Indiana 2024 Regular Session

Indiana House Bill HB1420 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. 1420
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 5-10-8-27; IC 27-8-40; IC 27-13-7-29.
7	7	Synopsis: Contraceptive coverage. Requires a state employee health
8	8	plan, a policy of accident and sickness insurance, and a health
9	9	maintenance organization contract to provide coverage, without cost
10	10	sharing, for: (1) contraceptive products and services; (2) counseling
11	11	and screening for certain sexually transmitted infections; and (3)
12	12	pre-exposure prophylaxis, post-exposure prophylaxis, and human
13	13	papillomavirus vaccination.
14	14	Effective: July 1, 2024.
15	15	Errington, Fleming
16	16	January 16, 2024, read first time and referred to Committee on Insurance.
17	17	2024 IN 1420—LS 6660/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. 1420
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 5-10-8-27 IS ADDED TO THE INDIANA CODE
33	33	2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
34	34	3 1, 2024]: Sec. 27. (a) As used in this section, "contraceptive
35	35	4 products and services" means the following:
36	36	5 (1) All contraceptive drugs, devices, products, and procedures
37	37	6 that are approved by the federal Food and Drug
38	38	7 Administration, including over-the-counter contraceptive
39	39	8 drugs, devices, and products as prescribed by the covered
40	40	9 individual's health care provider or as otherwise authorized
41	41	10 under state or federal law.
42	42	11 (2) All emergency contraception that is approved by the
43	43	12 federal Food and Drug Administration.
44	44	13 (3) Voluntary sterilization procedures.
45	45	14 (4) Patient education and counseling concerning
46	46	15 contraception.
47	47	16 (5) Follow-up services related to the drugs, devices, products,
48	48	17 and procedures covered under this section, including:
49	49	2024 IN 1420—LS 6660/DI 141 2
50	50	1 (A) management of side effects;
51	51	2 (B) counseling for continued adherence; and
52	52	3 (C) device insertion and removal.
53	53	4 (b) As used in this section, "cost sharing" means payment of a
54	54	5 deductible, coinsurance, copayment, or other out-of-pocket cost
55	55	6 required under a state employee health plan.
56	56	7 (c) As used in this section, "covered individual" means an
57	57	8 individual entitled to coverage under a state employee health plan.
58	58	9 (d) As used in this section, "state employee health plan" means
59	59	10 the following:
60	60	11 (1) A self-insurance program established under section 7(b) of
61	61	12 this chapter.
62	62	13 (2) A contract for prepaid health care services entered into
63	63	14 under section 7(c) of this chapter.
64	64	15 (e) As used in this section, "therapeutic equivalent" means a
65	65	16 drug, device, or product that is designated as therapeutically
66	66	17 equivalent by the federal Food and Drug Administration in the
67	67	18 Approved Drug Products with Therapeutic Equivalence
68	68	19 Evaluations.
69	69	20 (f) Except as provided in subsection (h), a state employee health
70	70	21 plan shall provide coverage for contraceptive products and
71	71	22 services without cost sharing, subject to the following:
72	72	23 (1) If the federal Food and Drug Administration has
73	73	24 designated a therapeutic equivalent of a contraceptive
74	74	25 product or service, the state employee health plan must
75	75	26 include either the original contraceptive product or service or
76	76	27 a therapeutic equivalent of the contraceptive product or
77	77	28 service. If there is no therapeutic equivalent for the
78	78	29 contraceptive product or service, the state employee health
79	79	30 plan must include the original contraceptive product or
80	80	31 service.
81	81	32 (2) If the contraceptive product or service is deemed
82	82	33 medically inadvisable by the covered individual's health care
83	83	34 provider, the state employee health plan shall:
84	84	35 (A) defer to the determination and judgment of the
85	85	36 attending health care provider; and
86	86	37 (B) provide coverage for the alternate prescribed
87	87	38 contraceptive product or service.
88	88	39 (3) The coverage must provide for the single dispensing of a
89	89	40 thirteen (13) unit supply of contraceptive products and
90	90	41 services intended to last over a twelve (12) month duration,
91	91	42 which may be furnished or dispensed all at once or over the
92	92	2024 IN 1420—LS 6660/DI 141 3
93	93	1 course of the twelve (12) months at the discretion of the health
94	94	2 care provider regardless of whether the covered individual
95	95	3 was entitled to coverage under the state employee health plan
96	96	4 at the time of the first dispensing. The state employee health
97	97	5 plan shall reimburse a health care provider or dispensing
98	98	6 entity per unit for furnishing or dispensing an extended
99	99	7 supply of contraceptive products and services.
