Indiana 2024 Regular Session

Indiana House Bill HB1377 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. 1377
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 27-1-51.
7	7	Synopsis: Prescription drug pricing. Provides that the price that a
8	8	health plan, third party administrator, or pharmacy benefit manager sets
9	9	for a covered individual's purchase of a prescription drug from a
10	10	pharmacist or pharmacy must be equal to or less than the amount
11	11	directly or indirectly paid by the health plan, third party administrator,
12	12	or pharmacy benefit manager to the pharmacist or pharmacy for the
13	13	prescription drug.
14	14	Effective: July 1, 2024.
15	15	Schaibley, Barrett, McGuire
16	16	January 10, 2024, read first time and referred to Committee on Insurance.
17	17	2024 IN 1377—LS 6886/DI 141 Introduced
18	18	Second Regular Session of the 123rd General Assembly (2024)
19	19	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
20	20	Constitution) is being amended, the text of the existing provision will appear in this style type,
21	21	additions will appear in this style type, and deletions will appear in this style type.
22	22	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
23	23	provision adopted), the text of the new provision will appear in this style type. Also, the
24	24	word NEW will appear in that style type in the introductory clause of each SECTION that adds
25	25	a new provision to the Indiana Code or the Indiana Constitution.
26	26	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
27	27	between statutes enacted by the 2023 Regular Session of the General Assembly.
28	28	HOUSE BILL No. 1377
29	29	A BILL FOR AN ACT to amend the Indiana Code concerning
30	30	insurance.
31	31	Be it enacted by the General Assembly of the State of Indiana:
32	32	1 SECTION 1. IC 27-1-51 IS ADDED TO THE INDIANA CODE AS
33	33	2 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
34	34	3 1, 2024]:
35	35	4 Chapter 51. Prescription Drug Pricing
36	36	5 Sec. 1. As used in this chapter, "covered individual" means an
37	37	6 individual who is entitled to coverage under a health plan.
38	38	7 Sec. 2. As used in this chapter, "health plan" means the
39	39	8 following:
40	40	9 (1) A state employee health plan (as defined in IC 5-10-8-6.7).
41	41	10 (2) A policy of accident and sickness insurance (as defined in
42	42	11 IC 27-8-5-1). However, the term does not include the
43	43	12 coverages described in IC 27-8-5-2.5(a).
44	44	13 (3) An individual contract (as defined in IC 27-13-1-21) or a
45	45	14 group contract (as defined in IC 27-13-1-16) that provides
46	46	15 coverage for basic health care services (as defined in
47	47	16 IC 27-13-1-4).
48	48	17 (4) Medicaid or a managed care organization (as defined in
49	49	2024 IN 1377—LS 6886/DI 141 2
50	50	1 IC 12-7-2-126.9) that has contracted with Medicaid to provide
51	51	2 services to a Medicaid recipient.
52	52	3 (5) A self-funded health benefit plan, including a self-funded
53	53	4 health benefit plan that complies with the federal Employee
54	54	5 Retirement Income Security Act (ERISA) of 1974 (29 U.S.C.
55	55	6 1001 et seq.).
56	56	7 (6) Any other plan or program that provides payment,
57	57	8 reimbursement, or indemnification to a covered individual for
58	58	9 the cost of prescription drugs.
59	59	10 Sec. 3. As used in this chapter, "pharmacist" has the meaning
60	60	11 set forth in IC 27-1-24.5-9.
61	61	12 Sec. 4. As used in this chapter, "pharmacy" has the meaning set
62	62	13 forth in IC 27-1-24.5-11.
63	63	14 Sec. 5. As used in this chapter, "pharmacy benefit manager" has
64	64	15 the meaning set forth in IC 27-1-24.5-12.
65	65	16 Sec. 6. As used in this chapter, "third party administrator"
66	66	17 means a person or an organization that performs administrative
67	67	18 services for a health plan.
68	68	19 Sec. 7. (a) This section applies to a contract that is entered into,
69	69	20 issued, amended, or renewed after December 31, 2024.
70	70	21 (b) The price that a health plan, third party administrator, or
71	71	22 pharmacy benefit manager sets for a covered individual's purchase
72	72	23 of a prescription drug from a pharmacist or pharmacy must be:
73	73	24 (1) equal to; or
74	74	25 (2) less than;
75	75	26 the amount directly or indirectly paid by the health plan, third
76	76	27 party administrator, or pharmacy benefit manager to the
77	77	28 pharmacist or pharmacy for the prescription drug.
78	78	2024 IN 1377—LS 6886/DI 141