Introduced Version
HOUSE BILL No. 1420
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 5-10-8-27; IC 27-8-40; IC 27-13-7-29.
Synopsis: Contraceptive coverage. Requires a state employee health
plan, a policy of accident and sickness insurance, and a health
maintenance organization contract to provide coverage, without cost
sharing, for: (1) contraceptive products and services; (2) counseling
and screening for certain sexually transmitted infections; and (3)
pre-exposure prophylaxis, post-exposure prophylaxis, and human
papillomavirus vaccination.
Effective: July 1, 2024.
Errington, Fleming
January 16, 2024, read first time and referred to Committee on Insurance.
2024 IN 1420—LS 6660/DI 141 Introduced
Second Regular Session of the 123rd General Assembly (2024)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2023 Regular Session of the General Assembly.
HOUSE BILL No. 1420
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 5-10-8-27 IS ADDED TO THE INDIANA CODE
2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
3 1, 2024]: Sec. 27. (a) As used in this section, "contraceptive
4 products and services" means the following:
5 (1) All contraceptive drugs, devices, products, and procedures
6 that are approved by the federal Food and Drug
7 Administration, including over-the-counter contraceptive
8 drugs, devices, and products as prescribed by the covered
9 individual's health care provider or as otherwise authorized
10 under state or federal law.
11 (2) All emergency contraception that is approved by the
12 federal Food and Drug Administration.
13 (3) Voluntary sterilization procedures.
14 (4) Patient education and counseling concerning
15 contraception.
16 (5) Follow-up services related to the drugs, devices, products,
17 and procedures covered under this section, including:
2024 IN 1420—LS 6660/DI 141 2
1 (A) management of side effects;
2 (B) counseling for continued adherence; and
3 (C) device insertion and removal.
4 (b) As used in this section, "cost sharing" means payment of a
5 deductible, coinsurance, copayment, or other out-of-pocket cost
6 required under a state employee health plan.
7 (c) As used in this section, "covered individual" means an
8 individual entitled to coverage under a state employee health plan.
9 (d) As used in this section, "state employee health plan" means
10 the following:
11 (1) A self-insurance program established under section 7(b) of
12 this chapter.
13 (2) A contract for prepaid health care services entered into
14 under section 7(c) of this chapter.
15 (e) As used in this section, "therapeutic equivalent" means a
16 drug, device, or product that is designated as therapeutically
17 equivalent by the federal Food and Drug Administration in the
18 Approved Drug Products with Therapeutic Equivalence
19 Evaluations.
20 (f) Except as provided in subsection (h), a state employee health
21 plan shall provide coverage for contraceptive products and
22 services without cost sharing, subject to the following:
23 (1) If the federal Food and Drug Administration has
24 designated a therapeutic equivalent of a contraceptive
25 product or service, the state employee health plan must
26 include either the original contraceptive product or service or
27 a therapeutic equivalent of the contraceptive product or
28 service. If there is no therapeutic equivalent for the
29 contraceptive product or service, the state employee health
30 plan must include the original contraceptive product or
31 service.
32 (2) If the contraceptive product or service is deemed
33 medically inadvisable by the covered individual's health care
34 provider, the state employee health plan shall:
35 (A) defer to the determination and judgment of the
36 attending health care provider; and
37 (B) provide coverage for the alternate prescribed
38 contraceptive product or service.
39 (3) The coverage must provide for the single dispensing of a
40 thirteen (13) unit supply of contraceptive products and
41 services intended to last over a twelve (12) month duration,
42 which may be furnished or dispensed all at once or over the
2024 IN 1420—LS 6660/DI 141 3
1 course of the twelve (12) months at the discretion of the health
2 care provider regardless of whether the covered individual
3 was entitled to coverage under the state employee health plan
4 at the time of the first dispensing. The state employee health
5 plan shall reimburse a health care provider or dispensing
6 entity per unit for furnishing or dispensing an extended
7 supply of contraceptive products and services.
8 (4) Except as otherwise provided in this subsection, the state
9 employee health plan may not impose any restrictions or
10 delays on the coverage required under this subsection.
11 (5) Nothing in this subsection shall be construed to exclude
12 coverage for contraceptive products and services as
13 prescribed by a health care provider acting within the health
14 care provider's scope of practice for:
15 (A) reasons other than contraceptive purposes, such as
16 decreasing the risk of ovarian cancer or eliminating
17 symptoms of menopause; or
18 (B) contraception that is necessary to preserve the life or
19 health of a covered individual.
20 (g) Except as provided in subsection (h), a state employee health
21 plan shall provide coverage without cost sharing for the following:
22 (1) Counseling for sexually transmitted infections, including
23 human immunodeficiency virus and acquired immune
24 deficiency syndrome.
25 (2) Screening for:
26 (A) chlamydia;
27 (B) gonorrhea;
28 (C) hepatitis B;
29 (D) hepatitis C;
30 (E) human immunodeficiency virus;
31 (F) acquired immune deficiency syndrome;
32 (G) human papillomavirus; and
33 (H) syphilis.