100	100	8 (4) Except as otherwise provided in this subsection, the state
101	101	9 employee health plan may not impose any restrictions or
102	102	10 delays on the coverage required under this subsection.
103	103	11 (5) Nothing in this subsection shall be construed to exclude
104	104	12 coverage for contraceptive products and services as
105	105	13 prescribed by a health care provider acting within the health
106	106	14 care provider's scope of practice for:
107	107	15 (A) reasons other than contraceptive purposes, such as
108	108	16 decreasing the risk of ovarian cancer or eliminating
109	109	17 symptoms of menopause; or
110	110	18 (B) contraception that is necessary to preserve the life or
111	111	19 health of a covered individual.
112	112	20 (g) Except as provided in subsection (h), a state employee health
113	113	21 plan shall provide coverage without cost sharing for the following:
114	114	22 (1) Counseling for sexually transmitted infections, including
115	115	23 human immunodeficiency virus and acquired immune
116	116	24 deficiency syndrome.
117	117	25 (2) Screening for:
118	118	26 (A) chlamydia;
119	119	27 (B) gonorrhea;
120	120	28 (C) hepatitis B;
121	121	29 (D) hepatitis C;
122	122	30 (E) human immunodeficiency virus;
123	123	31 (F) acquired immune deficiency syndrome;
124	124	32 (G) human papillomavirus; and
125	125	33 (H) syphilis.
126	126	34 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
127	127	35 human papillomavirus vaccination.
128	128	36 (h) If a state employee health plan is offered as a qualifying high
129	129	37 deductible health plan for a health savings account, the state
130	130	38 employee health plan shall establish cost sharing for the coverage
131	131	39 under this section at the minimum level necessary to preserve the
132	132	40 covered individual's ability to claim tax exempt contributions and
133	133	41 withdrawal from the covered individual's health savings account
134	134	42 under 26 U.S.C. 223.
135	135	2024 IN 1420—LS 6660/DI 141 4
136	136	1 SECTION 2. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
137	137	2 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
138	138	3 1, 2024]:
139	139	4 Chapter 40. Coverage for Contraceptive Products and Services
140	140	5 Sec. 1. As used in this chapter, "contraceptive products and
141	141	6 services" means the following:
142	142	7 (1) All contraceptive drugs, devices, products, and procedures
143	143	8 that are approved by the federal Food and Drug
144	144	9 Administration, including over-the-counter contraceptive
145	145	10 drugs, devices, and products as prescribed by the insured's
146	146	11 health care provider or as otherwise authorized under state or
147	147	12 federal law.
148	148	13 (2) All emergency contraception that is approved by the
149	149	14 federal Food and Drug Administration.
150	150	15 (3) Voluntary sterilization procedures.
151	151	16 (4) Patient education and counseling concerning
152	152	17 contraception.
153	153	18 (5) Follow-up services related to the drugs, devices, products,
154	154	19 and procedures covered under this section, including:
155	155	20 (A) management of side effects;
156	156	21 (B) counseling for continued adherence; and
157	157	22 (C) device insertion and removal.
158	158	23 Sec. 2. As used in this chapter, "cost sharing" means payment
159	159	24 of a deductible, coinsurance, copayment, or other out-of-pocket
160	160	25 cost required under a policy of accident and sickness insurance.
161	161	26 Sec. 3. As used in this chapter, "insured" means an individual
162	162	27 entitled to coverage under a policy of accident and sickness
163	163	28 insurance.
164	164	29 Sec. 4. As used in this chapter, "policy of accident and sickness
165	165	30 insurance" has the meaning set forth in IC 27-8-5-1.
166	166	31 Sec. 5. As used in this chapter, "therapeutic equivalent" means
167	167	32 a drug, device, or product that is designated as therapeutically
168	168	33 equivalent by the federal Food and Drug Administration in the
169	169	34 Approved Drug Products with Therapeutic Equivalence
170	170	35 Evaluations.
171	171	36 Sec. 6. Except as provided in section 8 of this chapter, a policy
172	172	37 of accident and sickness insurance shall provide coverage for
173	173	38 contraceptive products and services without cost sharing, subject
174	174	39 to the following:
175	175	40 (1) If the federal Food and Drug Administration has
176	176	41 designated a therapeutic equivalent of a contraceptive
177	177	42 product or service, the policy of accident and sickness
178	178	2024 IN 1420—LS 6660/DI 141 5
179	179	1 insurance must include either the original contraceptive
180	180	2 product or service or a therapeutic equivalent of the
181	181	3 contraceptive product or service. If there is no therapeutic
182	182	4 equivalent for the contraceptive product or service, the policy
183	183	5 of accident and sickness insurance must include the original
184	184	6 contraceptive product or service.
