Indiana 2025 2025 Regular Session

Indiana House Bill HB1298 Introduced / Bill

Filed 01/09/2025

                     
Introduced Version
HOUSE BILL No. 1298
_____
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, 2025.
Errington
January 13, 2025, read first time and referred to Committee on Insurance.
2025	IN 1298—LS 6283/DI 154 Introduced
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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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 2024 Regular Session of the General Assembly.
HOUSE BILL No. 1298
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, 2025]: Sec. 27. (a) This section applies to a state employee health
4 plan that is established, entered into, amended, or renewed after
5 June 30, 2025.
6 (b) As used in this section, "contraceptive products and
7 services" means the following:
8 (1) All contraceptive drugs, devices, products, and procedures
9 that are approved by the federal Food and Drug
10 Administration, including over-the-counter contraceptive
11 drugs, devices, and products as prescribed by the covered
12 individual's health care provider or as otherwise authorized
13 under state or federal law.
14 (2) All emergency contraception that is approved by the
15 federal Food and Drug Administration.
16 (3) Voluntary sterilization procedures.
17 (4) Patient education and counseling concerning
2025	IN 1298—LS 6283/DI 154 2
1 contraception.
2 (5) Follow-up services related to the drugs, devices, products,
3 and procedures covered under this section, including:
4 (A) management of side effects;
5 (B) counseling for continued adherence; and
6 (C) device insertion and removal.
7 (c) As used in this section, "cost sharing" means payment of a
8 deductible, coinsurance, copayment, or other out-of-pocket cost
9 required under a state employee health plan.
10 (d) As used in this section, "covered individual" means an
11 individual entitled to coverage under a state employee health plan.
12 (e) As used in this section, "state employee health plan" means
13 the following:
14 (1) A self-insurance program established under section 7(b) of
15 this chapter.
16 (2) A contract for prepaid health care services entered into
17 under section 7(c) of this chapter.
18 (f) As used in this section, "therapeutic equivalent" means a
19 drug, device, or product that is designated as therapeutically
20 equivalent by the federal Food and Drug Administration in the
21 Approved Drug Products with Therapeutic Equivalence
22 Evaluations.
23 (g) Except as provided in subsection (i), a state employee health
24 plan shall provide coverage for contraceptive products and
25 services without cost sharing, subject to the following:
26 (1) If the federal Food and Drug Administration has
27 designated a therapeutic equivalent of a contraceptive
28 product or service, the state employee health plan must
29 include either the original contraceptive product or service or
30 a therapeutic equivalent of the contraceptive product or
31 service. If there is no therapeutic equivalent for the
32 contraceptive product or service, the state employee health
33 plan must include the original contraceptive product or
34 service.
35 (2) If the contraceptive product or service is deemed
36 medically inadvisable by the covered individual's health care
37 provider, the state employee health plan shall:
38 (A) defer to the determination and judgment of the
39 attending health care provider; and
40 (B) provide coverage for the alternate prescribed
41 contraceptive product or service.
42 (3) The coverage must provide for the single dispensing of a
2025	IN 1298—LS 6283/DI 154 3
1 thirteen (13) unit supply of contraceptive products and
2 services intended to last over a twelve (12) month duration,
3 which may be furnished or dispensed all at once or over the
4 course of the twelve (12) months at the discretion of the health
5 care provider regardless of whether the covered individual
6 was entitled to coverage under the state employee health plan
7 at the time of the first dispensing. The state employee health
8 plan shall reimburse a health care provider or dispensing
9 entity per unit for furnishing or dispensing an extended
10 supply of contraceptive products and services.
11 (4) Except as otherwise provided in this subsection, the state
12 employee health plan may not impose any restrictions or
13 delays on the coverage required under this subsection.
14 (5) Nothing in this subsection shall be construed to exclude
15 coverage for contraceptive products and services as
16 prescribed by a health care provider acting within the health
17 care provider's scope of practice for:
18 (A) reasons other than contraceptive purposes, such as
19 decreasing the risk of ovarian cancer or eliminating
20 symptoms of menopause; or
21 (B) contraception that is necessary to preserve the life or
22 health of a covered individual.
23 (h) Except as provided in subsection (i), a state employee health
24 plan shall provide coverage without cost sharing for the following:
25 (1) Counseling for sexually transmitted infections, including
26 human immunodeficiency virus and acquired immune
27 deficiency syndrome.
28 (2) Screening for:
29 (A) chlamydia;
30 (B) gonorrhea;
31 (C) hepatitis B;
32 (D) hepatitis C;
33 (E) human immunodeficiency virus;
34 (F) acquired immune deficiency syndrome;
35 (G) human papillomavirus; and
36 (H) syphilis.
37 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
38 human papillomavirus vaccination.
