Indiana 2024 Regular Session

Indiana House Bill HB1114 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	HOUSE BILL No. 1114
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 5-10-8; IC 27-8; IC 27-13-7.
7	7	Synopsis: Coverage for cancer screening and prescriptions. Requires
8	8	a state employee health plan to cover supplemental breast
9	9	examinations. Requires a policy of accident and sickness insurance and
10	10	a health maintenance organization to cover diagnostic breast
11	11	examinations and supplemental breast examinations. Provides that the
12	12	coverage of diagnostic breast examinations and supplemental breast
13	13	examinations may not be subject to any cost sharing requirements.
14	14	Prohibits a state employee health plan, a policy of accident and
15	15	sickness insurance, and a health maintenance organization that
16	16	provides coverage for advanced, metastatic cancer and associated
17	17	conditions from requiring that, before providing coverage of a
18	18	prescription drug, the insured fail to successfully respond to a different
19	19	prescription drug or prove a history of failure of a different prescription
20	20	drug.
21	21	Effective: July 1, 2024.
22	22	Pryor
23	23	January 8, 2024, read first time and referred to Committee on Insurance.
24	24	2024 IN 1114—LS 6439/DI 141 Introduced
25	25	Second Regular Session of the 123rd General Assembly (2024)
26	26	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
27	27	Constitution) is being amended, the text of the existing provision will appear in this style type,
28	28	additions will appear in this style type, and deletions will appear in this style type.
29	29	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
30	30	provision adopted), the text of the new provision will appear in this style type. Also, the
31	31	word NEW will appear in that style type in the introductory clause of each SECTION that adds
32	32	a new provision to the Indiana Code or the Indiana Constitution.
33	33	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
34	34	between statutes enacted by the 2023 Regular Session of the General Assembly.
35	35	HOUSE BILL No. 1114
36	36	A BILL FOR AN ACT to amend the Indiana Code concerning
37	37	insurance.
38	38	Be it enacted by the General Assembly of the State of Indiana:
39	39	1 SECTION 1. IC 5-10-8-7.2, AS AMENDED BY P.L.56-2023,
40	40	2 SECTION 37, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
41	41	3 JULY 1, 2024]: Sec. 7.2. (a) As used in this section, "breast cancer
42	42	4 diagnostic service" means a procedure intended to aid in the diagnosis
43	43	5 of breast cancer. The term includes procedures performed on an
44	44	6 inpatient basis and procedures performed on an outpatient basis,
45	45	7 including the following:
46	46	8 (1) Breast cancer screening mammography.
47	47	9 (2) Surgical breast biopsy.
48	48	10 (3) Pathologic examination and interpretation.
49	49	11 (b) As used in this section, "breast cancer outpatient treatment
50	50	12 services" means procedures that are intended to treat cancer of the
51	51	13 human breast and that are delivered on an outpatient basis. The term
52	52	14 includes the following:
53	53	15 (1) Chemotherapy.
54	54	16 (2) Hormonal therapy.
55	55	17 (3) Radiation therapy.
56	56	2024 IN 1114—LS 6439/DI 141 2
57	57	1 (4) Surgery.
58	58	2 (5) Other outpatient cancer treatment services prescribed by a
59	59	3 physician.
60	60	4 (6) Medical follow-up services related to the procedures set forth
61	61	5 in subdivisions (1) through (5).
62	62	6 (c) As used in this section, "breast cancer rehabilitative services"
63	63	7 means procedures that are intended to improve the results of or to
64	64	8 ameliorate the debilitating consequences of the treatment of breast
65	65	9 cancer and that are delivered on an inpatient or outpatient basis. The
66	66	10 term includes the following:
67	67	11 (1) Physical therapy.
68	68	12 (2) Psychological and social support services.
69	69	13 (3) Reconstructive plastic surgery.
70	70	14 (d) As used in this section, "breast cancer screening mammography"
71	71	15 means a standard, two (2) view per breast, low-dose radiographic
72	72	16 examination of the breasts that is:
73	73	17 (1) furnished to an asymptomatic woman; and
74	74	18 (2) performed by a mammography services provider using
75	75	19 equipment designed by the manufacturer for and dedicated
76	76	20 specifically to mammography in order to detect unsuspected
77	77	21 breast cancer.