185	185	7 (2) If the contraceptive product or service is deemed
186	186	8 medically inadvisable by the insured's health care provider,
187	187	9 the policy of accident and sickness insurance shall:
188	188	10 (A) defer to the determination and judgment of the
189	189	11 attending health care provider; and
190	190	12 (B) provide coverage for the alternate prescribed
191	191	13 contraceptive product or service.
192	192	14 (3) The coverage must provide for the single dispensing of a
193	193	15 thirteen (13) unit supply of contraceptive products and
194	194	16 services intended to last over a twelve (12) month duration,
195	195	17 which may be furnished or dispensed all at once or over the
196	196	18 course of the twelve (12) months at the discretion of the health
197	197	19 care provider regardless of whether the insured was entitled
198	198	20 to coverage under the policy of accident and sickness
199	199	21 insurance at the time of the first dispensing. The policy of
200	200	22 accident and sickness insurance shall reimburse a health care
201	201	23 provider or dispensing entity per unit for furnishing or
202	202	24 dispensing an extended supply of contraceptive products and
203	203	25 services.
204	204	26 (4) Except as otherwise provided in this section, the policy of
205	205	27 accident and sickness insurance may not impose any
206	206	28 restrictions or delays on the coverage required under this
207	207	29 section.
208	208	30 (5) Nothing in this section shall be construed to exclude
209	209	31 coverage for contraceptive products and services as
210	210	32 prescribed by a health care provider acting within the health
211	211	33 care provider's scope of practice for:
212	212	34 (A) reasons other than contraceptive purposes, such as
213	213	35 decreasing the risk of ovarian cancer or eliminating
214	214	36 symptoms of menopause; or
215	215	37 (B) contraception that is necessary to preserve the life or
216	216	38 health of an insured.
217	217	39 Sec. 7. Except as provided in section 8 of this chapter, a policy
218	218	40 of accident and sickness insurance shall provide coverage without
219	219	41 cost sharing for the following:
220	220	42 (1) Counseling for sexually transmitted infections, including
221	221	2024 IN 1420—LS 6660/DI 141 6
222	222	1 human immunodeficiency virus and acquired immune
223	223	2 deficiency syndrome.
224	224	3 (2) Screening for:
225	225	4 (A) chlamydia;
226	226	5 (B) gonorrhea;
227	227	6 (C) hepatitis B;
228	228	7 (D) hepatitis C;
229	229	8 (E) human immunodeficiency virus;
230	230	9 (F) acquired immune deficiency syndrome;
231	231	10 (G) human papillomavirus; and
232	232	11 (H) syphilis.
233	233	12 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
234	234	13 human papillomavirus vaccination.
235	235	14 Sec. 8. If a policy of accident and sickness insurance is offered
236	236	15 as a qualifying high deductible health plan for a health savings
237	237	16 account, the policy of accident and sickness insurance shall
238	238	17 establish cost sharing for the coverage under this section at the
239	239	18 minimum level necessary to preserve the insured's ability to claim
240	240	19 tax exempt contributions and withdrawal from the insured's health
241	241	20 savings account under 26 U.S.C. 223.
242	242	21 SECTION 3. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
243	243	22 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
244	244	23 1, 2024]: Sec. 29. (a) As used in this section, "contraceptive
245	245	24 products and services" means the following:
246	246	25 (1) All contraceptive drugs, devices, products, and procedures
247	247	26 that are approved by the federal Food and Drug
248	248	27 Administration, including over-the-counter contraceptive
249	249	28 drugs, devices, and products as prescribed by the enrollee's
250	250	29 health care provider or as otherwise authorized under state or
251	251	30 federal law.
252	252	31 (2) All emergency contraception that is approved by the
253	253	32 federal Food and Drug Administration.
254	254	33 (3) Voluntary sterilization procedures.
255	255	34 (4) Patient education and counseling concerning
256	256	35 contraception.
257	257	36 (5) Follow-up services related to the drugs, devices, products,
258	258	37 and procedures covered under this section, including:
259	259	38 (A) management of side effects;
260	260	39 (B) counseling for continued adherence; and
261	261	40 (C) device insertion and removal.