39 (i) If a state employee health plan is offered as a qualifying high
40 deductible health plan for a health savings account, the state
41 employee health plan shall establish cost sharing for the coverage
42 under this section at the minimum level necessary to preserve the
2025	IN 1298—LS 6283/DI 154 4
1 covered individual's ability to claim tax exempt contributions and
2 withdrawal from the covered individual's health savings account
3 under 26 U.S.C. 223.
4 SECTION 2. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
5 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
6 1, 2025]:
7 Chapter 40. Coverage for Contraceptive Products and Services
8 Sec. 1. This chapter applies to a policy of accident and sickness
9 insurance that is issued, delivered, amended, or renewed after June
10 30, 2025.
11 Sec. 2. As used in this chapter, "contraceptive products and
12 services" means the following:
13 (1) All contraceptive drugs, devices, products, and procedures
14 that are approved by the federal Food and Drug
15 Administration, including over-the-counter contraceptive
16 drugs, devices, and products as prescribed by the insured's
17 health care provider or as otherwise authorized under state or
18 federal law.
19 (2) All emergency contraception that is approved by the
20 federal Food and Drug Administration.
21 (3) Voluntary sterilization procedures.
22 (4) Patient education and counseling concerning
23 contraception.
24 (5) Follow-up services related to the drugs, devices, products,
25 and procedures covered under this chapter, including:
26 (A) management of side effects;
27 (B) counseling for continued adherence; and
28 (C) device insertion and removal.
29 Sec. 3. As used in this chapter, "cost sharing" means payment
30 of a deductible, coinsurance, copayment, or other out-of-pocket
31 cost required under a policy of accident and sickness insurance.
32 Sec. 4. As used in this chapter, "insured" means an individual
33 entitled to coverage under a policy of accident and sickness
34 insurance.
35 Sec. 5. As used in this chapter, "policy of accident and sickness
36 insurance" has the meaning set forth in IC 27-8-5-1.
37 Sec. 6. As used in this chapter, "therapeutic equivalent" means
38 a drug, device, or product that is designated as therapeutically
39 equivalent by the federal Food and Drug Administration in the
40 Approved Drug Products with Therapeutic Equivalence
41 Evaluations.
42 Sec. 7. Except as provided in section 9 of this chapter, a policy
2025	IN 1298—LS 6283/DI 154 5
1 of accident and sickness insurance shall provide coverage for
2 contraceptive products and services without cost sharing, subject
3 to the following:
4 (1) If the federal Food and Drug Administration has
5 designated a therapeutic equivalent of a contraceptive
6 product or service, the policy of accident and sickness
7 insurance must include either the original contraceptive
8 product or service or a therapeutic equivalent of the
9 contraceptive product or service. If there is no therapeutic
10 equivalent for the contraceptive product or service, the policy
11 of accident and sickness insurance must include the original
12 contraceptive product or service.
13 (2) If the contraceptive product or service is deemed
14 medically inadvisable by the insured's health care provider,
15 the policy of accident and sickness insurance shall:
16 (A) defer to the determination and judgment of the
17 attending health care provider; and
18 (B) provide coverage for the alternate prescribed
19 contraceptive product or service.
20 (3) The coverage must provide for the single dispensing of a
21 thirteen (13) unit supply of contraceptive products and
22 services intended to last over a twelve (12) month duration,
23 which may be furnished or dispensed all at once or over the
24 course of the twelve (12) months at the discretion of the health
25 care provider regardless of whether the insured was entitled
26 to coverage under the policy of accident and sickness
27 insurance at the time of the first dispensing. The policy of
28 accident and sickness insurance shall reimburse a health care
29 provider or dispensing entity per unit for furnishing or
30 dispensing an extended supply of contraceptive products and
31 services.
32 (4) Except as otherwise provided in this section, the policy of
33 accident and sickness insurance may not impose any
34 restrictions or delays on the coverage required under this
35 section.
36 (5) Nothing in this section shall be construed to exclude
37 coverage for contraceptive products and services as
38 prescribed by a health care provider acting within the health
39 care provider's scope of practice for:
40 (A) reasons other than contraceptive purposes, such as
41 decreasing the risk of ovarian cancer or eliminating
42 symptoms of menopause; or
2025	IN 1298—LS 6283/DI 154 6
1 (B) contraception that is necessary to preserve the life or
2 health of an insured.
3 Sec. 8. Except as provided in section 9 of this chapter, a policy
4 of accident and sickness insurance shall provide coverage without
5 cost sharing for the following:
6 (1) Counseling for sexually transmitted infections, including
7 human immunodeficiency virus and acquired immune
8 deficiency syndrome.