78	78	22 The term includes the interpretation of the results of a breast cancer
79	79	23 screening mammography by a physician.
80	80	24 (e) As used in this section, "cost sharing requirements" means:
81	81	25 (1) a deductible;
82	82	26 (2) coinsurance;
83	83	27 (3) a copayment; and
84	84	28 (4) any maximum limitation on the application of a
85	85	29 deductible, coinsurance, copayment, or similar out-of-pocket
86	86	30 expense.
87	87	31 (e) (f) As used in this section, "covered individual" means a female
88	88	32 individual who is:
89	89	33 (1) covered under a self-insurance program established under
90	90	34 section 7(b) of this chapter to provide group health coverage; or
91	91	35 (2) entitled to services under a contract with a health maintenance
92	92	36 organization (as defined in IC 27-13-1-19) that is entered into or
93	93	37 renewed under section 7(c) of this chapter.
94	94	38 (f) (g) As used in this section, "mammography services provider"
95	95	39 means an individual or facility that:
96	96	40 (1) has been accredited by the American College of Radiology;
97	97	41 (2) meets equivalent guidelines established by the Indiana
98	98	42 department of health; or
99	99	2024 IN 1114—LS 6439/DI 141 3
100	100	1 (3) is certified by the federal Department of Health and Human
101	101	2 Services for participation in the Medicare program (42 U.S.C.
102	102	3 1395 et seq.).
103	103	4 (h) As used in this section, "supplemental breast examination"
104	104	5 means a medically necessary and appropriate examination of the
105	105	6 breast, including an examination using breast cancer screening
106	106	7 mammography, breast magnetic resonance imaging, or ultrasound
107	107	8 services, that is:
108	108	9 (1) used to screen for breast cancer when there is no
109	109	10 abnormality seen or detected; and
110	110	11 (2) based on:
111	111	12 (A) personal or family medical history; or
112	112	13 (B) additional factors;
113	113	14 that may increase the covered individual's risk of breast
114	114	15 cancer.
115	115	16 (g) (i) As used in this section, "woman at risk" means a woman who
116	116	17 meets at least one (1) of the following descriptions:
117	117	18 (1) A woman who has a personal history of breast cancer.
118	118	19 (2) A woman who has a personal history of breast disease that
119	119	20 was proven benign by biopsy.
120	120	21 (3) A woman whose mother, sister, or daughter has had breast
121	121	22 cancer.
122	122	23 (4) A woman who is at least thirty (30) years of age and has not
123	123	24 given birth.
124	124	25 (h) (j) A self-insurance program established under section 7(b) of
125	125	26 this chapter to provide health care coverage must provide covered
126	126	27 individuals with coverage for breast cancer diagnostic services, breast
127	127	28 cancer outpatient treatment services, and breast cancer rehabilitative
128	128	29 services. The coverage must provide reimbursement for breast cancer
129	129	30 screening mammography at a level at least as high as:
130	130	31 (1) the limitation on payment for screening mammography
131	131	32 services established in 42 CFR 405.534(b)(3) according to the
132	132	33 Medicare Economic Index at the time the breast cancer screening
133	133	34 mammography is performed; or
134	134	35 (2) the rate negotiated by a contract provider according to the
135	135	36 provisions of the insurance policy;
136	136	37 whichever is lower. Except as provided in subsection (o), the costs of
137	137	38 the coverage required by this subsection may be paid by the state or by
138	138	39 the employee or by a combination of the state and the employee.
139	139	40 (i) (k) A contract with a health maintenance organization that is
140	140	41 entered into or renewed under section 7(c) of this chapter must provide
141	141	42 covered individuals with breast cancer diagnostic services, breast
142	142	2024 IN 1114—LS 6439/DI 141 4
143	143	1 cancer outpatient treatment services, and breast cancer rehabilitative
144	144	2 services.