34 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
35 human papillomavirus vaccination.
36 (h) If a state employee health plan is offered as a qualifying high
37 deductible health plan for a health savings account, the state
38 employee health plan shall establish cost sharing for the coverage
39 under this section at the minimum level necessary to preserve the
40 covered individual's ability to claim tax exempt contributions and
41 withdrawal from the covered individual's health savings account
42 under 26 U.S.C. 223.
2024 IN 1420—LS 6660/DI 141 4
1 SECTION 2. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
2 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
3 1, 2024]:
4 Chapter 40. Coverage for Contraceptive Products and Services
5 Sec. 1. As used in this chapter, "contraceptive products and
6 services" means the following:
7 (1) All contraceptive drugs, devices, products, and procedures
8 that are approved by the federal Food and Drug
9 Administration, including over-the-counter contraceptive
10 drugs, devices, and products as prescribed by the insured's
11 health care provider or as otherwise authorized under state or
12 federal law.
13 (2) All emergency contraception that is approved by the
14 federal Food and Drug Administration.
15 (3) Voluntary sterilization procedures.
16 (4) Patient education and counseling concerning
17 contraception.
18 (5) Follow-up services related to the drugs, devices, products,
19 and procedures covered under this section, including:
20 (A) management of side effects;
21 (B) counseling for continued adherence; and
22 (C) device insertion and removal.
23 Sec. 2. As used in this chapter, "cost sharing" means payment
24 of a deductible, coinsurance, copayment, or other out-of-pocket
25 cost required under a policy of accident and sickness insurance.
26 Sec. 3. As used in this chapter, "insured" means an individual
27 entitled to coverage under a policy of accident and sickness
28 insurance.
29 Sec. 4. As used in this chapter, "policy of accident and sickness
30 insurance" has the meaning set forth in IC 27-8-5-1.
31 Sec. 5. As used in this chapter, "therapeutic equivalent" means
32 a drug, device, or product that is designated as therapeutically
33 equivalent by the federal Food and Drug Administration in the
34 Approved Drug Products with Therapeutic Equivalence
35 Evaluations.
36 Sec. 6. Except as provided in section 8 of this chapter, a policy
37 of accident and sickness insurance shall provide coverage for
38 contraceptive products and services without cost sharing, subject
39 to the following:
40 (1) If the federal Food and Drug Administration has
41 designated a therapeutic equivalent of a contraceptive
42 product or service, the policy of accident and sickness
2024 IN 1420—LS 6660/DI 141 5
1 insurance must include either the original contraceptive
2 product or service or a therapeutic equivalent of the
3 contraceptive product or service. If there is no therapeutic
4 equivalent for the contraceptive product or service, the policy
5 of accident and sickness insurance must include the original
6 contraceptive product or service.
7 (2) If the contraceptive product or service is deemed
8 medically inadvisable by the insured's health care provider,
9 the policy of accident and sickness insurance shall:
10 (A) defer to the determination and judgment of the
11 attending health care provider; and
12 (B) provide coverage for the alternate prescribed
13 contraceptive product or service.
14 (3) The coverage must provide for the single dispensing of a
15 thirteen (13) unit supply of contraceptive products and
16 services intended to last over a twelve (12) month duration,
17 which may be furnished or dispensed all at once or over the
18 course of the twelve (12) months at the discretion of the health
19 care provider regardless of whether the insured was entitled
20 to coverage under the policy of accident and sickness
21 insurance at the time of the first dispensing. The policy of
22 accident and sickness insurance shall reimburse a health care
23 provider or dispensing entity per unit for furnishing or
24 dispensing an extended supply of contraceptive products and
25 services.
26 (4) Except as otherwise provided in this section, the policy of
27 accident and sickness insurance may not impose any
28 restrictions or delays on the coverage required under this
29 section.
30 (5) Nothing in this section shall be construed to exclude
31 coverage for contraceptive products and services as
32 prescribed by a health care provider acting within the health
33 care provider's scope of practice for:
34 (A) reasons other than contraceptive purposes, such as
35 decreasing the risk of ovarian cancer or eliminating
36 symptoms of menopause; or
37 (B) contraception that is necessary to preserve the life or
38 health of an insured.
39 Sec. 7. Except as provided in section 8 of this chapter, a policy
40 of accident and sickness insurance shall provide coverage without
41 cost sharing for the following:
42 (1) Counseling for sexually transmitted infections, including
2024 IN 1420—LS 6660/DI 141 6
1 human immunodeficiency virus and acquired immune
2 deficiency syndrome.
3 (2) Screening for:
4 (A) chlamydia;
5 (B) gonorrhea;
6 (C) hepatitis B;
7 (D) hepatitis C;
8 (E) human immunodeficiency virus;
9 (F) acquired immune deficiency syndrome;
10 (G) human papillomavirus; and
11 (H) syphilis.
12 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
13 human papillomavirus vaccination.
