cost

Sec. 75.054.  PARTICIPATION BY SMALL EMPLOYERS; SHARE OF COST.  Subject to Section 75.153, the governing body may establish criteria for participation in a regional or local health care program by small employers, the employees of the small employers, and their dependents.  The criteria must require that participating employers and participating employees pay a share of the premium or other cost of the program.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.055 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter B. Regional or Local Health Care Program|Section 75.055. Additional Funding

Sec. 75.055.  ADDITIONAL FUNDING.  (a)  A governing body may accept and use state money made available through an appropriation from the general revenue fund or a gift, grant, or donation from any source to operate the regional or local health care program and to provide services or benefits under the program.(b)  A governing body may apply for and receive funding from the health opportunity pool trust fund under Subchapter D.(b-1)  Expired.(c)  A governing body shall actively solicit gifts, grants, and donations to:(1)  fund services and benefits provided under the regional or local health care program; and(2)  reduce the cost of participation in the program for small employers and their employees.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.101 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter C. Health Care Services and Benefits|Section 75.101. Alternative Programs Authorized; Program Objectives

Sec. 75.101.  ALTERNATIVE PROGRAMS AUTHORIZED; PROGRAM OBJECTIVES.  In developing a regional or local health care program, a governing body may provide health care services or benefits as described by this subchapter or may develop another type of program to accomplish the purposes of this chapter.  A regional or local health care program must be developed, to the extent practicable, to:(1)  reduce the number of individuals without health benefit plan coverage within the boundaries of the participating county or counties;(2)  address rising health care costs and reduce the cost of health care services or health benefit plan coverage for small employers and their employees within the boundaries of the participating county or counties;(3)  promote preventive care and reduce the incidence of preventable health conditions, such as heart disease, cancer, and diabetes and low birth weight in infants;(4)  promote efficient and collaborative delivery of health care services;(5)  serve as a model for the innovative use of health information technology to promote efficient delivery of health care services, reduce health care costs, and improve the health of the community; and(6)  provide fair payment rates for health care providers.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.102 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter C. Health Care Services and Benefits|Section 75.102. Health Benefit Plan Coverage

Sec. 75.102.  HEALTH BENEFIT PLAN COVERAGE.  (a)  A regional or local health care program may provide health care benefits to the employees of small employers by purchasing or facilitating the purchase of health benefit plan coverage for those employees from a health benefit plan issuer, including coverage under:(1)  a small employer health benefit plan offered under Chapter 1501, Insurance Code;(2)  a standard health benefit plan offered under Chapter 1507, Insurance Code; or(3)  any other health benefit plan available in this state.(b)  The governing body may form one or more cooperatives under Subchapter B, Chapter 1501, Insurance Code.(c)  Notwithstanding Chapter 1251, Insurance Code, an insurer may issue a group accident and health insurance policy, including a group contract issued by a group hospital service corporation, to cover the employees of small employers participating in a regional or local health care program.  The group policyholder of a policy issued in accordance with this subsection is the governing body or the designee of the governing body.(d)  A health maintenance organization may issue a health care plan to cover the employees of small employers participating in a regional or local health care program.  The group contract holder of a contract issued in accordance with this subsection is the governing body or the designee of the governing body.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|
TX Health & Safety Code § 75.103 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 75 - Regional or Local Health Care Programs for Employees of Small Employers|Subchapter C. Health Care Services and Benefits|Section 75.103. Other Health Benefit Plans or Programs

Sec. 75.103.  OTHER HEALTH BENEFIT PLANS OR PROGRAMS.  To the extent authorized by federal law, the governing body may establish or facilitate the establishment of self-funded health benefit plans or may facilitate the provision of health benefit coverage through health savings accounts and high-deductible health plans.|Added by Acts 2007, 80th Leg., R.S., Ch. 268 (S.B. 10), Sec. 13(a), eff. September 1, 2007.|