145	145	3 (j) (l) The coverage required by subsection (h) (j) and services
146	146	4 required by subsection (i) (k) may not be subject to dollar limits,
147	147	5 deductibles, or coinsurance provisions that are less favorable to
148	148	6 covered individuals than the dollar limits, deductibles, or coinsurance
149	149	7 provisions applying to physical illness generally under the
150	150	8 self-insurance program or contract with a health maintenance
151	151	9 organization.
152	152	10 (k) (m) The coverage for breast cancer diagnostic services required
153	153	11 by subsection (h) (j) and the breast cancer diagnostic services required
154	154	12 by subsection (i) (k) must include the following:
155	155	13 (1) In the case of a covered individual who is at least thirty-five
156	156	14 (35) years of age but less than forty (40) years of age, at least one
157	157	15 (1) baseline breast cancer screening mammography performed
158	158	16 upon the individual before she becomes forty (40) years of age.
159	159	17 (2) In the case of a covered individual who is:
160	160	18 (A) less than forty (40) years of age; and
161	161	19 (B) a woman at risk;
162	162	20 at least one (1) breast cancer screening mammography performed
163	163	21 upon the covered individual every year.
164	164	22 (3) In the case of a covered individual who is at least forty (40)
165	165	23 years of age, at least one (1) breast cancer screening
166	166	24 mammography performed upon the individual every year.
167	167	25 (4) Any additional mammography views that are required for
168	168	26 proper evaluation.
169	169	27 (5) Ultrasound services, if determined medically necessary by the
170	170	28 physician treating the covered individual.
171	171	29 (6) Supplemental breast examination.
172	172	30 (l) (n) The coverage for breast cancer diagnostic services required
173	173	31 by subsection (h) (j) and the breast cancer diagnostic services required
174	174	32 by subsection (i) (k) shall be provided in addition to any benefits
175	175	33 specifically provided for x-rays, laboratory testing, or wellness
176	176	34 examinations.
177	177	35 (o) The coverage for breast cancer diagnostic services required
178	178	36 by subsection (j) and the breast cancer diagnostic services required
179	179	37 by subsection (k) may not be subject to any cost sharing
180	180	38 requirements.
181	181	39 SECTION 2. IC 5-10-8-18.5 IS ADDED TO THE INDIANA CODE
182	182	40 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
183	183	41 1, 2024]: Sec. 18.5. (a) This section applies only to a prescription
184	184	42 drug that is:
185	185	2024 IN 1114—LS 6439/DI 141 5
186	186	1 (1) consistent with best practices for the treatment of
187	187	2 advanced, metastatic cancer or an associated condition;
188	188	3 (2) supported by peer reviewed, evidence based literature;
189	189	4 and
190	190	5 (3) approved by the federal Food and Drug Administration.
191	191	6 (b) As used in this section, "advanced, metastatic cancer" means
192	192	7 cancer that has spread from the primary or original site of the
193	193	8 cancer to nearby tissues, lymph nodes, or other areas or parts of
194	194	9 the body.
195	195	10 (c) As used in this section, "associated conditions" means the
196	196	11 symptoms or side effects associated with advanced, metastatic
197	197	12 cancer or its treatment, which would, in the judgment of a health
198	198	13 care practitioner, further jeopardize the health of the covered
199	199	14 individual if left untreated.
200	200	15 (d) As used in this section, "covered individual" means an
201	201	16 individual entitled to coverage under a state employee health plan.
202	202	17 (e) As used in this section, "state employee health plan" refers
203	203	18 to the following that provide coverage for prescription drugs:
204	204	19 (1) A self-insurance program established under section 7(b) of
205	205	20 this chapter.
206	206	21 (2) A contract with a prepaid health care delivery plan that is
207	207	22 entered into or renewed under section 7(c) of this chapter.
208	208	23 (f) A state employee health plan that provides coverage for
209	209	24 advanced, metastatic cancer and associated conditions may not
210	210	25 require that, before the state employee health plan provides
211	211	26 coverage of a prescription drug, the covered individual:
212	212	27 (1) fail to successfully respond to a different prescription
213	213	28 drug; or
214	214	29 (2) prove a history of failure of a different prescription drug.