262	262	41 (b) As used in this section, "cost sharing" means payment of a
263	263	42 deductible, coinsurance, copayment, or other out-of-pocket cost
264	264	2024 IN 1420—LS 6660/DI 141 7
265	265	1 required under an individual contract or a group contract.
266	266	2 (c) As used in this chapter, "therapeutic equivalent" means a
267	267	3 drug, device, or product that is designated as therapeutically
268	268	4 equivalent by the federal Food and Drug Administration in the
269	269	5 Approved Drug Products with Therapeutic Equivalence
270	270	6 Evaluations.
271	271	7 (d) An individual contract or a group contract shall provide
272	272	8 coverage for contraceptive products and services without cost
273	273	9 sharing, subject to the following:
274	274	10 (1) If the federal Food and Drug Administration has
275	275	11 designated a therapeutic equivalent of a contraceptive
276	276	12 product or service, the individual contract or group contract
277	277	13 must include either the original contraceptive product or
278	278	14 service or a therapeutic equivalent of the contraceptive
279	279	15 product or service. If there is no therapeutic equivalent for
280	280	16 the contraceptive product or service, the individual contract
281	281	17 or group contract must include the original contraceptive
282	282	18 product or service.
283	283	19 (2) If the contraceptive product or service is deemed
284	284	20 medically inadvisable by the enrollee's health care provider,
285	285	21 the individual contract or group contract shall:
286	286	22 (A) defer to the determination and judgment of the
287	287	23 attending health care provider; and
288	288	24 (B) provide coverage for the alternate prescribed
289	289	25 contraceptive product or service.
290	290	26 (3) The coverage must provide for the single dispensing of a
291	291	27 thirteen (13) unit supply of contraceptive products and
292	292	28 services intended to last over a twelve (12) month duration,
293	293	29 which may be furnished or dispensed all at once or over the
294	294	30 course of the twelve (12) months at the discretion of the health
295	295	31 care provider regardless of whether the enrollee was entitled
296	296	32 to coverage under the individual contract or group contract
297	297	33 at the time of the first dispensing. The individual contract or
298	298	34 a group contract shall reimburse a health care provider or
299	299	35 dispensing entity per unit for furnishing or dispensing an
300	300	36 extended supply of contraceptive products and services.
301	301	37 (4) Except as otherwise provided in this subsection, the
302	302	38 individual contract or group contract may not impose any
303	303	39 restrictions or delays on the coverage required under this
304	304	40 subsection.
305	305	41 (5) Nothing in this subsection shall be construed to exclude
306	306	42 coverage for contraceptive products and services as
307	307	2024 IN 1420—LS 6660/DI 141 8
308	308	1 prescribed by a health care provider acting within the health
309	309	2 care provider's scope of practice for:
310	310	3 (A) reasons other than contraceptive purposes, such as
311	311	4 decreasing the risk of ovarian cancer or eliminating
312	312	5 symptoms of menopause; or
313	313	6 (B) contraception that is necessary to preserve the life or
314	314	7 health of an enrollee.
315	315	8 (e) An individual contract or a group contract shall provide
316	316	9 coverage without cost sharing for the following:
317	317	10 (1) Counseling for sexually transmitted infections, including
318	318	11 human immunodeficiency virus and acquired immune
319	319	12 deficiency syndrome.
320	320	13 (2) Screening for:
321	321	14 (A) chlamydia;
322	322	15 (B) gonorrhea;
323	323	16 (C) hepatitis B;
324	324	17 (D) hepatitis C;
325	325	18 (E) human immunodeficiency virus;
326	326	19 (F) acquired immune deficiency syndrome;
327	327	20 (G) human papillomavirus; and
328	328	21 (H) syphilis.
329	329	22 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
330	330	23 human papillomavirus vaccination.
331	331	24 SECTION 4. [EFFECTIVE JULY 1, 2024] (a) IC 5-10-8-27, as
332	332	25 added by this act, applies to a state employee health plan that is
333	333	26 established, entered into, amended, or renewed after June 30, 2024.
334	334	27 (b) IC 27-8-40, as added by this act, applies to a policy of
335	335	28 accident and sickness insurance that is issued, delivered, amended,
336	336	29 or renewed after June 30, 2024.
337	337	30 (c) IC 27-13-7-29, as added by this act, applies to an individual
338	338	31 contract and a group contract that is entered into, delivered,
339	339	32 amended, or renewed after June 30, 2024.
340	340	33 (d) This SECTION expires July 1, 2025.
341	341	2024 IN 1420—LS 6660/DI 141