Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter F - PHARMACY SERVICES
Division 8 - DRUG UTILIZATION REVIEW BOARD
Section 354.1942 - Conflict of Interest Policy
Universal Citation: 1 TX Admin Code ยง 354.1942
Current through Reg. 49, No. 38; September 20, 2024
(a) Definitions. The following words or phrases have the meaning indicated for purposes of this section:
(1) Board member--A
person who is appointed to the DUR Board.
(2) Conflict of interest-- A situation that
arises wherein a board member or any family member or relative has a financial
relationship with an entity, ownership or financial interest with an entity, or
any other interest where the member is in a position to derive a personal
benefit from action or decisions made in their professional capacity, with an
entity.
(3) DUR Board--Drug
Utilization Review Board.
(4)
Entity--Includes an individual, a corporation, organization, business trust,
estate, trust, partnership, association, and any other legal entity that may
have business come before the DUR Board or before the Medicaid Vendor Drug
Program. The term includes:
(A) a
pharmaceutical manufacturer or labeler with a product on the Texas Drug Code
Index and any other entity the Texas Health and Human Services Commission
(HHSC) has engaged to assist in developing the preferred drug list or in
administering of the DUR Program; and
(B) an "affiliate" or "associate," as defined
in Texas Business Organizations Code §
RSA
1.002, of an entity.
(5) Family member or relative--An individual
who is related within the third degree by consanguinity or within the second
degree by affinity, as defined by the Government Code, Chapter 573, Subchapter
B (concerning Relationships by Consanguinity or by Affinity).
(6) Financial relationship--A written or oral
agreement between a board member and an entity that results in the payment of
federally reportable income to the board member (i.e., income reported on IRS
Form 1099 or Form W-2).
(7) Other
interest--Involvement in the affairs of an entity that impairs or may be
perceived as impairing a board member's independence of judgment regarding the
board member's performance of duties for the DUR Board.
(8) Ownership or financial interest--An
equity interest in where a board member exercises control over the selection of
investments and any other financial interest whose value cannot be readily
determined through reference to public records.
(b) Policy.
(1) A board member must avoid conflicts of
interest with the member's DUR Board duties.
(2) To avoid a conflict of interest, a board
member must:
(A) disclose any conflict of
interest as defined by subsection (a)(2) of this section; and
(B) comply with any action the DUR Board or
HHSC may require under subsection (d) of this section to mitigate the effect of
any relationship disclosed.
(c) Disclosure.
(1) A board member of or person under
consideration for appointment to the DUR Board must report any new or existing
financial relationship, ownership or financial interest, or other interest that
the board member or their family member or relative, holds or acquires during
the board member's tenure on the DUR Board or that was held or acquired during
the two-year period that immediately precedes the board member's
tenure.
(2) A board member must
report any relationships or interests described in paragraph (1) of this
subsection within established timeframes to HHSC.
(d) Mitigation. If HHSC determines that a potential conflict of interest exists, the following actions are taken.
(1) HHSC determines whether the potential
conflict will impair the board member's exercise of independent
judgment.
(2) HHSC informs the
board member and the DUR Board chair of its recommended action.
(3) In response to a recommendation from
HHSC, the DUR Board may require:
(A) recusal
of the board member; or
(B) any
other action HHSC determines necessary to avoid or mitigate a potential
conflict of interest.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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