215	215	30 SECTION 3. IC 27-8-5-32 IS ADDED TO THE INDIANA CODE
216	216	31 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
217	217	32 1, 2024]: Sec. 32. (a) This section applies only to a prescription drug
218	218	33 that is:
219	219	34 (1) consistent with best practices for the treatment of
220	220	35 advanced, metastatic cancer or an associated condition;
221	221	36 (2) supported by peer reviewed, evidence based literature;
222	222	37 and
223	223	38 (3) approved by the federal Food and Drug Administration.
224	224	39 (b) As used in this section, "advanced, metastatic cancer" means
225	225	40 cancer that has spread from the primary or original site of the
226	226	41 cancer to nearby tissues, lymph nodes, or other areas or parts of
227	227	42 the body.
228	228	2024 IN 1114—LS 6439/DI 141 6
229	229	1 (c) As used in this section, "associated conditions" means the
230	230	2 symptoms or side effects associated with advanced, metastatic
231	231	3 cancer or its treatment, which would, in the judgment of a health
232	232	4 care practitioner, further jeopardize the health of the insured if left
233	233	5 untreated.
234	234	6 (d) As used in this section, "insured" means an individual who
235	235	7 is entitled to coverage under a policy of accident and sickness
236	236	8 insurance.
237	237	9 (e) As used in this section, "policy of accident and sickness
238	238	10 insurance" means a policy of accident and sickness insurance that
239	239	11 provides coverage for prescription drugs.
240	240	12 (f) A policy of accident and sickness insurance that provides
241	241	13 coverage for advanced, metastatic cancer and associated conditions
242	242	14 may not require that, before the policy of accident and sickness
243	243	15 insurance provides coverage of a prescription drug, the insured:
244	244	16 (1) fail to successfully respond to a different prescription
245	245	17 drug; or
246	246	18 (2) prove a history of failure of a different prescription drug.
247	247	19 SECTION 4. IC 27-8-14-2.5 IS ADDED TO THE INDIANA CODE
248	248	20 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
249	249	21 1, 2024]: Sec. 2.5. As used in this chapter, "cost sharing
250	250	22 requirements" means:
251	251	23 (1) a deductible;
252	252	24 (2) coinsurance;
253	253	25 (3) a copayment; and
254	254	26 (4) any maximum limitation on the application of a
255	255	27 deductible, coinsurance, copayment, or similar out-of-pocket
256	256	28 expense.
257	257	29 SECTION 5. IC 27-8-14-2.7 IS ADDED TO THE INDIANA CODE
258	258	30 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
259	259	31 1, 2024]: Sec. 2.7. As used in this chapter, "diagnostic breast
260	260	32 examination" means a medically necessary and appropriate
261	261	33 examination of the breast, including an examination using
262	262	34 diagnostic mammography, breast magnetic resonance imaging, or
263	263	35 ultrasound services, that is:
264	264	36 (1) used to evaluate an abnormality seen or suspected from a
265	265	37 screening examination for breast cancer; or
266	266	38 (2) used to evaluate an abnormality detected by another
267	267	39 means of examination.
268	268	40 SECTION 6. IC 27-8-14-4.5 IS ADDED TO THE INDIANA CODE
269	269	41 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
270	270	42 1, 2024]: Sec. 4.5. As used in this chapter, "supplemental breast
271	271	2024 IN 1114—LS 6439/DI 141 7
272	272	1 examination" means a medically necessary and appropriate
273	273	2 examination of the breast, including an examination using
274	274	3 diagnostic mammography, breast magnetic resonance imaging, or
275	275	4 ultrasound services, that is:
276	276	5 (1) used to screen for breast cancer when there is no
277	277	6 abnormality seen or detected; and
278	278	7 (2) based on:
279	279	8 (A) personal or family medical history; or
280	280	9 (B) additional factors;
281	281	10 that may increase the insured's risk of breast cancer.
282	282	11 SECTION 7. IC 27-8-14-6 IS AMENDED TO READ AS
283	283	12 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 6. (a) Except as
284	284	13 provided in subsection (f), (g), an insurer must provide coverage for
285	285	14 breast cancer screening mammography and diagnostic breast
286	286	15 examination in any accident and sickness insurance policy that the
287	287	16 insurer issues in Indiana.
