Health insurance giant Centene Corporation has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. Texas is the 12th state to settle with Centene in the corporation’s largest payout yet. Since 2021, Centene has settled with Arkansas, Illinois, Kansas, Mississippi, New Hampshire, New Mexico, Ohio, Texas, Washington, and 3 others (which have not been publicly disclosed) for a total of $475 million.

HB 1919 has been signed into law, further regulating pharmacy benefit manager (PBM) practices in the state of Texas. This law prohibits a PBM, health benefit plan insurer, or its affiliate from transferring any patient data for commercial use, and it also prohibits these entities from steering patients to an affiliated pharmacy or even flat-out requiring them to go to that pharmacy.

Texas Governor Abbott signed a PBM reform bill, HB 1763, that is supported by NCPA and Texas community pharmacy advocates. The bill allows local pharmacies to mail anddeliver prescriptions, bans clawbacks, bans PBM patient-steering, prohibits PBMS from paying affiliated pharmacies more than other in-network pharmacies, and more.