TX HB4533

Requires Medicaid managed care organizations and pharmacy benefit managers to reimburse pharmacies at least the vendor drug program rate (including dispensing fee) or the pharmacy's claimed amount, whichever is less

Mandates that actual acquisition cost (AAC) methodology for prescription drugs be based on monthly surveys of Texas retail, specialty, and long-term care pharmacies to reflect actual prices paid

Requires the commission to conduct studies of pharmacy dispensing costs at least every two years and adjust minimum professional dispensing fees for retail and specialty pharmacies accordingly

Extends the same reimbursement requirements to managed care organizations and pharmacy benefit managers administering the Children's Health Insurance Program (CHIP)

Takes effect March 1, 2026, with provisions allowing delay if federal waiver or authorization is required for implementation