9 (2) Screening for:
10 (A) chlamydia;
11 (B) gonorrhea;
12 (C) hepatitis B;
13 (D) hepatitis C;
14 (E) human immunodeficiency virus;
15 (F) acquired immune deficiency syndrome;
16 (G) human papillomavirus; and
17 (H) syphilis.
18 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
19 human papillomavirus vaccination.
20 Sec. 9. If a policy of accident and sickness insurance is offered
21 as a qualifying high deductible health plan for a health savings
22 account, the policy of accident and sickness insurance shall
23 establish cost sharing for the coverage under this chapter at the
24 minimum level necessary to preserve the insured's ability to claim
25 tax exempt contributions and withdrawal from the insured's health
26 savings account under 26 U.S.C. 223.
27 SECTION 3. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
28 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
29 1, 2025]: Sec. 29. (a) This section applies to an individual contract
30 and a group contract that is entered into, delivered, amended, or
31 renewed after June 30, 2025.
32 (b) As used in this section, "contraceptive products and
33 services" means the following:
34 (1) All contraceptive drugs, devices, products, and procedures
35 that are approved by the federal Food and Drug
36 Administration, including over-the-counter contraceptive
37 drugs, devices, and products as prescribed by the enrollee's
38 health care provider or as otherwise authorized under state or
39 federal law.
40 (2) All emergency contraception that is approved by the
41 federal Food and Drug Administration.
42 (3) Voluntary sterilization procedures.
2025	IN 1298—LS 6283/DI 154 7
1 (4) Patient education and counseling concerning
2 contraception.
3 (5) Follow-up services related to the drugs, devices, products,
4 and procedures covered under this section, including:
5 (A) management of side effects;
6 (B) counseling for continued adherence; and
7 (C) device insertion and removal.
8 (c) As used in this section, "cost sharing" means payment of a
9 deductible, coinsurance, copayment, or other out-of-pocket cost
10 required under an individual contract or a group contract.
11 (d) As used in this chapter, "therapeutic equivalent" means a
12 drug, device, or product that is designated as therapeutically
13 equivalent by the federal Food and Drug Administration in the
14 Approved Drug Products with Therapeutic Equivalence
15 Evaluations.
16 (e) An individual contract or a group contract shall provide
17 coverage for contraceptive products and services without cost
18 sharing, subject to the following:
19 (1) If the federal Food and Drug Administration has
20 designated a therapeutic equivalent of a contraceptive
21 product or service, the individual contract or group contract
22 must include either the original contraceptive product or
23 service or a therapeutic equivalent of the contraceptive
24 product or service. If there is no therapeutic equivalent for
25 the contraceptive product or service, the individual contract
26 or group contract must include the original contraceptive
27 product or service.
28 (2) If the contraceptive product or service is deemed
29 medically inadvisable by the enrollee's health care provider,
30 the individual contract or group contract shall:
31 (A) defer to the determination and judgment of the
32 attending health care provider; and
33 (B) provide coverage for the alternate prescribed
34 contraceptive product or service.
35 (3) The coverage must provide for the single dispensing of a
36 thirteen (13) unit supply of contraceptive products and
37 services intended to last over a twelve (12) month duration,
38 which may be furnished or dispensed all at once or over the
39 course of the twelve (12) months at the discretion of the health
40 care provider regardless of whether the enrollee was entitled
41 to coverage under the individual contract or group contract
42 at the time of the first dispensing. The individual contract or
2025	IN 1298—LS 6283/DI 154 8
1 a group contract shall reimburse a health care provider or
2 dispensing entity per unit for furnishing or dispensing an
3 extended supply of contraceptive products and services.
4 (4) Except as otherwise provided in this subsection, the
5 individual contract or group contract may not impose any
6 restrictions or delays on the coverage required under this
7 subsection.
8 (5) Nothing in this subsection shall be construed to exclude
9 coverage for contraceptive products and services as
10 prescribed by a health care provider acting within the health
11 care provider's scope of practice for:
12 (A) reasons other than contraceptive purposes, such as
13 decreasing the risk of ovarian cancer or eliminating
14 symptoms of menopause; or
15 (B) contraception that is necessary to preserve the life or
16 health of an enrollee.
17 (f) An individual contract or a group contract shall provide
18 coverage without cost sharing for the following:
19 (1) Counseling for sexually transmitted infections, including
20 human immunodeficiency virus and acquired immune
21 deficiency syndrome.
22 (2) Screening for:
23 (A) chlamydia;
24 (B) gonorrhea;
25 (C) hepatitis B;
26 (D) hepatitis C;
27 (E) human immunodeficiency virus;
28 (F) acquired immune deficiency syndrome;
29 (G) human papillomavirus; and
30 (H) syphilis.
31 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
32 human papillomavirus vaccination.
2025	IN 1298—LS 6283/DI 154