14 Sec. 8. If a policy of accident and sickness insurance is offered
15 as a qualifying high deductible health plan for a health savings
16 account, the policy of accident and sickness insurance shall
17 establish cost sharing for the coverage under this section at the
18 minimum level necessary to preserve the insured's ability to claim
19 tax exempt contributions and withdrawal from the insured's health
20 savings account under 26 U.S.C. 223.
21 SECTION 3. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
22 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
23 1, 2024]: Sec. 29. (a) As used in this section, "contraceptive
24 products and services" means the following:
25 (1) All contraceptive drugs, devices, products, and procedures
26 that are approved by the federal Food and Drug
27 Administration, including over-the-counter contraceptive
28 drugs, devices, and products as prescribed by the enrollee's
29 health care provider or as otherwise authorized under state or
30 federal law.
31 (2) All emergency contraception that is approved by the
32 federal Food and Drug Administration.
33 (3) Voluntary sterilization procedures.
34 (4) Patient education and counseling concerning
35 contraception.
36 (5) Follow-up services related to the drugs, devices, products,
37 and procedures covered under this section, including:
38 (A) management of side effects;
39 (B) counseling for continued adherence; and
40 (C) device insertion and removal.
41 (b) As used in this section, "cost sharing" means payment of a
42 deductible, coinsurance, copayment, or other out-of-pocket cost
2024 IN 1420—LS 6660/DI 141 7
1 required under an individual contract or a group contract.
2 (c) As used in this chapter, "therapeutic equivalent" means a
3 drug, device, or product that is designated as therapeutically
4 equivalent by the federal Food and Drug Administration in the
5 Approved Drug Products with Therapeutic Equivalence
6 Evaluations.
7 (d) An individual contract or a group contract shall provide
8 coverage for contraceptive products and services without cost
9 sharing, subject to the following:
10 (1) If the federal Food and Drug Administration has
11 designated a therapeutic equivalent of a contraceptive
12 product or service, the individual contract or group contract
13 must include either the original contraceptive product or
14 service or a therapeutic equivalent of the contraceptive
15 product or service. If there is no therapeutic equivalent for
16 the contraceptive product or service, the individual contract
17 or group contract must include the original contraceptive
18 product or service.
19 (2) If the contraceptive product or service is deemed
20 medically inadvisable by the enrollee's health care provider,
21 the individual contract or group contract shall:
22 (A) defer to the determination and judgment of the
23 attending health care provider; and
24 (B) provide coverage for the alternate prescribed
25 contraceptive product or service.
26 (3) The coverage must provide for the single dispensing of a
27 thirteen (13) unit supply of contraceptive products and
28 services intended to last over a twelve (12) month duration,
29 which may be furnished or dispensed all at once or over the
30 course of the twelve (12) months at the discretion of the health
31 care provider regardless of whether the enrollee was entitled
32 to coverage under the individual contract or group contract
33 at the time of the first dispensing. The individual contract or
34 a group contract shall reimburse a health care provider or
35 dispensing entity per unit for furnishing or dispensing an
36 extended supply of contraceptive products and services.
37 (4) Except as otherwise provided in this subsection, the
38 individual contract or group contract may not impose any
39 restrictions or delays on the coverage required under this
40 subsection.
41 (5) Nothing in this subsection shall be construed to exclude
42 coverage for contraceptive products and services as
2024 IN 1420—LS 6660/DI 141 8
1 prescribed by a health care provider acting within the health
2 care provider's scope of practice for:
3 (A) reasons other than contraceptive purposes, such as
4 decreasing the risk of ovarian cancer or eliminating
5 symptoms of menopause; or
6 (B) contraception that is necessary to preserve the life or
7 health of an enrollee.
8 (e) An individual contract or a group contract shall provide
9 coverage without cost sharing for the following:
10 (1) Counseling for sexually transmitted infections, including
11 human immunodeficiency virus and acquired immune
12 deficiency syndrome.
13 (2) Screening for:
14 (A) chlamydia;
15 (B) gonorrhea;
16 (C) hepatitis B;
17 (D) hepatitis C;
18 (E) human immunodeficiency virus;
19 (F) acquired immune deficiency syndrome;
20 (G) human papillomavirus; and
21 (H) syphilis.
22 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
23 human papillomavirus vaccination.
24 SECTION 4. [EFFECTIVE JULY 1, 2024] (a) IC 5-10-8-27, as
25 added by this act, applies to a state employee health plan that is
26 established, entered into, amended, or renewed after June 30, 2024.
27 (b) IC 27-8-40, as added by this act, applies to a policy of
28 accident and sickness insurance that is issued, delivered, amended,
29 or renewed after June 30, 2024.
30 (c) IC 27-13-7-29, as added by this act, applies to an individual
31 contract and a group contract that is entered into, delivered,
32 amended, or renewed after June 30, 2024.
33 (d) This SECTION expires July 1, 2025.
2024 IN 1420—LS 6660/DI 141