Sections
Subchapter A Coverage of Prescription Drugs in General 1369.001 – 1369.005
Subchapter B Requirements Affecting Coverage of Specific Prescription Drugs or Cost Sharing 1369.051 – 1369.057
Subchapter B-1 Transparency Requirements for Certain Individual Health Benefit Plans 1369.076 – 1369.080
Subchapter B-2 Disclosure of Certain Prescription Drug Information Specified by Drug Formulary 1369.091 – 1369.094
Subchapter C Coverage of Prescription Contraceptive Drugs and Devices and Related Services 1369.101 – 1369.109
Subchapter D Pharmacy Benefit Cards 1369.151 – 1369.154
Subchapter E Coverage for Orally Administered Anticancer Medications 1369.201 – 1369.204
Subchapter E-1 Coverage of Prescription Drugs for Stage-Four Advanced, Metastatic Cancer 1369.211 – 1369.213
Subchapter F Audits of Pharmacists and Pharmacies 1369.251 – 1369.270
Subchapter G Standard Request Form for Prior Authorization of Prescription Drug Benefits 1369.301 – 1369.306
Subchapter H Maximum Allowable Cost 1369.351 – 1369.362
Subchapter I Pharmacy Benefit Claim Adjudication 1369.401 – 1369.402
Subchapter J Coverage Related to Prescription Drug Synchronization 1369.451 – 1369.456
Subchapter K Prescription Drug Cost Transparency 1369.501 – 1369.504
Subchapter L Affiliated Providers 1369.551 – 1369.555
Subchapter M Contracts With Pharmacists and Pharmacies 1369.601 – 1369.610
Subchapter N Coverage of Prescription Drugs for Autoimmune Diseases and Certain Blood Disorders 1369.651 – 1369.654
Subchapter Q Clinician-Administered Drugs 1369.761 – 1369.764

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Terms Used In Texas Insurance Code Chapter 1369 - Benefits Related to Prescription Drugs and Devices and Related Services

  • Affidavit: means a statement in writing of a fact or facts signed by the party making it, sworn to before an officer authorized to administer oaths, and officially certified to by the officer under his seal of office. See Texas Government Code 312.011
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Comptroller: means the state comptroller of public accounts. See Texas Government Code 312.011
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Court: means and includes:
    (1) a county court in the exercise of its probate jurisdiction;
    (2) a court created by statute and authorized to exercise original probate jurisdiction; and
    (3) a district court exercising original probate jurisdiction in a contested matter. See Texas Estates Code 22.007
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • Dependent: A person dependent for support upon another.
  • Devise: To gift property by will.
  • Effects: includes all personal property and all interest in that property. See Texas Government Code 312.011
  • Estate: means a decedent's property, as that property:
    (1) exists originally and as the property changes in form by sale, reinvestment, or otherwise;
    (2) is augmented by any accretions and other additions to the property, including any property to be distributed to the decedent's representative by the trustee of a trust that terminates on the decedent's death, and substitutions for the property; and
    (3) is diminished by any decreases in or distributions from the property. See Texas Estates Code 22.012
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Fee simple: Absolute title to property with no limitations or restrictions regarding the person who may inherit it.
  • Fiduciary: A trustee, executor, or administrator.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Fraud: Intentional deception resulting in injury to another.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • in writing: includes any representation of words, letters, or figures, whether by writing, printing, or other means. See Texas Government Code 312.011
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Justice: when applied to a magistrate, means justice of the peace. See Texas Government Code 312.011
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Minor: means a person younger than 18 years of age who:
    (1) has never been married; and
    (2) has not had the disabilities of minority removed for general purposes. See Texas Estates Code 22.022
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Oath: A promise to tell the truth.
  • Oath: includes affirmation. See Texas Government Code 311.005
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: includes a natural person and a corporation. See Texas Estates Code 22.027
  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
  • Personal property: All property that is not real property.
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Population: means the population shown by the most recent federal decennial census. See Texas Government Code 311.005
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Property: means real and personal property. See Texas Government Code 311.005
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Signature: includes the mark of a person unable to write, and "subscribe" includes the making of such a mark. See Texas Government Code 312.011
  • Signed: includes any symbol executed or adopted by a person with present intention to authenticate a writing. See Texas Government Code 311.005
  • Statute: A law passed by a legislature.
  • Swear: includes affirm. See Texas Government Code 311.005
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Week: means seven consecutive days. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005