288	288	17 (b) Except as provided in subsection (f), (g), the coverage that an
289	289	18 insurer must provide under this section must include the following:
290	290	19 (1) If the insured is at least thirty-five (35) but less than forty (40)
291	291	20 years of age, coverage for at least one (1) baseline breast cancer
292	292	21 screening mammography performed upon the insured before she
293	293	22 becomes forty (40) years of age.
294	294	23 (2) If the insured is:
295	295	24 (A) less than forty (40) years of age; and
296	296	25 (B) a woman at risk;
297	297	26 one (1) breast cancer screening mammography performed upon
298	298	27 the insured every year.
299	299	28 (3) If the insured is at least forty (40) years of age, one (1) breast
300	300	29 cancer screening mammography performed upon the insured
301	301	30 every year.
302	302	31 (4) Any additional mammography views that are required for
303	303	32 proper evaluation.
304	304	33 (5) Ultrasound services, if determined medically necessary by the
305	305	34 physician treating the insured.
306	306	35 (6) Supplemental breast examination.
307	307	36 (c) Except as provided in subsection (f), (g), the coverage that an
308	308	37 insurer must provide under this section must provide reimbursement
309	309	38 for breast cancer screening mammography at a level at least as high as:
310	310	39 (1) the limitation on payment for screening mammography
311	311	40 services established in 42 CFR 405.534(b)(3) according to the
312	312	41 Medicare Economic Index at the time the breast cancer screening
313	313	42 mammography is performed; or
314	314	2024 IN 1114—LS 6439/DI 141 8
315	315	1 (2) the rate negotiated by a contract provider according to the
316	316	2 provisions of the insurance policy;
317	317	3 whichever is lower.
318	318	4 (d) Except as provided in subsection (f), (g), the coverage that an
319	319	5 insurer must provide under this section may not be subject to dollar
320	320	6 limits, deductibles, or coinsurance provisions that are less favorable to
321	321	7 the insured than the dollar limits, deductibles, or coinsurance
322	322	8 provisions applying to physical illness generally under the accident and
323	323	9 sickness insurance policy.
324	324	10 (e) Except as provided in subsection (f), (g), the coverage that an
325	325	11 insurer must provide is in addition to any benefits specifically provided
326	326	12 for x-rays, laboratory testing, or wellness examinations.
327	327	13 (f) Except as provided in subsection (g), the coverage that an
328	328	14 insurer must provide under this section may not be subject to any
329	329	15 cost sharing requirements.
330	330	16 (f) (g) In the case of insurance policies that are not employer based,
331	331	17 the insurer must offer to provide the coverage described in subsections
332	332	18 (a) through (e). (f).
333	333	19 SECTION 8. IC 27-13-7-15.3 IS AMENDED TO READ AS
334	334	20 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 15.3. (a) As used in this
335	335	21 section, "breast cancer screening mammography" has the meaning set
336	336	22 forth in IC 27-8-14-2.
337	337	23 (b) As used in this section, "cost sharing requirements" has the
338	338	24 meaning set forth in IC 27-8-14-2.5.
339	339	25 (c) As used in this section, "diagnostic breast examination" has
340	340	26 the meaning set forth in IC 27-8-14-2.7.
341	341	27 (d) As used in this section, "supplemental breast examination"
342	342	28 has the meaning set forth in IC 27-8-14-4.5.
343	343	29 (b) (e) As used in this section, "woman at risk" has the meaning set
344	344	30 forth in IC 27-8-14-5.
345	345	31 (c) (f) Except as provided in subsection (g), (k), a health
346	346	32 maintenance organization issued a certificate of authority in Indiana
347	347	33 shall provide breast cancer screening mammography and diagnostic
348	348	34 breast examination as a covered service services under every group
349	349	35 contract that provides coverage for basic health care services.
350	350	36 (d) (g) Except as provided in subsection (g), (k), the coverage that
351	351	37 a health maintenance organization must provide under this section must
352	352	38 include the following:
353	353	39 (1) If the enrollee is at least thirty-five (35) years of age but less
354	354	40 than forty (40) years of age and a female, coverage for at least one
355	355	41 (1) baseline breast cancer screening mammography performed
356	356	42 upon the enrollee before the enrollee becomes forty (40) years of
357	357	2024 IN 1114—LS 6439/DI 141 9
358	358	1 age.
359	359	2 (2) If the enrollee is less than forty (40) years of age and a woman
360	360	3 at risk, one (1) breast cancer screening mammography performed
361	361	4 upon the enrollee every year.
362	362	5 (3) If the enrollee is at least forty (40) years of age and a female,
363	363	6 one (1) breast cancer screening mammography performed upon
364	364	7 the enrollee every year.
365	365	8 (4) Any additional mammography views that are required for
366	366	9 proper evaluation.
367	367	10 (5) Ultrasound services, if determined medically necessary by the
368	368	11 physician treating the enrollee.
369	369	12 (6) Supplemental breast examination.
370	370	13 (e) (h) Except as provided in subsection (g), (k), the coverage that
371	371	14 a health maintenance organization must provide under this section may
372	372	15 not be subject to a contract provision that is less favorable to an
373	373	16 enrollee or a subscriber than contract provisions applying to physical
374	374	17 illness generally under the health maintenance organization contract.
375	375	18 (f) (i) Except as provided in subsection (g), (k), the coverage that a
376	376	19 health maintenance organization must provide under this section is in
377	377	20 addition to services specifically provided for x-rays, laboratory testing,
378	378	21 or wellness examinations.
379	379	22 (j) Except as provided in subsection (k), the coverage that a
380	380	23 health maintenance organization must provide under this section
381	381	24 may not be subject to any cost sharing requirements.
382	382	25 (g) (k) In the case of coverage that is not employer based, the health
383	383	26 maintenance organization must offer to provide the coverage described
384	384	27 in subsections (c) (f) through (f). (j).
385	385	28 SECTION 9. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
386	386	29 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
387	387	30 1, 2024]: Sec. 29. (a) This section applies only to a prescription drug
388	388	31 that is:
389	389	32 (1) consistent with best practices for the treatment of
390	390	33 advanced, metastatic cancer or an associated condition;
391	391	34 (2) supported by peer reviewed, evidence based literature;
392	392	35 and
393	393	36 (3) approved by the federal Food and Drug Administration.
394	394	37 (b) As used in this section, "advanced, metastatic cancer" means
395	395	38 cancer that has spread from the primary or original site of the
396	396	39 cancer to nearby tissues, lymph nodes, or other areas or parts of
397	397	40 the body.
398	398	41 (c) As used in this section, "associated conditions" means the
399	399	42 symptoms or side effects associated with advanced, metastatic
400	400	2024 IN 1114—LS 6439/DI 141 10
401	401	1 cancer or its treatment, which would, in the judgment of a health
402	402	2 care practitioner, further jeopardize the health of the enrollee if
403	403	3 left untreated.
404	404	4 (d) As used in this section, "group contract" refers to a group
405	405	5 contract that provides coverage for prescription drugs.
406	406	6 (e) As used in this section, "health maintenance organization"
407	407	7 refers to a health maintenance organization that provides coverage
408	408	8 for prescription drugs. The term includes the following:
409	409	9 (1) A limited service health maintenance organization.
410	410	10 (2) A person that administers prescription drug benefits on
411	411	11 behalf of a health maintenance organization or a limited
412	412	12 service health maintenance organization.
413	413	13 (f) As used in this section, "individual contract" refers to an
414	414	14 individual contract that provides coverage for prescription drugs.
415	415	15 (g) A health maintenance organization that provides coverage
416	416	16 under an individual contract or a group contract for advanced,
417	417	17 metastatic cancer and associated conditions may not require that,
418	418	18 before the health maintenance organization provides coverage of
419	419	19 a prescription drug, the enrollee:
420	420	20 (1) fail to successfully respond to a different prescription
421	421	21 drug; or
422	422	22 (2) prove a history of failure of a different prescription drug.
423	423	2024 IN 1114—LS 6439/DI 141